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Misc. News
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L.etter to E.ditor
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Nov 3, 2006, 10:45
D.iet & H.ealth
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C.ancer
Nutritionist: Drinking too much milk promotes cancer growth After 27 years of animal studies, Dr. T. Collin Campbell, Emeritus professor from Cornell University, came to a shocking conclusion that drinking too much milk promotes cancer growth. The details were revealed in his book titled "China Study". Dec 8, 2006, 22:47
F.ood & H.ealth
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T.echnologies
Mushrooms Have a Future in Fighting a Fowl Parasite Wide use of a mushroom extract to protect poultry against a major parasitic disease is now closer, thanks to an Agricultural Research Service (ARS) scientist and her South Korean colleagues. Dec 8, 2006, 09:38
F.ood & H.ealth
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Agri. & Environ.
Pesticides linked to high risk of pediatric cancers Rare pediatric cancers have been found not so rare in a potato-farming community of 14,000 residents on the western tip of Canada's Prince Edward Island, Global and Mail reported Wednesday Dec. 6. Dec 7, 2006, 21:34
F.ood & H.ealth
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L.aws & P.olitics
Congress Passes Sober Truth on Preventing (STOP) Underage Drinking Act Passage of the STOP Act represents a long-overdue acknowledgement of the need to do more as a nation to address the harm caused by underage drinking. Unlike illicit drugs, for which we have a comprehensive government-wide strategy, there has been no credible national plan to combat alcohol problems, Dec 7, 2006, 19:01
D.iet & H.ealth
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C.ancer
High Protein Diets May Boost Cancer Risk Eating a low-protein diet may protect against certain cancers, while a diet high in protein may increase the risk for malignancies, a new study suggests. Dec 7, 2006, 14:36
Misc. News
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C.onsumer A.ffair
Cereal prices surge to highest levels in decade Cereal prices, particularly for wheat and maize, have reached levels not seen for a decade, according to FAO’s latest Food Outlook report. Dec 7, 2006, 14:32
D.iet & H.ealth
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B.ody W.eight
Nasal spray intended to treat obesity A Boston company named Compellis Pharmaceuticals said that it obtained an initial patent for a nasal spray that aims to treat obesity by blocking the olfactory activity in the nose, Boston.com reported Wednesday Dec. 6. Dec 7, 2006, 11:17
Misc. News
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C.onsumer A.ffair
Not to pile on Taco Bell, but how many times does lightening need to strike? In early December, 2000, Lake County Florida Health Department (LCHD) learned of seven hepatitis A cases, including five hospitalizations, in Lake and neighboring Sumter Counties in a two week span. During the previous two years, the total number of known hepatitis A cases in Lake County was twenty-two. Dec 7, 2006, 10:34
F.ood & H.ealth
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L.aws & P.olitics
FDA investigating E. colo 0157 infections linked with Taco Bell The Food and Drug Administration is assisting in the investigation of an outbreak of E. coli O157 infection in consumers associated with eating food from several Taco Bell restaurants in Northeastern states. Dec 6, 2006, 23:31
D.iet & H.ealth
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C.hildren & W.omen
Infants & Fluoride: New Warning from Dentists In a little-noticed but dramatic turnaround, the nation's leading fluoride advocate, The American Dental Association (ADA), issued an alert on November 9th urging parents to avoid fluoridated water when reconstituting infant formula. Dec 6, 2006, 15:46
Misc. News
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C.onsumer A.ffair
Taco Bell Removes Green Onions From Its Restaurants (HealthDay News) -- Preliminary tests have linked the E. coli outbreak at Taco Bell restaurants in three northeastern states to samples of green onions possibly contaminated with a harsh strain of the bacteria. Dec 6, 2006, 13:04
D.iet & H.ealth
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C.ancer
Eating greens may cut skin cancer risk Skin cancer survivors may halve their chance of relapse by eating lots of leafy green vegetables, a new Australian study suggests. Dec 6, 2006, 11:50
Misc. News
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C.onsumer A.ffair
Schools Getting Raw Deal from Bottlers Most school beverage deals aren't very lucrative, raising an average of only $18 per student per year, according to the first-ever multi-state analysis of school systems' contracts with beverage companies. Dec 6, 2006, 11:11
F.ood & H.ealth
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L.aws & P.olitics
Raw milk advocate says government made a big mistake Michael Schmidt, living off nothing but raw milk and water for almost two weeks, was cited as saying the provincial government is messing with the wrong man, adding, "They made a big mistake. They should have known that I'm very determined, and that the public is too well educated to buy all their crap. Dec 6, 2006, 11:07
F.ood & H.ealth
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L.aws & P.olitics
Give consumers choice in milk If consumers want raw milk so badly, then government should, according to this editorial, relax the rules and make it available. Dec 6, 2006, 11:00
Misc. News
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Non-f.ood Things
Minnesota Tops State Health Rankings For the fourth straight year, Minnesota has taken first place in state health rankings in the annual United Health Foundation report, which also found Americans 0.3 percent healthier in 2006 than they were last year. Dec 5, 2006, 16:47
F.ood & H.ealth
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L.aws & P.olitics
FSIS to Hold a Public Meeting to Help Define 'Natural' Label The U.S. Department of Agriculture's (USDA) Food Safety and Inspection Service (FSIS) today announced a public meeting to discuss a petition to establish a definition for the voluntary claim "natural" and to gather comments on conditions under which the claim should be allowed to be used on the labels of meat and poultry products. Dec 5, 2006, 16:38
Misc. News
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R.ecalls & A.lerts
Cleugh's Frozen Foods Inc. Recalls Frozen Strawberries Sold to Jamba Juice Cleugh's Frozen Foods Inc., Salinas, CA, a wholly-owned subsidiary of SunOpta Inc. (NASDAQ-STKL) (TSX-SOY), today announced a voluntary recall of frozen strawberries sold exclusively to Jamba Juice for use in strawberry smoothies Dec 5, 2006, 16:21
Misc. News
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R.ecalls & A.lerts
Jamba Juice Issues Alert Regarding Strawberry Smoothies Jamba Juice of San Francisco, CA in consultation with the FDA is notifying the public that smoothies containing strawberries which were sold at its Jamba Juice stores in Arizona, Southern Nevada and Southern California between November 25 - December 1, 2006, may have been contaminated with Listeria monocytogenes. Dec 5, 2006, 16:20
D.iet & H.ealth
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G.eneral H.ealth
Anorexia nervosa: what you need to know
A person with anorexia (a-neh-RECK-see-ah) nervosa, often called anorexia, has an intense fear of gaining weight. Someone with anorexia thinks about food a lot and limits the food she or he eats, even though she or he is too thin. Dec 5, 2006, 16:14
D.iet & H.ealth
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G.eneral H.ealth
Bulimia: What you need to know Bulimia (buh-LEE-me-ah) nervosa, often called bulimia, is a type of eating disorder. A person with bulimia eats a lot of food in a short amount of time (binges) and then tries to prevent weight gain by getting rid of the food, called purging. Dec 5, 2006, 16:09
F.ood & H.ealth
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L.aws & P.olitics
NYC Trans Fat, Calorie Labeling Initiatives Approved Congratulations to the New York City Board of Health, Health Commissioner Tom Frieden and Mayor Michael Bloomberg for adopting these bold new measures to promote the public’s health. When New York City's major chain restaurants comply with these sensible new regulations, I hope they make the changes nationwide. Dec 5, 2006, 13:17
Former Texas Governor Ann Richards, 72, said Tuesday she feels "terrific" after receiving treatment for her esophageal cancer and expects a full recovery from the disease, Associated press reported.
Richards was diagnosed with cancer of the esophagus in March.
Richards has not yet finished her cancer treatment. Doctors will determine whether she needs more treatments after three more sessions.
Richards served as governor from 1991 to 1995 and lost her re-election bid to George W. Bush.
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The following are the basics about cancer of the esophagus cited in verbatim from wikipedia.org.
Esophageal cancer
Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and is diagnosed with biopsy. Small and localized tumors are treated with surgery, and advanced tumors are treated with chemotherapy, radiotherapy or combinations. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.
Signs and symptoms
Dysphagia (difficulty swallowing) is the first symptom in most patients. Odynophagia (painful swallowing) may be present. Fluids and soft foods are usually tolerated, while hard or bulky substances (such as bread or meat) cause much more difficulty. Substantial weight loss is characteristic as a result of poor nutrition and the active cancer. Pain, often of a burning nature, may be severe and worsened by swallowing, and can be spasmodic in character.
The presence of the tumor may disrupt normal peristalsis (the organised swallowing reflex), leading to nausea and vomiting, regurgitation of food, coughing and an increased risk of aspiration pneumonia. The tumor surface may be fragile and bleed, causing hematemesis (vomiting up blood). Compression of local structures occurs in advanced disease, leading to such problems as superior vena cava syndrome. Fistulas may develop between the esophagus and the trachea, increasing the pneumonia risk; this symptom is usually heralded by cough, fever or aspiration (Enzinger & Mayer 2003).
If the disease has spread to elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.
Cause and risk factors
Increased risk
There are a number of risk factors for esophageal cancer. Some subtypes of cancer are linked to particular risk factors:
1, Age. Most patients are over 60, and the median in US patients is 67 (Enzinger & Mayer 2003).
2, Sex. It is more common in men.
3, Tobacco smoking and heavy alcohol use increase the risk, and together appear to increase the risk more than these two individually.
4, Swallowing lye or other caustic substances.
Particular dietary substances, such as nitrosamine.
5, A medical history of other head and neck cancers increases the chance of developing a second cancer in the head and neck area, including esophageal cancer.
6, Plummer-Vinson syndrome (anemia and esophageal webbing)
Tylosis and Howel-Evans syndrome (hereditary thickening of the skin of the palms and soles).
7, Radiation therapy for other conditions in the mediastinum (Enzinger & Mayer 2003).
8, Gastroesophageal reflux disease (GERD) and its resultant Barrett's esophagus increase esophageal cancer risk due to the chronic irritation of the mucosal lining (adenocarcinoma is more common in this condition), while all other risk factors predispose more for squamous cell carcinoma.
9, Celiac disease and primary biliary cirrhosis predispose toward squamous cell carcinomas
Decreased risk
Risk appears to be less in patients using aspirin or related drugs (NSAIDs). Statistically, it appears that Helicobacter pylori, known for increasing risk for gastric cancer, actually decreases the risk of esophageal cancer (O'Connor 1999); the exact mechanism for this phenomenon is unclear.
Diagnosis
Although an occlusive tumor may be suspected on a barium swallow or barium meal, the diagnosis is best made with esophagogastroduodenoscopy (EGD, endoscopy); this involves the passing of a flexible tube down the esophagus and visualising the wall. Biopsies taken of suspicious lesions are then examined histologically for signs of malignancy.
Most tumors of the esophagus are malignant. A very small proportion (under 10%) is leiomyoma (smooth muscle tumor) or gastrointestinal stromal tumor (GIST). Malignant tumors are generally adenocarcinomas, squamous cell carcinomas, and occasionally small-cell carcinomas. The latter share many properties with small-cell lung cancer, and are relatively sensitive to chemotherapy compared to the other types.
The location of the tumor is generally measured by the distance from the teeth. The esophagus (25 cm or 10 inches long) is commonly divided into three parts for purposes of determining the location. Adenocarcinomas tend to occur distally and squamous cell carcinomas proximally, but the converse may also be the case.
Treatment
General approaches
The treatment is determined by the cellular type of cancer (adenocarcinoma or squamous cell carcinoma vs. other types), the stage of the disease, the general condition of the patient and other diseases present. On the whole, adequate nutrition needs to be assured, and adequate dental care is vital.
If the patient cannot swallow at all, a stent may be inserted to keep the esophagus patent; stents may also assist in occluding fistulas. A nasogastric tube may be necessary to continue feeding while treatment for the tumor is given, and some patients require a gastrostomy (feeding hole in the skin that gives direct access to the stomach). The latter two are especially important if the patient tends to aspirate food or saliva into the airways, predisposing for aspiration pneumonia.
Tumor treatments
Surgery is possible if the disease is localised, which is the case in 20-30% of all patients. If the tumor is larger but localised, chemotherapy and/or radiotherapy may occasionally shrink the tumor to the extent that it becomes "operable"; however, this combination of treatments (referred to as neoadjuvant chemoradiation) is still somewhat controversial in most medical circles. Esophagectomy is the removal of a segment of the esophagus; as this shortens the distance between the throat and the stomach, some other segment of the digestive tract (typically the stomach or part of the colon) is placed in the chest cavity and interposed. If the tumor is metastatic, surgical resection is not considered worthwile, but palliative surgery may offer some benefit.
Laser therapy is the use of high-intensity light to destroy tumor cells; it affects only the treated area. This is typically done if the cancer cannot be removed by surgery. The relief of a blockage can help to reduce dysphagia and pain. Photodynamic therapy (PDT), a type of laser therapy, involves the use of drugs that are absorbed by cancer cells; when exposed to a special light, the drugs become active and destroy the cancer cells.
Chemotherapy depends on the tumor type, but tends to be cisplatin-based (or carboplatin or oxaliplatin) every three weeks with fluorouracil (5-FU) either continuously or every three weeks. In more recent studies, addition of epirubicin (ECF) was better than other comparable regimens in advanced nonresectable cancer (Ross et al 2002). Chemotherapy may be given after surgery (adjuvant, i.e. to reduce risk of recurrence), before surgery (neoadjuvant) or if surgery is not possible; in this case, cisplatin and 5-FU are used. Ongoing trials compare various combinations of chemotherapy; the phase II/III REAL-2 trial - for example - compares four regimens containing epirubicin and either cisplatin or oxaliplatin and either continuously infused fluorouracil or capecitabine.
Radiotherapy is given before, during or after chemotherapy or surgery, and sometimes on its own to control symptoms. In patients with localised disease but contraindications to surgery, "radical radiotherapy" may be used with curative intent.
Follow-up and prognosis
Patients are followed up frequently after a treatment regimen has been completed. Frequently, other treatments are necessary to improve symptoms and maximize nutrition.
Prognosis of esophageal cancer is fairly poor. Even in patients who undergo surgery with curative intent, the five year survival rate is only 25%, and prognosis is poorer in those who are not fit for surgery. Early emphasis on symptom control and palliative care may improve the quality of life.
Epidemiology
Esophageal cancer is a relatively rare form of cancer, but some world areas have a markedly higher incidence than others: China, India and Japan, as well as the United Kingdom, appear to have a higher incidence, as well as the region around the Caspian Sea (Stewart & Kleihues 2003).
Annual incidence is between 3-11 per 100,000 for males and 0.6-6 per 100,000 for females (Stewart & Kleihues 2003).
