When Dr. Sachin Wani goes to work every day at the University of Colorado Anschutz Medical Campus, it can often feel like he is fighting an uphill battle.
Wani is a gastroenterologist and an interventional endoscopist, as well as a professor of medicine at the University of Colorado School of Medicine. Much of his work with patients involves diagnosing and treating cancer of the esophagus.
But, too often, doctors don’t catch esophageal cancer soon enough — and the same goes for patients with stomach cancer.
“We don’t have too many options for patients when they get diagnosed at a late stage and all we can really do is provide palliative care,” Wani said. “That really is the paradigm that we are trying to change.”
To help in making that change, CU-Anschutz on Tuesday announced the creation of a new center it hopes will bring together world-class doctors and researchers, both to improve patient care and also advance new methods for detecting esophageal and gastric cancers early.
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The center will be called the Katy O. and Paul M. Rady Esophageal and Gastric Center of Excellence, named after the Colorado couple whose $20 million gift will fund the center. Paul Rady is the chairman, CEO and president of Denver-based Antero Resources, an oil and gas company.
Personal tragedy is what inspired the Radys to make the commitment. Katy Rady’s brother, Paul R. O’Hara II, died of esophageal cancer in 2015. Part of the new center will include an endowed position — the Katy O. and Paul M. Rady Endowed Chair in Esophageal Cancer Research. Wani will be the first to hold that position.
“When my brother was seen at the CU Cancer Center, we knew this place was different,” Katy Rady said in a statement. “That was partly due to their multidisciplinary approach in treating cancer and the experts that provided him advanced care. We want others to receive this same care by acting as a vessel that will spur breakthroughs and create new therapies. We hope this gift today will continue to help make a difference for families facing this cancer.”
Doing better at early detection
This year, roughly 21,000 people will be diagnosed with cancer of the esophagus in the United States, and another 26,000 will be diagnosed with stomach cancer. There will be about 16,000 deaths from esophageal cancer and 11,000 from gastric cancer, said Dr. Richard Schulick, the director of the CU Cancer Center and chair of the Department of Surgery at CU-Anschutz.
According to state data, 203 people in Colorado died last year from esophageal cancer, and 136 died from gastric cancer.
“If we continue to diagnose and treat the way we’re going today, then a lot of people in the next five, 10, 20 years are going to get esophageal or gastric cancer and succumb to it and suffer from it,” Schulick said.
While esophageal and gastric cancers are not the most prevalent forms of cancer, Schulick said, they continue to have higher mortality rates, while other cancers — such as colon cancer — have seen their death rates decline. The difference is in early detection. While screenings for oral cancer and colon cancer are common, screenings for esophageal and gastric cancers represent a missing link in the prevention system.
Currently, detecting esophageal and gastric cancers involves often invasive and time-consuming procedures. One of the things Wani and Schulick hope to work on at the new center is developing and refining methods that are simpler and can be performed right in a gastroenterologist’s office.
Wani mentioned one method: A small sponge or a balloon attached to a string. People swallow the object and then the doctor pulls it back out slowly using the string. The sponge or balloon is sent off to a lab to have it analyzed for any cancer cells or other worrying signs.
He assures that patients in clinical trials often prefer this screening method over the standard endoscopic screening for esophageal cancer, which involves sedating a patient and shoving a camera down their throat.
“It’s very similar to the stool-based tests that are available for colon cancer screening,” Wani said.
Halting a rise in esophageal cancer
Esophageal cancer has been rising in the U.S., Wani said, though it is unclear why.
One of the major risk factors for developing esophageal cancer is a condition called Barrett’s esophagus that can, itself, be a consequence of frequent acid reflux or heartburn.
“As a result of ongoing injury and reflux, the lining of the esophagus changes,” Wani said. “That can turn into cancer.”
Wani said an estimated 2 million to 5 million people in the U.S. suffer from Barrett’s esophagus. He said nearly 20% of the adult U.S. population suffers from acid reflux at least once per week.
Risk factors include a history of smoking, obesity and a family history of Barrett’s esophagus or esophageal cancer. Men seem more prone to the disease than women.
Wani encouraged patients at risk to talk with a doctor about getting screened.
“Screening does make a difference,” he said, “and it really can be a game changer.”
Correction: This article was updated at 4:05 p.m. on Tuesday, Dec. 6, 2022, to correct the name of the endowed chair position the Rady’s are funding. It is the Katy O. and Paul M. Rady Endowed Chair in Esophageal Cancer Research. The Paul R. O’Hara II Endowed Chair in Esophageal Cancer is a previously existing endowed position currently held by a different doctor.