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Mayo Clinic researchers have demonstrated that a noninvasive screening test can detect not only colorectal cancer but also the common cancers above the colon — including pancreas, stomach, biliary and esophageal cancers. This is one of more than 100 Mayo Clinic studies being presented at Digestive Disease Week 2009 in Chicago, May 30June 4.
Patients are often worried about invasive tests like colonoscopies, and yet these tests have been the key to early cancer detection and prevention, says David Ahlquist, M.D., Mayo Clinic gastroenterologist and lead researcher on the study. Our research team continues to look for more patient-friendly tests with expanded value, and this new study reveals an opportunity for multi-organ digestive cancer screening with a single noninvasive test.
The researchers studied 70 patients with cancers throughout the digestive tract. Besides colon cancer, the study looked at throat, esophagus, stomach, pancreatic, bile duct, gallbladder and small bowel cancers to determine if gene mutations could be detected in stool samples. Using a stool test approach developed at Mayo Clinic, researchers targeted DNA from cells that are shed continuously from the surface of these cancers. Also studied were 70 healthy patients. Stool tests were performed on cancer patients and healthy controls by technicians unaware of sample source. The stool DNA test was positive in over 70 percent of digestive cancers, but remained negative for all healthy controls, thus demonstrating the approachs feasibility.
Stool DNA testing detected cancers at each organ site, including 65 percent of esophageal cancers, 62 percent of pancreatic cancers, and 75 percent of bile duct and gallbladder cancers. In this series, 100 percent of both stomach and colorectal cancers were detected. Importantly, stool test results did not differ by cancer stage; early-stage cancers were just as likely to be detected as late-stage cancers.
One in five Americans experiences heartburn at least once a week, and many dismiss the malady as a mere annoyance, choosing to swallow antacids and get on with their lives.
But what they don’t know can hurt them. Left untreated, the condition can lead to Barrett’s esophagus, which in turn can put patients at risk for esophageal cancer, one of the most deadly forms of cancer.
The reason Barrett’s esophagus matters is that patients with at least 3 centimeters of Barrett’s esophagus lining have a 30- to 125-fold increased risk of esophageal cancer compared to the general population. Although the cancer risk figures initially sound frightening, only 3 to 10 percent of persons with Barrett’s esophagus will develop cancer in their lifetime.
At this weeks national scientific meeting Digestive Diseases Week, Mayo Clinic researchers are presenting new research on the use of fluorescence in situ hybridization (FISH) tests to determine which patients with heartburn might have something more serious.
Right now, our best indicator of the seriousness of Barrett’s esophagus is the degree of dysplasia, or precancerous changes, found on a biopsy, says Kenneth Wang, M.D., gastroenterologist at Mayo Clinic. However, physicians have to biopsy multiple areas of the esophagus and they still may not detect the pre-cancerous cells. Fluorescence in situ hybridization (FISH) could allow for us to change the way doctors diagnose Barretts esophagus.
While traditional cytology analysis relies on identifying abnormally shaped cells, the FISH test detects malignant cells using colored DNA probes for specific abnormal genes visible with a fluorescence microscope. Since cancer cells have an abnormal amount of DNA, by FISH these cells show more of the probes compared to normal cells. The advantage of these techniques is that they can easily applied by any endoscopist and the diagnosis can be made on a single abnormal cell.
Michael Picco, M.D., gastroenterologist at Mayo Clinic, shares information about Crohn’s disease, a commonly misunderstood disorder that can be debilitating to patients and impact their quality of life. Each year, Mayo Clinic physicians treat more than 2,000 people with Crohn’s disease. Crohn’s disease is one of several Inflammatory Bowel Diseases that physicians and researchers at Mayo Clinic are addressing – through medical management and surgery; clinical trials and other therapies. For more information, visit www.mayoclinic.org/crohns
Pectus excavatum (PE) is the most common deformity of the chest wall, a condition in which the chest appears abnormally sunken. More than just a cosmetic issue, PE, left untreated, can worsen with age and cause breathing and heart problems. Mayo Clinic in Arizona is collaborating with Phoenix Children’s Hospital to treat pectus in both adults and children. Dr. Dawn Jaroszewski, Mayo Clinic cardiothoracic surgeon, explains about surgical treatment of PE. Also, we see how a young Phoenix patient, age 17, underwent surgery at Phoenix Children’s Hospital for her pectus excavatum.
