(Transcript from World News Australia Radio)
While the rate of stomach cancer has fallen in Australia in last few decades, medical experts say other cancers of the gastrointestinal tract are on the rise, specifically those affecting the oesophagus and upper stomach.
Peggy Giakoumelos takes a closer look at the factors behind the rise.
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Gastrointestinal cancers are cancers that start anywhere from the gullet or the oesophagus going all the way down to the very end of the gastrointestinal tract which is the rectum and the anus.
These cancers cover a large part of the body affecting many organs such as the pancreas, the liver and the gall bladder.
Associate Professor Chris Karapetis is Regional Director of Cancer Services for the Southern Area Health Network in Adelaide.
He says while there has been a drop in gastric or stomach cancer over the past few decades, an increase in oesophageal cancer is starting to emerge.
"We've been talking mainly about cancer of the stomach and we've been talking mainly about how the incidence of that cancer has decreased. But if we move up just a little bit and look at cancers that arise from the junction of the stomach and the oesophagus, that's the gastro-oesophageal junction, that cancer's increased in incidence over the past 30 years. The gastro-oesophageal cancers we're probably looking at at about 1000 cases, or just over actually, if we actually include the lower the oesophagus as well. But the alarming thing there is that it's increasing, so the projections there are that they will keep going up, where as the cancer of the stomach itself in the West has been reducing."
The Cancer Council of Australia says while the latest data doesn't suggest a substantial increase in the rate of oesophageal cancer, oncologists such as Dr. Karapetis say they are seeing many more patients diagnosed with these types of cancers in their day to day work.
Professor Brian Burmeister is the Director of Radiation Oncology at Princes Alexander Hospital in Queensland.
He's also concerned by the increase.
"It's a disease of Western society, we're seeing an epidemic growth of this disease in Australia and the United States, in Western Europe and in New Zealand. All the countries which appear to have good living conditions seem to be getting this disease and it's a major epidemiological problem."
Professor Brian Burmeister says it's believed the main cause of the cancer is related to reflux.
"What happens with reflux is you get the stomach acids going backwards into the oesophagus, because the valve which is supposed to control food going down from the gullet to the oesophagus is incompetent. And therefore the acids go backwards up into the oesophagus and eventually cause the cancer. It probably depends on the individual but the more often it happens the more likely the cancer will develop."
Professor Brian Burmeister says there are good public awareness campaigns about reflux, but they don't go far enough in informing people about the long-term consequences.
He urges people who don't get relief from over-the-counter or prescription medications to see their doctor about having an endoscopy.
Andrew Barber is an oncology surgeon and an Associate Professor in the University of Queensland's School of Medicine.
He says evidence is emerging about who is more susceptible to getting this kind of cancer.
"Men eight to one, compared with women so they will mostly be males aged somewhere between 60 and 65, overweight typically. Possibly a history of smoking, but they will often have a history of oesophageal reflux symptoms to some degree. The incidence has doubled to some over the last 20 years and is expected to double again by 2020. It is an alarming increase given how dangerous the cancer is if you get it. Thankfully it's not even close to the numbers we would see with breast cancer or colon cancer or melanoma for that matter. But most other cancer incidence has either plateaued or even slightly decreased just over time and this one is doubling for reasons that are probably related to lifestyle as much as anything."
The Cancer Council of New South Wales says the five-year survival rate for those diagnosed with localised oesophageal cancer sits at around 25 percent, while the survival rate is much lower for those whose cancer has metastasised.
Associate Professor Andrew Barber says with low survival rates early detection is essential.
"So patients who have reflux or are having endoscopy for other gastrointestinal type symptoms, and are found to have something called Barrett's Oesophagus which is a change in the type of lining in the type of lining in the oesophagus. So it changes in response to the kind of chronic acid exposure in reflux. So that if you're found to have Barrett's then most surgeons will put someone on a surveillance program at that moment, and then they would be getting endoscopies every one to two years for the rest of their lives basically."
