Esophageal Cancer Research

Cancer arises slowly over time as cells go through a progression of genetic rearrangements that transform normal tissue to malignancy. While studying this evolution in the laboratory is useful, ultimately, understanding how these changes occur in the human body holds the key to halting the disease before it begins. The American Cancer Society estimates that during 2007 approximately 16,000 new esophageal cancer cases will be diagnosed in the United States and 14,000 deaths from esophageal cancer will occur. Because esophageal cancer is usually diagnosed at a late stage, most people with esophageal cancer eventually die of this disease.

Esophageal cancer research at Mayo Clinic takes a multidisciplinary approach that includes a laboratory team that is investigating the genetic and cell-cycle abnormalities that lead to cancer, epidemiologists who are investigating environmental risk factors that may cause esophageal cancer, and clinicians conducting clinical trials.

Researchers are also investigating Barrett's esophagus, a pre-cursor to esophageal cancer. Our scientists are also looking for ways to prevent the occurrence of esophageal cancer by identifying behavior and environmental exposures that correlate with the development of esophageal cancer. Efforts in this area are led by a number of researchers including Yvonne Romero, M.D.; Navtej Buttar, M.D.; Kenneth Wang, M.D.; and Louis Wong Kee Song, M.D.

Some other areas of research focus include:

Genetics
Many of the changes in certain genes appear to be responsible for causing normal cells of the esophagus to develop into esophageal cancer. Additional progress could lead to new tests for finding esophageal cancer at an earlier, more curable stage. Understanding these changes will eventually lead to new gene therapies that repair the abnormal DNA changes in esophageal cancer cells. Dr. Romero and others have active projects in this area.

Neo-adjuvant Therapy
Researchers are testing new ways to combine drugs already known to be active against esophageal cancer that may improve their effectiveness, and testing optimal combinations of chemotherapy and radiation therapy. Current research efforts include those led by Aminah Jatoi, M.D., and Michael Haddock, M.D.

Screening and prevention
Mayo investigators continue to look for ways to prevent esophageal cancer. They have a number of clinical trials open including one that is evaluating the impact of different doses of aspirin on Barrett's cell growth; and another that involves screening individuals with a first degree relative with long segment Barrett's esophagus or esophageal adenocarcinoma — the type of cancer that is due to reflux, to determine if they have Barrett’s esophagus.

Continuing that line of investigation, in people with Barrett’s esophagus, researchers are investigating ways to determine which patients will go on to develop cancer. One such research project, led by Virender Sharma, M.D., is looking at ways to more effectively use a pill-cam (pill-sized camera that a patient swallows and transmits images for diagnosis). Dr. Wang is leading another project evaluating the effectiveness of using photodynamic therapy to cure Barrett’s esophagus, thus preventing the transformation to esophageal cancer.