The Link Between Oral Bacteria And Esophageal Cancer

Although relatively rare in comparison to other cancers like breast cancer, esophageal cancer is the 11th principal reason for cancer death in the United States.

Esophageal Cancer Statistics: What the Numbers Say About It

From 2010-2014, about 4.1 per 100,000 people (on average) died per year, and only 18.8 percent will likely survive five or more years after being diagnosed based on data from SEER 18 2007-2013. In 2009, the 5-year relative survival rate was at 20.6 percent, a 500-percent rise from the 1975 rate of only four percent.

In 2018, an estimated 17,290 people will be diagnosed with esophageal cancer. Meanwhile, about 15,850 will die from it.

Also, esophageal cancer is more prevalent among men whose lifetime risk is at one in 132 compared to women’s at one in 455. In the 17,290 estimates of new cases for 2018, 13,480 will be in men and only 3,810 in women. Among the deaths, more than 81 percent are among men.

The cancer is also more common in Whites with 7.7 number of new cases per 100,000 persons than other race or ethnicity. However, Whites tied with Non-Hispanics in the number of deaths at 7.6 per 100,000 persons.

By age, esophageal cancer is usually diagnosed in people aged 65 to 74, with the median age at diagnosis at 67 years old. The percent of deaths by age group is also higher in 65 to 74-year-olds than other age brackets. The median age at death due to esophageal cancer is 69 years old.

The Development of the Cancer: How Does It Start?

Esophageal cancer is characterized by the development of cancer cells beginning at the inner layer of the muscular tube that runs from pharynx to the stomach called esophagus. The cancer cells can spread to the other segments of the esophagus and move to other parts of the body or metastasis.

Moreover, esophageal cancer can be squamous cell carcinoma or adenocarcinoma. Squamous cell cancer is the most common type of esophageal cancer which develops from the flat, thin cells called squamous cells that line the inner esophagus and can affect its entirety. On the one hand, adenocarcinoma spring from the gland cells typically in the lower esophagus.

During the early development of esophageal cancer, no symptom is often experienced, but will later manifest in advanced cases. Indications of cancer include weight loss, indigestion and heartburn, pain when swallowing, hoarseness, and pain behind the breastbone.

Its Risk Factors: What Puts You At Risk

Tobacco use, heavy consumption of alcohol, gastroesophageal reflux disease, and Barrett’s esophagus increase the likelihood of the development of esophageal cancer.

However, aside from the risk factors mentioned above, a study conducted by researchers at the Laura and Isaac Perlmutter Center at NYU Langone Health found that periodontal disease can also increase the risk for esophageal cancer.

Oral Bacteria and Esophaheal Cancer

The research examined 122,000 samples of oral wash — 106 of which developed esophageal cancer. The researchers then obtained the DNA and sequenced the oral wash samples. They compared the oral microbiomes of participants with esophageal cancer and those without cancer.

The findings showed that high levels of certain oral bacteria like Tannerella forsythia and Porphyromonas gingivalis increase the risk of esophageal adenocarcinoma by 21 percent and esophageal squamous cell carcinoma, respectively.

Also, the study found that not all bacteria heightens the risk of esophageal cancer. It found links which suggest that Neisseria bacteria reduce the risk of esophageal adenocarcinoma.

According to Dr. Jiyoung Ahn of NYU Langone Health, the research can push for more studies regarding the role of oral microbiota in the development of esophageal cancer that may lead to the prevention of cancer or its early detection. Ahn added that a follow-up study on oral microbiota to verify these bacteria’s role as predictive biomarkers is needed.

Diagnosis of esophageal cancer may involve:

  • barium swallow X-ray
  • endoscopy
  • biopsy
  • evaluation of symptoms
  • review of medical history
  • physical examination
  • tests like computed tomography scans, laparoscopy, positron emission tomography scan, and thoracoscopy

Treatment Options: What You Can Do

Treatment of esophageal cancer may be through:

  • surgery
  • radiation therapy
  • chemotherapy
  • targeted therapy
  • immunotherapy
  • photodynamic therapy
  • electrocoagulation
  • cryotherapy

The success of esophageal cancer treatment depends on the stage of cancer and the overall health condition of the patient. Early detection of cancer is also vital in increasing the rate of survival. However, esophageal cancer is usually detected in its advanced stage.

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