Esophageal cancer

Esophageal cancer is a rare cancer form in Norway, and the incidence has been relatively stable for many years with about 140 patients per year. The average age is 70 years.

Overview

Esophageal cancer, especially the spinocellular type, occurs somewhat more frequently in men. This cancer form has changed character in the last 20 years. Previously, this cancer form mostly consisted of squamous epithelial carcinoma. Today, adenocarcinomas constitute 50% of all esophageal cancer.

There are national guidelines for diagnosing and treating esophageal cancer. This cancer type is rare and treatment is relatively complicated. There is consensus that treatment should be centralized. The etiology is, in most cases unknown, but development of esophageal cancer is often found in association with risk factors.

Spinocellular cancer is related to alcohol abuse, smoking, and caustic injuries. Adenocarcinomas are related to obesity with increasing frequency of reflux esophagitis. Intestinal metaplasia (Barrett’s esophagus, BE), which is a result of this, appears to be a precursor for development into cancer.

Treatment is dependent on the stage of the disease, the patient’s general health status, and any possible additional conditions. In terms of treatment, there is no difference between squamous epithelial carcinoma and adenocarcinoma. Only 20-25% of all patients with esophageal cancer are appropriate for radical surgery. For very small tumors and Barrett’s esophagus, photodynamic therapy (PDT) may be considered. For about 20–25% of all patients with inoperable localized tumors, curative oncological treatment (chemotherapy or radiation therapy) may be given. Adequate heart and lung function is necessary to undergo radical surgery, as well as good kidney function to complete radical oncological treatment.

Research Materials

The Barrett Esophagus project is a collaborative study with the University College in London. We have received material from 130 BE patients (N10) separated into two groups to be prepared and analyzed by IMI. Also, we have received image files from around 300 patients (N29).

Activity 2010 – 2011

• Laboratory work finished (N10 monolayers)
• DNA ploidy and nucleotyping analyses finished (N10 monolayers)
• Paper published (N10 monolayers)
• Scanning of HE-stained slides sent to UCL for Dline (N10 2D sections for nucleotyping)
• Re- cell classification of 16 cases (monolayer image files, N29)