Flinders Medical Centre Foundation
Flinders Medical Centre Foundation

Oesophageal Cancer



Obesity Key in Oesophageal Cancer

Take Note Of Oesophageal Cancer

$1.35M For Oesophageal Cancer Reserch


Obesity Key in Oesophageal Cancer
First Published: Investigator - Autumn 2010


Flinders researchers are part of a national collaborative which has proven a direct link between the significant growth in oesophageal cancer cases in Australia and rising obesity rates.


The incidence of oesophageal cancer, which has a less than 10 per cent survival rate, has increased more than 400% in Australia in the last 30 years.


Flinders researchers worked in conjunction with Queensland, New South Wales and Victorian research institutes to collect lifestyle data and healthy and cancerous tissue samples from more than 1,000 endoscopy patients in the hope of explaining the exponential increase in oesophageal cancer cases.


The results of the five-year study showed the dramatic increase in cases of oesophageal cancer was directly linked to rising obesity rates and the hormone Leptin which regulates appetite and metabolism and is expressed in greater concentrations in obese people.


Obesity can also increase the risk of Barrett’s Oesophagus, a chronic gastric reflux condition which often progresses to cancer.  The link also helps to explain why 90 per cent of oesophageal cancer incidences occur in males, which may be caused by men storing fat in the abdomen rather than distributing it evenly.


Alcohol and smoking and the human papilloma virus which is also responsible for, among others, cervical cancer, were also shown to be causes in both reflux and non-reflux related cancer.


Flinders researchers looked at microRNA changes, and specifically at how the molecules relate to cells changing from non-cancerous cells to cancerous cells in the oesophagus.


Professor David Watson, Head of Surgery in the Flinders School of Medicine, said the future of the research is in finding ways for clinicians to better diagnose patients and their suitability for surgery or chemotherapy.


“We have identified a number of changes in MicroRNA markers that might be of interest as mechanisms that may drive the cancer,” he said. “We hope to determine whether these markers can be used to identify which patients with oesophageal cancer will benefit from specific treatments such as chemotherapy and radiotherapy.”


Take Note Of Oesophageal Cancer
First Published: South Health News - September 2008


Flinders researchers are spearheading a campaign for better outcomes for an increasingly common but “underrecognised” condition, Barrett’s-derived oesophageal cancer.


Barrett’s oesophagus is a pre-cancerous condition affecting severe reflux sufferers in which normal cells lining the oesophagus are replaced with abnormal cells that, in some people, develop into a type of cancer of the oesophagus called adenocarcinoma.


Barrett’s oesophagus affects around 10 percent of severe reflux sufferers, with one to two in every hundred per year going on to develop Barrett’s-derived adenocarcinoma.


He said that this means that for every two deaths from colon cancer in Australia, there is one death from Barrett’s-derived adenocarcinoma.


‘Because there is such a high death rate associated with the cancer there’s not a strong lobby group to advocate for the disease and bring it to the public attention.’


David hopes that the research he is leading into improved outcomes for Barrett’s-derived oesophageal cancer will change that.

‘Our research has two components,’ David explained. ‘The first is a laboratory focus, where we are trying to understand new markers of disease progression and changes in cell and gene function.

‘From that, we hope to develop a panel of bio-markers that will allow us to determine which patients with reflux are likely to go on to develop Barrett’s oesophagus and adenocarcinoma.’

David said this would allow medical staff to better target and treat patients in the future.

The second component of the research, being conducted in conjunction with researchers from the Repatriation General Hospital, aims to develop a cost-effective surveillance model for the disease.

‘At the moment surveillance has not been able to be cost effective in the Australian health care system. However, the work has not been done to look at this issue. We might be able to mount a better argument for surveillance, and possibly even screening, if we develop better markers of risk.’

David said the research was important because the incidence of Barrett’s-derived oesophageal cancer was on the increase.

‘The condition mostly affects older men and it is associated with obesity – particularly abdominal obesity – so we’re seeing more and more of it.’

In fact, he said over the past three decades there had been a 600 percent increased prevalence of this cancer.


$1.35M For Oesophageal Cancer Reserch
First Published: Investigator - October 2004
Updated: Obesity Key in Oesophageal Cancer


A major funding grant of $1.35m from the US is helping Flinders researchers uncover the reasons behind the rapid increase in cancer of the oesophagus.


Professor David Watson, Head of Surgery Department in the School of Medicine and Dr Paul Drew from the School of Nursing and Midwifery at Flinders are working in collaboration with the Adelaide University and Queensland Institute of Medical Research to investigate the fastest growing form of cancer in the world.


“Cancer of the oesophagus, adenocarcinoma, is rapidly increasing in incidence all around the world but particularly in Australia, Europe and the United States,” Professor Watson said. “It is a particularly aggressive form of cancer which, at present, is proving difficult to treat”


Professor Watson hopes this research will help uncover the reasons why Barrett’s Oesophagus often leads to cancer. Barrett’s Oesophagus is a condition which is due to gastric reflux resulting in changes to the lining of the oesophagus, so that it resembles the lining of the small bowel.


The five year project involves identifying patients with Barrett’s Oesophagus and the pre-cursor legions. Patients will be interviewed to get a detailed description of their lifestyle in order to identify any potential causes or triggers. In addition blood samples and biopsies from the lining of the oesophagus will be collected. The results of analysis of this material will be analysed with the interview results.


Professor Watson hopes that this work will provide new insights into some of the triggers that may cause the progression to oesophageal cancer, and in turn lay the ground work for the development of future treatments.


On average only five percent of those who develop cancer of the oesophagus will survive. In the past 20 years, the incident rate has increased by 400% making it the fastest growing form of cancer in the world.

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