Esophageal cancer, which claimed the life of former Gov. Ann Richards on Sept. 13, is a rare but insidious killer that is difficult to detect early, said a San Antonio surgeon who treats the disease.
Scott Johnson, M.D., associate professor of surgery at The University of Texas Health Science Center at San Antonio, said esophageal cancer is the fastest rising major cancer in the United States. “We don’t understand all the factors of why this is so,” he said. The esophagus is the tube through which food passes to the stomach.
“This cancer can be related to reflux disease, so a thorough checkup by a physician and due vigilance for people with reflux problems is warranted,” Dr. Johnson said. “Esophageal cancer becomes apparent usually in the later stages of disease when it is largely incurable. Patients may not realize they have a serious problem. While I cannot comment on Governor Richards’ specific case, because I was not her physician, I will tell you that most patients present with symptoms after it is too late to cure them.”
Treatment is often multidisciplinary, he said, and includes combinations of surgery, radiation therapy and chemotherapy.
Dr. Johnson also specializes in surgical treatment of lung cancer, and he said that “in general, we see about 9-10 patients with lung cancer for every one patient with esophageal cancer.”
The National Cancer Institute estimates that 14,550 new cases of esophageal cancer will be diagnosed in 2006, and that the disease and its complications will kill 13,770 Americans.
“The key is, if you have gastroesophageal reflux disease or suspect you have it, see your physician regularly and ask him or her about the risk of developing esophageal cancer,” Dr. Johnson said.
He said new treatments, both surgical techniques and medication, are being developed that ultimately will improve the outlook for patients with esophageal cancer. Research is examining how the cancer forms, including its relationship to stomach and duodenal juice that can regularly bathe the esophagus in patients with reflux disease.