Cancer of the esophagus has numerous causes. In previous decades, many cases were affected by excessive alcohol consumption or smoking. More recently, prolonged damage from reflux of stomach acid (gastroesophageal reflux disease or GERD), which is seen more commonly in obese patients, may damage the esophagus and eventually cause a condition called Barrett's esophagus. People with Barrett's esophagus have an increased risk of developing esophageal cancer.

Smoking and alcohol consumption are most often associated with the squamous cell type of esophageal cancer while adenocarcinomas are more common among people with GERD and reflux. According to the American Cancer Society, there will be more than 15,500 new cases of esophageal cancer in 2007. The death toll is expected to reach more than 13,900 people this year. Esophageal cancer is one of the deadliest forms of cancer. In many cases, it is not diagnosed until it has reached an advanced stage.

People who are diagnosed with this type of cancer often undergo surgery to remove cancerous sections of the esophagus. The procedure, called a transhiatal esophagectomy or THE, can be performed without opening the chest. The stomach is pulled up to the neck and connected to the remaining section of the esophagus to allow proper food digestion. The procedure can be complicated by risks of bleeding, infection and leakage around the feeding tube incision.

Researchers from the University of Michigan Health System (UM) studied the medical charts of 133 obese patients (with body mass indexes of 35 or more) who underwent THE esophageal surgery between 1977 and 2006. They were compared to a randomly selected group of non-obese patients who underwent the same procedure.

"The type of patient who currently develops esophageal cancer has changed dramatically in the last 20 years," UM's Dr. Mark Orringer said in a press release. He presented the study results to the 43rd annual meeting of the Society of Thoracic Surgeons January 30 in San Diego. "Currently about 85 percent of the esophageal cancers removed in this country are adenocarcinomas, most related to obesity and reflux disease, and 15 percent are squamous cell carcinomas, typically due to smoking or alcohol consumption. Two decades ago, those numbers were reversed."

The UM researchers found that both groups had comparable outcomes following the surgery when accounting for length of hospital stay, infection and death. The results suggest that the surgery is safe in obese patients. However, the researchers noted that results may vary by hospital depending on the volume of esophageal surgeries conducted at each facility. High-volume hospitals may have fewer cases of complications or death following the procedures than hospitals that do not often or rarely perform the operations, according to researchers.

Copyright 2007 iVillage Total Health.