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This week, we’re shining a light on acid reflux, a condition that affects millions. From raising awareness of symptoms to sharing tips for managing it, we’re here to support patients, caregivers, and families every step of the way.
Stay tuned for informative posts and resources throughout the week! Let’s work together to spread awareness and empower those affected.
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Grant has taken up an advisory post with the Scottish Government as the Clinical Lead for General Surgery. Grant has managed to introduce the Cytosponge in NHS Scotland as a National Service. The Cytosponge, now known as EndoSign, is a new technique to screen Barrett’s oesophagus patients.
Grant is the former lead Oesophago-Gastric Consultant Surgeon in Glasgow Royal Infirmary with major interests in management of malignant and complex benign upper GI disease. Grant is a former Associate Professor of Clinical Surgery with extensive research interest in benign and malignant upper GI disease. His particular interest is in the field of Barrett’s oesophagus including its role in cancer development and treatment with Radiofrequency Ablation.
Scotland to become first country to offer widespread capsule sponge testing for the detection of oesophageal cancer and Barrett’s oesophagus
NHS Scotland through the CytoScot program has introduced the national adoption of capsule sponge test technology across all 14 health boards. The test is currently available to patients in secondary care with known Barrett’s oesophagus or severe reflux where there is suspicion of Barrett’s or early cancer . This will ensure the early diagnosis of oesophageal cancer and Barrett’s oesophagus is readily available to patients across Scotland.
The capsule sponge test takes less than ten minutes and can help ensure that oesophageal cancer and precancerous conditions are quickly detected and treated. It will vastly improve the availability of vital diagnostic services for patients suffering from chronic heartburn, which could be a sign of Barrett’s oesophagus, a condition that carries a high risk of developing oesophageal cancer.
Patients swallow a capsule the size of a multivitamin pill containing a small sponge on a strong thread, which collects cell samples for analysis. The test reduces the need for invasive endoscopies which can often require a lengthy hospital visit and sedation, limiting access for certain patients. Patients have found the sponge test to be simple and more acceptable than endoscopy.
Capsule sponge testing has helped provide more targeted care for patients, cutting waiting times and boosting clinical capacity as demand for endoscopy is reduced and detection rates increase. In addition there are major health economic benefits with significant cost savings by moving to a capsule sponge diagnostic service.
Patients suffering from persistent heartburn, or indigestion should be aware that these could be symptoms of Barrett’s oesophagus, or even oesophageal cancer, and should speak with their GP about being referred for a capsule sponge test.
Many patients currently have to travel long distances to receive an endoscopy, but the option of taking the capsule sponge test, which can be delivered in community settings closer to home, means that unnecessary travel can be avoided if Scotland chooses to offer the service in primary and community care.
In 2020, gastrointestinal health company Cyted and NHS Scotland launched a pilot programme with the goal of detecting oesophageal cancer at an earlier stage, reducing the demand for endoscopy services and improving patient access to vital diagnostic services. Approximately 4,000 tests were delivered during the four-year programme. As a result of the improvements to patient triage, 1 in 2 endoscopies now find concerning pathologies compared with 1 in 10 before, waiting times have been cut from nine to five months, with more early vs late stage abnormal cell changes being detected.
“It’s great to have the support of NHS Scotland, and we are excited to continue working closely to see how the technology can help further improve access to early cancer detection for patients,” said Dr Marcel Gehrung, CEO and Co-founder at Cyted. “This is the first national roll-out of many and we are scaling globally to realise the full potential of patient impact for our technology.”
Under the roll-out, approximately 5,000 tests are expected to be delivered per year for the first two years, which will then be increased to 8,000 per year. Scaling up the number of tests deployed will allow more patients to be tested, helping identify a greater number of patients at risk of developing oesophageal cancer. There are around 9,300 new oesophageal cancer cases in the UK every year. The key to saving lives is to detect cancer at an earlier stage of Barrett’s oesophagus before it becomes cancerous.
“The development of the capsule sponge test has been a major breakthrough in improving early diagnosis of pre and early oesophageal cancer in Scotland. It has prioritised patients care where a rapid diagnosis is critical. We hope that ultimately this will lead to improved survival in this high mortality cancer “- Professor Grant Fullarton, Clinical Lead CytoScot NHS Scotland spokesperson.
This guideline covers investigating and managing gastro-oesophageal reflux disease (GORD) and dyspepsia in people aged 18 and over. It aims to improve the treatment of GORD and dyspepsia by making detailed recommendations on Helicobacter pylori eradication, and specifying when to consider laparoscopic fundoplication and referral to specialist services.
Dyspepsia describes a range of symptoms arising from the upper gastrointestinal (GI) tract, but it has no universally accepted definition. The British Society of Gastroenterology (BSG) defines dyspepsia as a group of symptoms that alert doctors to consider disease of the upper GI tract, and states that dyspepsia itself is not a diagnosis. These symptoms, which typically are present for 4 weeks or more, include upper abdominal pain or discomfort, heartburn, gastric reflux, nausea or vomiting. In this guideline, gastro-oesophageal reflux disease (GORD) refers to endoscopically determined oesophagitis or endoscopy-negative reflux disease.
This information is from NICE, National Institute for Health and Care Excellence – Homepage | NICE
A growing epidemic of preventable cancers will lead to 184,000 people in the UK being diagnosed with the disease this year and will cost the country more than £78bn, research reveals.
The cost of the cancer cases diagnosed in 2023 caused by smoking, drinking, obesity and sunburn leads to £40bn in lost productivity, costs the people affected £30bn and takes up £3.7bn of the NHS’s budget, the study found. Preventable cancers also cost families and carers £3.4bn and the social care system £1.3bn.
The stark findings sparked calls by doctors and public health campaigners for a crackdown on smoking, drinking and poor diet to reduce avoidable cancers because of the huge human toll they involve and their financial consequences.
This article is from the Guardian- 184,000 in UK to get preventable cancer diagnosis this year, study finds | Cancer | The Guardian
^(A UHS nurse, Danielle Harding, and consultant general and oesophagogastric surgeon at UHS Fergus Noble. Danielle Harding, 30, is the first patient with gastro-oesophageal reflux disease to undergo the RefluxStop procedure at UHS (University Hospital Southampton/PA Wire)
The first patients in the UK have had a new device implanted to prevent severe acid reflux disease.
University Hospital Southampton (UHS) and Imperial College London have become the first NHS trusts in the country to install the device called the RefluxStop, with Southampton being the first to use robotic surgery for the procedure.
Known as gastro-oesophageal reflux disease (GORD), the condition occurs when contents from the stomach flow back into the oesophagus – the long tube that carries food from the throat to the stomach.
This can result in a range of symptoms including heartburn, regurgitation, difficulty swallowing, bloating, excessive salivation, coughing, nausea and a hoarse voice, as well as teeth and gum damage, nutritional problems, and sleep impairment.
It happens when the muscular valve – the lower oesophageal sphincter – at the bottom of the oesophagus becomes weakened because it has moved too close to the diaphragm or even into the chest which affects its function to allow food in and stop acid leaking out.”
This article is from the Independent, to continue reading click here – First patients in UK receive revolutionary device to stop acid reflux and heartburn | The Independent
If you would like more information on RefluxStop, check out our leaflet here- RefluxStop Leaflet – The OPA
“Findings from the phase 3 ESOPEC trial demonstrate an overall survival advantage with a perioperative chemotherapy regimen known as FLOT compared with a neoadjuvant chemoradiation approach, called CROSS, in patients with resectable, locally advanced esophageal adenocarcinoma.
The study results, presented as a late-breaking abstract at the American Society of Clinical Oncology (ASCO) annual conference, help settle a long-standing debate about whether chemotherapy with FLOT — 5-florouracil, leucovorin, oxaliplatin, and docetaxel — before and after surgery, or neoadjuvant radiation plus CROSS — carboplatin and paclitaxel — followed by surgery is the best approach.
There has been “considerable disagreement as to whether giving all adjuvant therapy upfront versus ‘sandwich’ adjuvant therapy before and after surgery is the better standard of care for locally advanced resectable esophageal cancer,” Jennifer Tseng, MD, of Boston Medical Center, Boston, said in an ASCO press release. This randomized clinical trial shows the sandwich approach “provides better outcomes.”
The practice-changing ESOPEC findings will have an important effect on the management of patients with resectable esophageal adenocarcinoma and gastroesophageal junction adenocarcinoma, but local and distant failures remain a challenge in this population, explained invited discussant Karyn A. Goodman, MD.
Advances since the initiation of ESOPEC — such as immunotherapy options and personalized strategies — suggest the esophageal adenocarcinoma story is still evolving, said Goodman, professor and vice-chair of research and quality in the Department of Radiation Oncology at Icahn School of Medicine at Mount Sinai, New York City.
Both the FLOT and CROSS regimens are established standards of care in resectable esophageal adenocarcinoma, and the choice of treatment has largely varied based on geographical location.
The current randomized, prospective, open-label ESOPEC trial, however, demonstrated that FLOT can prolong overall survival, first author Jens Hoeppner, MD, from the University of Bielefeld in Detmold, Germany, reported.
Overall, 438 patients with locally advanced, resectable esophageal adenocarcinoma recruited between February 2016 and April 2020 from 25 sites in Germany and randomized to either FLOT (n = 221) or CROSS (n = 217). The median age was 63 years, and most (89.3%) were men. Patients were followed until November 2023, and median follow-up was 55 months.
Patients in the FLOT arm received four cycles — one every 2 weeks for 8 weeks —followed by surgery 4-6 weeks later. FLOT cycles were reinitiated 4-6 weeks after surgery and given every 2 weeks for 8 weeks.
Those in the CROSS arm received one cycle per week of radiation therapy for 5 weeks plus carboplatin and paclitaxel followed by surgery 4-6 weeks after the last cycle.
Overall, 86% received both neoadjuvant therapy and surgery in the FLOT arm vs 82.9% in the CROSS group. Among these patients, 16.8% in the FLOT group achieved a pathological complete remission vs 10.0% in the CROSS arm.
In the intention-to-treat population, median overall survival was almost twice as long in the FLOT group — 66 months vs 37 months. At 3 years, those who received FLOT had a 30% lower risk of dying (hazard ratio [HR], 0.70), with 57.4% patients alive at that point compared with 50.7% patients in the CROSS arm.
The 5-year overall survival was 50.6% in the FLOT group vs 38.7% in the CROSS group.
Patients receiving FLOT also demonstrated improved progression-free survival (PFS), with a median PFS of 38 months vs 16 months. The 3-year PFS was 51.6% with FLOT vs 35.0% with CROSS (HR, 0.66). The exploratory subgroup analyses for sex, age, ECOG status, and clinical T and N stages also favored FLOT.
The 30-day postoperative mortality was 1.0% in the FLOT group and 1.7% in the CROSS group, and the 90-day postoperative mortality rate was 3.2% and 5.6%, respectively.
Based on these findings, perioperative chemotherapy with FLOT should be preferred over neoadjuvant chemoradiation with CROSS, Hoeppner concluded.
Goodman agreed, noting that, in the wake of ESOPEC, FLOT will likely be adopted as a more standard approach in the United States for patients who are fit. And, for patients who are not candidates for FLOT, CROSS is a reasonable option, she said.
But, she asked, does it really have to be an either/or situation?
Multiple studies, including Goodman’s 2021 Alliance/CALGB 80803 study, have demonstrated promising outcomes with combined modalities and adapting therapy based on treatment response. Several trials, for instance, are evaluating combining FLOT and CROSS, with some showing the approach is feasible and comes with manageable toxicity.
It’s also important to look outside of FLOT and CROSS. During ESOPEC, new approaches entered the treatment landscape, including the use of adjuvant immunotherapy following neoadjuvant chemoradiation and surgery for noncomplete response.
Take the CheckMate 577 study, which found that adjuvant nivolumab immunotherapy after preoperative CROSS and surgery significantly reduced metastatic recurrence and doubled disease-free survival in patients who did not achieve a complete response. This approach is now a standard of care for those patients.
FLOT plus neoadjuvant nivolumab may also be a viable option, Goodman noted, but we haven’t yet seen “any benefit in survival with the combo of chemotherapy and immunotherapy for resectable esophago-gastric cancer.”
Further studies are needed to evaluate the synergy of immunotherapy and radiotherapy. The next chapter of the esophageal adenocarcinoma story may feature a “best-of-both-worlds” approach that combines induction chemotherapy, followed by personalized chemoradiation, surgery, and potentially adjuvant immunotherapy, Goodman explained.
While the ESOPEC findings are impressive, the 5-year overall survival of only 50% is still suboptimal, she noted. “Given the poor prognosis with this disease, we need to continue to develop clinical trials to identify better targets, novel treatment combinations, and select patients that will respond best to specific treatment.”
ESOPEC was funded by the Deutsche Forschungsgemeinschaft (German Research Foundation). Hoeppner reported receiving travel, accommodations, and expenses from Intuitive Surgical. Goodman reported a relationship with the national Cancer Institute and consulting or advisory roles for Novartis, Philips healthcare, RenovoRX, and Roche/Genentech.”
This article is from: Medscape Registration
We are currently working in collaboration with Reckitt Benckiser PLC regarding a funded research study exploring the experiences of parents of infants with symptoms of gastro-oesophageal reflux disease (GORD), or reflux for short.
Study Summary
“What: A 60-minute discussion about your preferences for managing your child’s symptoms of GORD
Where: Zoom
When: To be decided
Will I be reimbursed: Yes, we are providing £60 as a bank transfer for participation in the research.
Who is this for: The research is being conducted on behalf of Reckitt Benckiser Group plc. Anonymised data (without personally identifiable information) will be shared with the funder.
Why are we conducting this research: We wish to better understand how parents of children with symptoms of heartburn and/or indigestion wish for their children to be managed.
What happens if I agree: You will be contacted (via e-mail) by a member of the research team who will provide you with additional information regarding the study, in the form of a participant information sheet. We will also provide you with a consent form. We will do this ahead of the date and time of the focus group, allowing you time to reconsider your participation if you wish. If you choose to take part the focus group will be conducted via Zoom and audio-recorded for later analysis. All responses will be kept confidential and no personally identifying information will be collected as part of the research study. You maintain the right to withdraw from the focus-group at any time.
Please read this document which explains the project in further detail- https://opa.org.uk/wp-content/uploads/2024/06/PIL-FOCUS-GROUP-PARENTS_v2.pdf
If you wish to be involved in the online focus group, email simon@visfo.health
Cancer survival in England is at an all-time high due to the speed and scale of advances in diagnosis and treatment across the NHS. Our work on cancer really matters to people. As we live longer, more of us will develop cancer ourselves, or will have family or friends who are affected by cancer. We want more people to be cured of their cancer or supported to find a way of living their life well with it.
Continue reading…- Click here
Date published: 9 May, 2024
This information is from www.england.nhs.uk
Introducing the three new OPA Publications.
These publications can be downloaded to be viewed in a PDF document or Flipbook-
Downloads – The OPA
Or if you would prefer to order hard copies, you can do this on the OPA Shop-
Shop – The OPA
OPA: Empowering hope and health in the battle against oesophageal and gastric cancer
Global Award Winner – Medical Awareness NPO of the Year 2023/24
In the world of cancer charities, OPA Cancer Charity stands as a beacon of hope and support for those affected by oesophageal and gastric cancer. This organisation goes beyond the ordinary, raising awareness, providing exceptional support, serving as a first class research resource, and showcasing the dedication of their OPA team. In this article, we will delve into the remarkable work of the OPA and how it is making a profound difference in the lives of those facing these challenging cancers across the globe.
Raising awareness
One of OPA’s core missions is to raise awareness about the critical link between chronic acid reflux and the increased risk of oesophageal and gastric cancer. Through public awareness campaigns, educational seminars, and global online campaigns, they’re actively educating individuals about prevention and early detection. By shedding light on this connection, they’re saving lives.
Exceptional support provision
What sets OPA apart is their unwavering commitment to providing exceptional support for patients and caregivers. They offer a range of services, including patient buddy service, support groups, and guidance as well as a strong worldwide social media presence navigating the complex journey of cancer treatment. OPA’s support is personalised, ensuring that individuals receive the assistance they need.
“ONE OF OPA’S CORE MISSIONS IS TO RAISE AWARENESS ABOUT THE CRITICAL LINK BETWEEN CHRONIC ACID REFLUX AND THE INCREASED RISK OF OESOPHAGEAL AND GASTRIC CANCER.”
First-class research resource
OPA’s commitment to combating these cancers doesn’t stop at support services. They serve as a first-class research resource, funding research and collaborating with top scientists and medical professionals. By investing in research, they’re advancing our understanding of reflux, oesophageal and gastric cancer, exploring innovative treatments, and improving patient outcomes.
The dedicated OPA team
At the heart of the OPA’s success is its dedicated team. The OPA team works tirelessly to ensure that the charity’s mission is fulfilled. Their passion and commitment drive the organisation’s impactful work.
Success stories
To understand the impact of the OPA, we spoke with Melanie, a cancer survivor who benefited from their support. “The helpline provided me with a tremendous amount of support,” she says. “Their online resources really made a difference.” Melanie’s story is just one of many examples of the positive change that OPA brings to the lives of patients and caregivers.
Conclusion
The OPA, a cancer charity dedicated to raising awareness of acid reflux’s link to oesophageal and gastric cancer, stands as a model of exceptional support, research advancement, and dedicated
teamwork. With their efforts, they’re changing the narrative for those affected by these challenging cancers. They offer not just hope but a concrete path to improved health and well-being in the face of adversity. For more information, please visit www.opa.org.uk
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Please note, the OPA does not provide medical advice or endorse any treatments. This content is provided for informational purposes only and should not be used as a replacement for direct medical advice from your health care provider. See our Terms and Conditions for more detailed information.
