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Delays in detecting cancer of the oesophagus mean it has low survival rates. But York patient Lottie Sturge offers hope that early detection, and better awareness of the diease, can save lives. 

AN afterthought at a doctor’s appointment saved Lottie Sturge’s life.

“By the way...” she said, gathering her things to leave as she described the difficulty she was having swallowing food.

“My appointment was for something else and it was a, ‘by the way’, because now you have to wait quite a long time for the appointment,” Lottie said, “I actually told the GP before I told my husband Michael, he didn’t know at that stage.”

It was fortunate she mentioned it as a series of tests revealed the retired music teacher, now 65, had a cancerous growth in the oesophagus, the tube which carries food from the throat to the stomach.

It’s typically a very hard cancer to detect, but in Lottie’s case, this early detection and referral to York Hospital meant she could have successful treatment.

About 7,800 people die from oesophageal cancer every year in the UK. For men it is the fourth most common cause of cancer death but a lack of awareness of symptoms in the early stages of the disease – when treatment is most likely to work – make early detection difficult.

York Hospital is campaigning to raise awareness of the symptoms, which can be subtle or mistaken as having other causes, in a bid to save lives.

“We still see oesophageal cancer presenting quite late and that’s always the sad story really,” Prashant Kant, consultant gastroenterologist at York Hospital said. “We can’t prevent cancer but at least if we can get them as early as possible we’re doing a much better job there.

“Prognosis is better than it used to be, there’s a lot better treatment available. The key thing is to get the diagnosis as early as possible.”

Risk factors include drinking, smoking and obesity, with symptoms including persistent heartburn or indigestion, a difficulty swallowing, weight loss and pain or discomfort in the stomach, chest or back However, for Lottie, the risk factors made her an unlikely candidate for the disease.

“It was a surprise because I don’t do the usual things like being a heavy drinker, or overweight or a big meat eater,” Lottie said, “I wasn’t a typical patient for this.”

Following an endoscopy test, Lottie had various scans at York Hospital and a meeting with a consultant.

Following diagnosis, she was given nine weeks of chemotherapy at the start of 2016, before a lengthy operation in Leeds, where a section of her oesophagus was removed and her stomach moved up partially through her diaphragm.

“I flowed from test to test and I just lived from day to day really but there was always somebody at the end of the telephone if I needed to talk to someone,” Lottie said, “As soon as I had the operation I considered myself cancer free, although they say it takes five years from a medical point of view. I’m cured in my mind, partly because the cancer was contained within the oesophagus wall.”

The operation was followed by radiotherapy and a lengthy recovery period at home in Acomb as her digestive system adapted.

Changes to her diet and regular check-ups mean life hasn’t completely gone back to normal for Lottie, a year on from finishing treatment, but she feels fortunate the disease was picked up so quickly and that she has been given the support of a specialist nurse and dietician.

“I have been quite lucky,” she said, “At the time, the long-term worry was more with the family.

“I have had fantastic good health and have been blessed for so long. A lot of people say ‘why me?’ but why not me?”

She has recently been well enough to enjoy a skiing holiday and to spend time visiting her children and six grandchildren.

Lottie is a success story for the upper gastrointestinal (GI) team (pictured below) at York Hospital, who hope an awareness campaign will lead to an early diagnosis for more people.

York Press:

“This is the first time ever we’re raising awareness of oesophageal cancer,” Eden Galang, upper GI clinical nurse specialist said. “It’s about raising awareness and catching it early.”

Many patients will write their persistent heartburn off as being something they have eaten or had to drink, she said.

The consultant, Mr Kant added: “Every time we see someone with cancer, we think, is there something in the symptoms which mean they could have gone to their GP earlier? Quite often it tends to be people who are quite well and delay seeing the doctor. It’s typically someone in their young, to middle age, with busy lives who just don’t get time to see their doctor.

“It’s particularly symptoms which are new, such as heartburn or indigestion or difficulty swallowing or general abdominal pain.”

Factfile

-Oesophageal cancer is a type of cancer affecting the oesophagus (gullet), the long tube that carries food from the throat to the stomach
It mainly affects people in their 60s and 70s and is more common in men than women. 

-Oesophageal cancer doesn’t usually cause any symptoms in the early stages when the tumour is small. As it gets bigger, symptoms tend to develop.

-Symptoms of oesophageal cancer can include:
-difficulty swallowing 
-persistent indigestion or heartburn 
-bringing up food soon after eating 
-loss of appetite and weight loss 
-pain or discomfort in your upper tummy, chest or back 

-See your GP if you experience:
-swallowing difficulties 
-heartburn on most days for three weeks or more 
-any other unusual or persistent symptoms 

-The symptoms can be caused by several conditions and in many cases won’t be caused by cancer but it’s a good idea to get them checked out.
If your GP thinks you need to have some tests, they can refer you to a hospital specialist.

-The exact cause of oesophageal cancer is unknown, but the following things can increase your risk:
- persistent gastro-oesophageal reflux disease (GORD) 
- smoking 
- drinking too much alcohol over a long period of time 
- being overweight or obese 
- having an unhealthy diet that’s low in fruit and vegetables 

-If oesophageal cancer is diagnosed at an early stage, it may be possible to cure it with:
- surgery to remove the affected section of oesophagus 
- chemotherapy, with or without radiotherapy (chemoradiation), to kill the cancerous cells and shrink the tumour 

-If oesophageal cancer is diagnosed at a later stage, a cure may not be achievable. But in these cases, surgery, chemotherapy and radiotherapy can be used to help keep the cancer under control and relieve any symptoms you have.