Multimodal treatment for oesophageal primary cancer. A preliminary study.

OBJECTIVE: This study examines the role of chemoradiotherapy, surgical reconstructive techniques of the esophagus and lymphadenectomy in relation to morbidity and mortality. METHODS. From January 2005 to January 2008 we observed 18 patients with esophagus cancer. Eleven patients manifested a lesion of the middle third, 4 patients had a lesion of the upper third and 3 patients had a lesion of the lower third. Preoperative histological evaluation revealed 3 adenocarcinomas and 15 squamous carcinomas. Four patients with a lesion of the upper third received neoadjuvant chemotherapy RESULTS: In 13 patients reconstruction used stomach and 5 patients underwent reconstruction with the colon. Complications ensued in 3 of the latter: dehiscence of the anastomosis, anastomotic stenosis and chylothorax. Three patients highlighted a moderate malabsorption syndrome. A T3N1M0 patient received postoperative cisplatin/5-fluorouracil and radiation therapy. CONCLUSIONS: The use of the stomach represents the therapeutic gold standard for minimized incidence of complications. Lymphadenectomy allows to establish a precise stage of cancer. Chemoradiotherapy is recommended in case of risk of relapse.

Diet and cancer.

The aim of our study is to evaluate the relationship between diet and cancer development. It has been estimated that 30-40% of all kinds of cancer can be prevented with a healthy lifestyle and dietary measures. A low use of fibres, the intake of red meat and an imbalance of Omega-3 and Omega-6 fats may contribute to increase the risk of cancer. On the other hand, the assumption of lots of fruit and vegetables may lower the risk of cancer. Protective elements in a cancer-preventive diet include selenium, folic acid, vitamin B12, vitamin D, chlorophyll and antioxidants such as carotenoids (alpha-carotene, beta-carotene, lycopene, lutein, cryptoxanthin). Ascorbic acid has limited benefits if taken orally, but it effective through intravenous injection. A supplementary use of oral digestive enzymes and probiotics is also an anticancer dietary measure. A diet drawn up according to the proposed guidelines could decrease the incidence of breast, colon-rectal, prostate and bronchogenic cancer.