arena, and we are slowly making progress. We have found that combinations of chemotherapy

drugs show improved response and overall survival, whereas in prior years we relied

on one agent. Hopefully, understand- ing which combinations to initiate will

result in better benefits for the patient. Esophageal Cancer

Nearly 17,500 new cases of esophageal cancer were diagnosed in 2012, resulting in more than 15,000 deaths from the disease. Esophageal cancer is three to four times more common in men than in women. The lifetime risk of esophageal cancer in the United States is about 1 in 125 in men and about 1 in 400 in wom- en, and many countries in central Asia and southern Africa have rates that are 10 to 100 times higher than those in the United States.

Esophageal cancer takes two main forms. Squamous cell cancer, targeting the squamous cells forming the lining of the esophagus, accounts for less

than half of all esophageal cancers. One type grows in the squamous cells that form the inside layer of the lining of the esophagus. Adenocarcinomas start in gland cells, not normally part of the esophageal lining before an adenocarcinoma can develop, glan- dular cells must replace an area of squamous cells.

Adenocarcinoma of the esophagus is now more prevalent than squamous cell carci- noma in the United States.

One of the principal risks of esophageal cancer is symptomatic gastroesophageal reflux. That was one of the first signs for Lanse Brown, a resident of Pendroy, Montana, who has been undergoing treat- ment for esophageal cancer at the Cancer Center since 2003. I was having a prob- lem holding down food, Mr. Brown recalls. My wife thought it was dysphagia. I had a physical that showed bleeding in my esophagus. That physical saved my life.

A friend of Mr. Brown s referred him to the Cancer Center at UAB, and five days later, he was in Birmingham for his first appointment. He immediately began chemotherapy and radiation therapy and eventually had surgery to remove six inches of his esophagus and part of his stomach. Throughout his experience, Mr. Brown maintained a positive attitude and the belief that he was in the right place.

4 U A B C O M P R E H E N S I V E C A N C E R C E N T E R

One of the

principal risks

of esophageal

cancer is

symptomatic

gastroesopha-

geal reflux.

17 500, NEARLY

M O R E T H A N 15 , 0 0 0 O F W H I C H R E S U LT E D I N D E AT H

new cases of esophageal cancer were diagnosed in 2012

1/400

1/125 E S O P H AG A E L C A N C E R R I S K

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