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Published: Friday, 7/28/2006

Heartburn linked to surge of tumors in digestive tract

BY JENNI LAIDMAN
BLADE SCIENCE WRITER

Gastric-reflux disease - heartburn - is behind a dramatic increase in the number of gastroesophageal tumors diagnosed in the United States, experts say.

Owens-Illinois Inc. announced yesterday that Steve McCracken, its chairman and chief executive officer, will have surgery at the Cleveland Clinic the week of Aug. 7 to remove a small malignant tumor that formed where the esophagus enters the stomach.

The company reported the cancer was discovered at its earliest stages.

A report last year in the journal CA: A Cancer Journal for Clinicians, announced a 600 percent increase in tumors of this type in recent decades.

Reflux occurs when the sphincter that separates the stomach from the esophagus relaxes, allowing digestive acids from the stomach to splash into the esophagus, leading to heartburn, said Dr. Frederick Cason, an associate professor of surgery at the University of Toledo College of Medicine.

Over the long haul, the acids can prompt a change in the esophageal lining. The cells lining the esophagus are replaced with stomach lining cells, possibly the body's way of protecting the esophagus from the corrosive acids, Dr. Cason said.

The American Cancer Society reports that 5 percent of acid reflux sufferers will develop this condition, which increases the risk of cancer 30 to 100-fold.

Because of that, doctors recommend such patients have regular examinations in which an endoscope - a flexible, lighted tube - is put down the patient's throat and into the stomach to look for changes.

If cancerous changes are discovered, patients may undergo surgery alone, or receive some combination of chemotherapy, radiation therapy, and surgery.

The surgery is a two-step process, beginning with an opening of the abdomen to remove all lymph nodes draining the stomach. The surgeon also must open the passage between the stomach and the intestine because nerves that control the opening will be severed during surgery and not grow back.

In addition, the stomach is split so that it can be lifted higher in the chest.

Dr. Cason uses a surgical technique in which instruments are inserted into small incisions into the abdominal cavity. But more often, the surgery requires a large incision through skin and muscle, which increases recovery time.

In the second phase of the operation, surgeons then open the right chest, remove all the lymph nodes around the esophagus and remove half to two-thirds of the esophagus. The stomach is then pulled up to the remaining esophagus, which is sewn in.

The patient remains on a feeding tube for seven to 10 days, and recovery can last about eight weeks.

Contact Jenni Laidman at:

jenni@theblade.com

or 419-724-6507.



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