The American Cancer Society estimates that there will be 15,560 new cases of esophageal cancer in 2007, with as many as 13,940 deaths from the disease. This is a remarkable increase compared to an estimated 12,500 new cases back in 1997. Esophageal cancer is primarily divided into two main types, squamous cell carcinoma ( SCC ) and adenocarcinoma. SCC had previously been the most common subtype, but this has changed in the United States and Western Europe over the past 2 decades. With the rise in overall incidence, doctors have seen adenocarcinomas become the more prevalent subtype. In addition, there has been a change in the anatomical location of these esophageal cancers, from the upper esophagus (which tend to be SCCs) to the lower esophagus and gastroesophageal junction. Why the change? SCC is caused by smoking and alcohol use, and remains common in Asian countries and other parts of the world. It is a disease mostly of urban centers in the United States. Adenocarcinomas, on the other hand, have been linked to Barrett's esophagus (a premalignant condition of the esophagus) and gastroesophageal reflux disease (GERD), both of which have become more common in the U.S. There may also be a link between adenocarcinomas and obesity, another problem that has become increasingly more common in the U.S.
Dr. Anil Rustgi and colleagues have developed a multidisciplinary research program at the University of Pennsylvania, combining the efforts of gastroenterologists, surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, and allied health personnel. This unique project has been funded by the National Cancer Institute and combines the resources of three successful researchers (Drs. Rustgi, Wafik El-Deiry, and Meenhard Herlyn) to provide the groundwork for collaborative research. The group's research focuses upon identifying genes that trigger the growth of esophageal cancers, understanding the tumor microenvironment, using imaging technologies, and developing innovative models that mimic esophageal cancer. Through three-dimensional (3D) cell culture models and animal models, their research is looking to develop approaches for prevention, diagnosis and treatment. While much progress has been made in the laboratory, with accompanying highly-featured publications and presentations at national meetings, Dr. Rustgi hopes to see the emergence of new clinical trials based on this basic science research in the coming years.
How can patients get involved? Patients undergoing diagnosis or treatment at the University of Pennsylvania Medical Center can allow their tumor tissue to be used for ongoing and future research studies. In some cases, patients from other institutions may be able to submit samples for use by the researchers. These efforts are in conjunction with the Department of Pathology and clinicians.
To learn more about the project, visit the NCI Program Project in Esophageal Carcinogenesis website. To learn more about clinical trials for esophageal cancer, please visit our clinical trials matching service.