Grey's Anatomy: Mr.O'Malley's Esophageal Cancer
When George's dad was diagnosed with esophageal cancer my first thought was "What a great cancer to bring up because that's one of the few cancers that's actually increasing in frequency."
But Grey's writers didn't get it quite right.
Deaths from most common cancers have dropped in recent years. But that's not true for esophageal cancer, which continues to rise. The National Cancer Institute estimates that around 15,000 people will be diagnosed with esophageal cancer in 2006 with nearly 14,000 people dying of this aggressive cancer.
We don't exactly know why it's getting more common. But there's one risk for esophageal cancer that may be the culprit.
The type of esophageal cancer that's on the rise is seen more commonly in people with heartburn. And one of the big risks for heartburn is being overweight. You can probably see where I'm going with this.
While Grey's writers didn't work heartburn into Mr. O'Malley's medical history, his big belly - and the diet and lifestyle that likely goes along with that rotund abdomen - makes him the perfect candidate.
That big belly puts increased pressure on his stomach, causing stomach acid to bounce back up into his esophagus where it doesn't belong. Over time, this acid can cause abnormal cellular changes in the esophagus - called Barrett's esophagus - which can lead to cancer.
As we continue to see more overweight and obese people, we're likely to see more people with chronic heartburn - known by doctors as gastroesophageal reflux disease or GERD - and very possibly more people with esophageal cancer.
That's why it's so important to not just continue to pop over-the-counter heartburn medicines without seeing your doctor. If you're having heartburn two times or more a week, you really need to talk to your doctor about it. This could be a sign that you have GERD and at increased risk for esophageal cancer. Treatment can help prevent cancer.
Now to where the writers got it wrong.
They said Mr. O'Malley had stage 3 "metastatic" esophageal cancer. That's an incorrect description because he apparently has stage 4. They said it "metastasized," which by definition means it's stage 4, the most severe form of cancer. Most patients with esophageal cancer are diagnosed with stage 4 and that's a big reason why it's so deadly.
Overall, fewer than 5% of people with esophageal cancer live for more than 5 years. And with Mr. O'Malley's stage of esophageal cancer, death is imminent -- probably within a year.
You can see now why George was so upset he couldn't even tell his dad. He had to get Cristina to break the news.
There is no way to cure stage 4 esophageal cancer and treatment is focused on relieving any symptoms the patient may be having, such as trouble swallowing. Chemotherapy may still be used to help buy some time, but it won't cure the cancer.
We have no way to screen for esophageal cancer and that's why prevention is best. In addition to getting heartburn under control, other ways to help prevent esophageal cancer are not smoking and avoiding heavy drinking.
Related Links: More On GERD Complications , Esophageal Cancer Treatments By Stagetags: greysanatomy, drmcdreamy, esophagealcancer, GERD, cancer
26 Comments:
I am so glad to see the esophageal cancer is being given the spotlight.My father died from this monstrous cancer in June of this year. It was painful to know that there was nothing this even the most skilled of doctors could to save or prolong his life.The more the public is educated about the risk factors, maybe people would begin to take small preventative measures that could possibly save lives.
My father died of esophogeal cancer in August 1996 after a painful, two-year bout with it and the brain, tongue, and lymphatic cancers that came afterward. It is a terrible way to go and the oncologists in 1994-96 seemed to be unfamiliar with the cancer and unsure how to best treat it. They never mentioned that being overweight or having chronic heartburn were factors in the development of his cancer. I hope that this small beginning of public awareness for esophogeal cancer can be of great benefit to others.
MY DAD DIED ALSO. IT WAS FAST.WITHIN A SHORT PERIOD AFTER THEY REMOVED SOME OF THE ESOPH. AND STOMACH HE WAS DIAGNOSED WITH BRAIN CANCER.THEY GAVE HIM 9-12 MO. BUT HE DIED WITHIN 2 WEEKS.HE POPPED TUMS DAILY BUT REFUSED TO GO TO DOC FOR MANY YEARS PRIOR.THIS YEAR IT WILL BE 7 YRS SINCE HE DIED.FALLS ON THANKSGIVING.(HE WAS OVERWEIGHT BUT NOT OBESE-HI FAT DIET,CARRIED IT IN HIS STOMACH MOSTLY)
Twelve years ago a co-worker died within six weeks of her diagnosis of esophageal cancer - it must have been at stage 4 since tumors were also found in her lungs. She was 55, thin and had minimal belly fat. I do not recall any digestive (tums popping) issues. She ate a good, balanced diet - I envied her the disciple she had. She was, however, a smoker and drank vodka once or twice weekly (that I knew about). Family stress was a huge factor in her life, particularly in the year before she was diagnosed and died. So it is not always diet and belly fat that precipitates things. The message I keep hearing is that weight is the devil above all else. My friend showed me it is more complicated and weight control is NOT ENOUGH!
has there been any reported link between esophageal or throat cancer and the eating disorder bulimia? there's a history of cancer in my family including sinus cancer. i am bulimic and have sinus problems as well, and am pretty worried having cancer. :/
My dad has just been diagnosed and went through an incredibly aggressive chemo and radiation treatment, and is scheduled to have surgery to beginning of December. The doctors can't say what stage he is in, other than it's pretty bad. They haven't been able to biopsy parts that would determine his stage, so I am assuming when they do the surgery, they will be able to biopsy deeper down and determine that hopefully it hasn't spread (God willing). The statistics are not encouraging.
My husband died of EC a few months ago. He was not obese -- never had been. While that may be a factor in some cases, it was not one for him. There is also a common misconception that EC is related to heavy drinking or smoking. While that may be a factor in squamous cell EC; reflux or GERD is the cause for adenocarcinoma EC, the fastest growing type.
My husband's EC was caught early, stage 1, as he was being scoped regularly because of Barrett's syndrome (a pre-cancerous change in the lining of the esophagus caused by chronic reflux).
While many people die because it is caught too late -- even early stage esophageal cancer can be deadly. Chronic heartburn is a key indicator of the disease. Patients with chronic heartburn need to be scoped.
my dad died of ec 6 months of being diagnosed. being overweight wasnt a factor for him as he lost weight rapdily. however he drank alcohol heavily and smoked alot through his lifetime. when my dad died he weighed 99 pounds. my dad had always been about 150lbs, but was not by any means overweight. im writing this in hopes that we can get a hold on this monsterous disease.
For the sake of accuracy, endoscopy and periodic biopsies of worrisome lesions (including Barrett's esophagus) are effective ways to screen at-risk patients. Surgery to prevent the development of cancer is very successful in these patients.
Did anyone ever relate to the Microwave oven as being the culprit on this cancer??? Just wondering, cause mostly everyone has one, including me...mostly for warming up food...and I do have frequent heartburn, and or GERD.
I take medication every day for chronic heartburn. I recently had an upper GI done and it couldn't mimic symptons (my doctor said). Years ago I had a scope but wonder if I should have another one. My doctor says the upper GI is more effective. As long as I faithfully take my medication my heartburn symptons are controlled but not totally. I also have hypertension and I am about 25 pounds overweight. Losing the weight I know will help my overall health.
Bad things happen to good people all the time. You can live a perfect life, controlling your weight, never smoking, not drinking, getting plenty of exercise and always watching the nutritional value of what you consume, and still you can get cancer, particularly if it's in your family. In that circumstance, it isn't if you'll get it, it's when you'll get it, so the best thing you can do is to have a body scan done. It'll cost you about a grand, but what's your life worth? Early detection is the key. Find it before it takes root in you.
I have a male friend that also died of esophageal cancer. I cant help but notice that the majority of this type of cancer appears to be predominently male. Are there any statistics professing this to be true.
I think another cause for this was the old x-ray machines. My Dad and several of his friends who worked for C & H Sugar had to have chest x-rays once a year. He and 5 of the men he worked with all died of esophageal cancer. He had originally been diagnosed with diabetes. I and my Mother said he must see another doctor since there was no diabetes in his family. By the time we got him seen, it was too late. With this type of cancer, any bleeding is digested in the stomach so there is no sign.
My brother died over 3 years ago with ec. He did not smoke or drink but was a overweight. He had had trouble with his throat for at least 10 years as he was a grain hauler and the dust from the grain, etc was hard to breathe at times. This could have and then again may not cause his cancer. Doctors gave him 1 year at most, didn't live past 6 months after taking chemo no surgery. There was nothing the doctors could really do for him. He took one day at a time until the end. I didn't know that it was more deadly then other cancers that at least you have more of a warning signs that ring bells with other more common cancers. This cancer does need more research and campaign tolet the public be aware of this type of cancer is real!
I lost my husband to ec 3 1/2 years ago. He was diagnosed in Oct '95 and died in May '96, 7months later. He had surgery, chemo, and radiation. After seeing how he suffered through these treatments, I truly wish he could have just passed in peace. He was a stage 4 at diagnosis but the Dr's never told us that this was such a progressive cancer and we were going to lose him no matter what. He smoked for many years and had just given it up about 6 months before this happened. He also carried extra weight. He weighed about 240 at diagnosis and 101 at his passing. I truly wish everyone would take seriously the dangers of smoking and poor eating habits.
My husband was diagnosed with EC 5 1/2 years ago. He had IVOR Lewis surgery. He was slightly overweight and was a social drinker. He hadn't smoked for over 25 years.
His CT scans were good up until 2 years ago when he developed lymphoma. Now after 2 years of chemo he's still a watch & see.
The doctor's feel his arthritis meds made be one of the culprits causing all the heartburn, etc.
I thank God for every day I still have him.
More awareness must be done for this horrific illness.
My dad had cardiovascular surgery resulting in a probable stroke. Since then he has not been able to swallow efficiently enough to eat or drink. He has a "peg" tube for formula feedings every four hours. (He is still very alert and active for 79.) He suctions his own saliva, because it often ends up going down the wrong pipe. Has anybody experienced this? I'm wondering the recovery potential as well as length of recovery, and what can be done to speed the recovery process. Thank you for your input.
thanks for telling it like it is - the death rate for ec should be a wakeup call for all of us - two members of my immediate family died of glioblastoma - we were given hope when there was none - --even when the truth is shocking and painful about survival rates of certain cancers i believe it is better to inform the patient and family with the truth, let them make future plans accordingly
I really think that diet also plays a role in cancer development. If you think about the all the chemicals we consume everyday from the commercial foods/fast foods if you don't read the labels, it makes sense. And if you combine that with smoking/polution/stress/drinking and such, it's a deadly combination...
People need to realize the true severity of esophageal cancer. More programs need to be instituted generating public awareness, which is what pharmaceutical companies try to do for various disease states like GERD, which could lead to esophageal cancer. In july of this year my cousin died of esophageal cancer. His doctor didn't recognize the severity of my cousin's symptoms. The doctor never ordered an endoscopy. My cousin was diagnosed at 25 and died one week bofore his 27th birthday. I hope people think before they criticize pharmaceutical companies for advertising drugs or drug rep lunches. Awareness and educations is critical to improving patient outcomes. If my cousin's cancer was caught earlier, maybe he would have lived longer.
EC seems to be more prevelant in men, but my grandmother was diagnosed with it in March, 2007 and died unbelieveably less than 24 hours after being diagnosed. My family is still in shock. She didn't drink or smoke, got regular exercise, and had a good diet overall, we still aren't sure what factors could have led to this as there is no family history of it that we know of....
i am 46 year old female and i was diagnosed with barretts esophogus a couple of years ago and i have not followed up with the scopes as i should have. i have heartburn dialy and live on over the counter drugs. i am having pain in my chest and back that started a month of so ago and is getting increasingly worse. is this a symptom i should be worried about?
i am seaching for answers and i am hesitant to contact the dr for fear of emberassing myself with symptons that may or may not be anything.
I am one of the lucky ones. I was dxed over five years ago with ec. However, it is painful to think that out of 70,000 people that were diagnosed in that period only about 5,000 (or 1 in 13) people survived it. I am in the middle of my check up and everything is looking good. Both my parents have it (dad is a 20+ year and mother is 15+ year survivor) so I had a 75% chance of getting it. I also have gerd and barretts as well. While I am over weight (most of it being muscle), I also exercise and am incredibly strong. So while I fall in most catagories of coming out of remission, my team of Drs. are confident that it won't happen.
I have recently been diagnosed with esophogeal cancer and have just begun to take radiation and chemo treatments for it. The doctors say my heart may be too weak to have the surgery to remove it after the other treatments so I may just be destined to die from this. I was slightly overweight and ate a diet high in meats. I have the idea that the possible cause of these and other cancers is in the meats we now eat which are full of steroids used to make the animals grow off quicker and resist some of the previous diseases. We have all seen the reports of many steroid using athletes being found to have cancers and dying from them. It just makes since to me that there should be some real research done in this area and possibly restrict or limit the use of steroids in growing our animals for food. There may also be a problem that is made worse by some of the chemicals and preservatives used by food processors. Maybe the Department of Agriculture should look into this and see if there could be a solution.
My husband was diagnosed w/EC in Aug. 2001. He underwent extrememly aggressive chemo and 5x week radiation for 5 weeks and then an operation (esophagogastrectomy) for adenocarcenoma. No stage was ever divulged however he had a 6cm X 10cm tumor & 2 enlarged lymph nodes prior to surgery so the surgeon was almost sure that the EC had spread. The tumor had permiated the esophageal wall but thank God the path report showed no cancer cells in the lymph nodes. My hubby remains cancer free and it will soon be 7 yrs. from diagnosis. His initial symptom was hiccups directly after eating for 2-3 min. w/only occasional instances of difficulty swallowing. He had just retired from a very stressful job (law enforcement), smoked and drank. Family doc was very perceptive at sending him immediately for tests. First GI doc told him it was "too late" for treatment. So grateful we sought other advice. Kudos to The James Cancer Hospital at Ohio State University, rated as among the top 20 cancer hospitals in 2008. Also, I have been opposed to selling acid reflux meds via over the counter since the very onset because, like my husband did for years & years, most folks will self-medicate and IGNORE THE VERY SYMPTOMS OF EC until it is usually too late to survive it. If you have symptoms, GO SEE A DOCTOR. Don't keep buying over-the-counter meds...cause you may be "buying" yourself more trouble by ignoring the symptoms.
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