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Peters, M. In the past, the typical esophageal cancer patient had the kind of cancer caused by smoking squamous cell carcinoma and was frequently terminal. Patients needed surgery to make swallowing easier in the time they had left. Today, the average patient is younger, diagnosed earlier with a different kind of cancer adenocarcinoma and more likely to be cured. The shift toward earlier diagnosis of esophageal cancer can be explained by the relationship of adenocarcinoma to gastroesophageal reflux disease GERD.

At the point where the esophagus empties into the stomach, a ring of muscle keeps stomach acid used in digestion from flowing back up into the esophagus. Acid can also cause long-term changes in the esophageal cells that make them pre-cancerous, with the patches of abnormal cells known as Barrett's esophagus. About 20 million Americans experience severe heartburn. Of those people with frequent heartburn for five years or more, about one in five develop Barrett's esophagus, giving them a fold higher than normal risk of developing GERD-associated adenocarcinoma.

While most cancer rates are falling, esophageal cancer has increased dramatically in recent years to become the fastest-growing type in the United States. The trend is likely to worsen as Americans gain more weight. The combination of the rise in GERD, the drop in smoking, and better diagnostics means that esophageal cancer is often found earlier, and increasingly, while still confined to the esophagus. The most important factors associated with better survival were age less then 45 , female gender, epithelioid cell type, stage 1 disease, peritoneal occurrence and treatment combining surgery with chemotherapy.

There are four types of mesothelioma , and the site where the cancer originates affects patient outcomes. Survival is significantly better for peritoneal patients. An advanced peritoneal mesothelioma therapy called hyperthermic intraperitoneal chemotherapy HIPEC has significantly improved survival rates for this cancer. The procedure combines cytoreductive surgery and heated chemotherapy. Not everyone qualifies for this aggressive procedure, but more than half who do live at least five years.

This compares to a median survival of less than 12 months for patients with pleural tumors.

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In select studies, heated chemotherapy has boosted peritoneal survival to between 40 and 92 months. A meta-study published in Translational Oncology analyzed 20 years of data, collected from to The five-year survival rate for peritoneal mesothelioma patients was more than five-times higher than the rate for pleural patients. The remaining two types of this asbestos-related cancer are pericardial and testicular. Median survival for testicular mesothelioma, the rarest type, is 24 months.

Pericardial mesothelioma is very rare, with only documented cases in the medical literature. It develops on the lining of the heart and has a median survival ranging from six weeks to 15 months.


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Alyssa Hankus is one of the youngest long-term mesothelioma survivors in the U. She was diagnosed with advanced peritoneal mesothelioma at age She now lives every day to the fullest and looks forward to what the next chapter of her life has in store. The stage of cancer at diagnosis is a strong predictor of overall survival. People with stage 1 mesothelioma , before cancer has spread, have the best survival rates.

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Early-stage patients who receive prompt treatment experience improved survival. They are more likely to qualify for surgery and other aggressive treatments. More aggressive therapies are associated with better outcomes. Most cases of pleural mesothelioma are not diagnosed until stage 3 or stage 4. At these stages, the tumor is large or has spread beyond the original cancer location.

Being diagnosed at later stages mean the disease is more difficult to treat and is associated with poorer survival rates. There is no established cancer staging system for peritoneal mesothelioma. Some researchers have developed their own systems based on TNM staging.

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One example is the peritoneal cancer index PCI , which places this tumor type into three stages instead of the usual four for other cancers. Pleural mesothelioma does not have favorable survival rates when compared with the survival rates of peritoneal disease. The pleural disease can be harder to treat. Patients often are not diagnosed early enough to receive the most aggressive available cancer therapies and may not be healthy enough to withstand invasive surgeries in particular.


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  • Diabetes, hypertension remission greater among teens vs. adults after bariatric surgery.
  • Russell Lamkins was diagnosed with stage 3 inoperable pleural mesothelioma in August Doctors told him he had a year to live. Jacques Fontaine. The novel treatment involves delivering high-doses of chemotherapy directly to specific blood vessels that feed tumors. Learn About the Stages of Mesothelioma. The mesothelioma cell type, or tumor histology , impacts patient survival. The cancer has three primary cell types: Epithelioid, sarcomatoid and biphasic.

    The most common cell type is epithelioid , which is also the least aggressive. It responds best to treatment.

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    Median survival for patients with this cell type is 12 to 24 months. Sarcomatoid mesothelioma is the most aggressive cell type. Patients with this diagnosis have a median survival of six to eight months. Biphasic tumors have epithelioid and sarcomatoid features. More epithelial cells means a better prognosis.

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    If the tumor is mostly sarcomatoid cells, life expectancy is decreased. Patients with a biphasic cell diagnosis have a median survival of around 13 months. Older mesothelioma patients have lower survival rates, on average, compared with younger patients. For now, while we hope to identify new, effective and less-invasive therapies and effective adjuncts to bariatric surgery in adolescents, decisions should be made on a case-by-case basis, with the knowledge that the 5-year data look promising but that the lifetime outcome is unknown.

    Please see the study for all other authors relevant financial disclosures. This is a very important piece of work showing what can be done for children with a high mortality risk disease. The remission rates reported here for hypertension and type 2 diabetes are impressive. The longer you have morbid obesity, the greater the long-term risk for conditions like heart failure. Early intervention is critical. However, having worked with pediatricians, there is a huge amount of sensitivity in that age group.

    Gastric bypass in adolescents is not trivial. This is a major procedure with lifelong effects, and that gives people pause. If it was my child, I would be thinking long and hard about going through with it. I would like to see longer-term data on the outcomes of this cohort. Disclosures: Heymsfield reports he serves on an advisory board for Medifast.

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