Esophageal cancer has been defying all scientific efforts to discover a treatment that can increase the rate of survival in patients for decades. The dreaded disease has claimed the lives of many eminent people like Humphrey Bogart, Christopher Hitchens, and Ann Richards the ex-governor of Texas. However, a new large-scale clinical trial has shown that a drug called nivolumab might be able to trigger the immune system to eliminate cancer cells. Experts have said that the drug might be able to increase disease-free survival in patients by twofold from 11 months to 22 months.
Dr. David Ilson, who is an esophageal cancer expert at Memorial Sloan Kettering Cancer Center in New York, has said that the drug might be a game-changer treatment for patients. Health experts have been waiting for this for a long time, said the expert. The trial has been funded by Bristol-Myers Squibb. Around 794 patients from 29 countries have been enrolled in the study. They have been randomly given infusions of the drug or a placebo during the study. These patients have been given chemotherapy and radiation followed by surgery to eliminate their cancers. Experts have said that as usually occurs the surgery has not been able to remove cancer majorly. However, pathology reports have shown that some cancer cells have been lurking in lymph nodes and other areas. As per the experts, it sets the stage for cancer to return as fatal metastases. The findings of the new trial have been released in the New England Journal of Medicine.
Health experts have said that nivolumab has been approved by the authorities for some patients with other types of cancers such as Hodgkin lymphoma, melanoma, and colorectal cancer. With the findings of the new trial, experts believe that the drug will easily get approval for the treatment of patients who are dealing with esophageal cancer. The lead author of the new study, Dr. Ronan Kelly who is the director of the Charles A. Sammons Cancer Center at Baylor University Medical Center, has said that his team has done a study on this drug to help the 75 percent of patients who deal with hard sequences of radiation, chemotherapy, and surgery that scars their digestive systems. These therapies pose a high risk of reoccurring cancer as well.
The lead author of the study has said that without some other effective form of treatment, many patients might end up dealing with reoccurring cancers more quickly. He has said that patients are not able to tolerate extra sessions of chemotherapy. These sessions are not a big help for such patients, said the expert. Dr. Kelly has said that although nivolumab is linked to certain side effects, it will be worth a try. Health experts have said that there is a rare prevalence of esophageal cancer in the US. The dreaded disease contributes to 1 percent of all cancers in the US. Around 15000 people lose their lives due to the disease every year. However, it is the seventh most deadly cancer across the world. It is quite prevalent in East Asia but the reason behind it is unclear. Experts have said that smoking is a major risk factor for this type of cancer. However, experts believe that it is not the high rate of smoking in China that leads to high incidences of esophageal cancer. Alcohol consumption and acid reflux disease as well are other risk factors for deadly cancer.
Health experts have said that esophageal cancer has not received much attention, as this cancer is not very prevalent in the US. Although new treatments have transformed the hopes for other cancer patients, people dealing with esophageal cancer are still in dilemma. The authors of the study have said that the new findings of the large-scale trial should be taken seriously to come up with an effective treatment for patients, who are dealing with esophageal cancer. Most patients with this type of cancer are diagnosed at a time, when there is no chance of survival, said the experts. Chemotherapy includes many difficult side effects and the radiation leads to a burning sensation that creates problems in swallowing.
After chemotherapy and radiation, patients need to undergo major surgery. During the surgery, doctors are able to remove most of the patients’ esophagus, which is a tract leading from the mouth to the stomach. They grab the stomach, drag it, and join it to the remains of the esophagus. The stomach is located in the vertical position and after the surgery; it lacks the sphincter muscles that prevent stomach acid from spilling out. After the surgery, patients can never lie down flat; otherwise, the contents of the stomach will choke their throat, said the experts. Even after these treatment options for patients with esophageal cancer, the rate of recovery is quite low and morbidity and death rate are quite high. However, after weighing their options, most patients opt for surgery as refusing treatment means allowing cancer to close off the esophagus to a point where patients are not able to swallow their own saliva. Such treatments last for a long time and they are quite traumatic for patients.
Dr. Paul Heft, who is a professor of surgery at Indiana University School of Medicine, has said that patients should be informed about the pros and cons before they are given these treatments. He has said that the findings of the new trial are a landmark discovery and it might set new standards for the treatment of esophageal cancer patients.