Eat cancer runs in families

Health Aargau - Esophageal cancer is often curable when detected early

Esophageal cancer is often curable when detected early

Esophageal cancer is associated with existential fears for those affected. But Mr. Maier can eat again without worries.

At that time he put the decreased appetite on the emotional burden. "About a year ago I accompanied my mother in the process of dying and thought that my symptoms had psychosomatic causes," says the 65-year-old, who wants to remain anonymous. Let's call him Mr. Maier. “Looking back, of course, I see approaches that manifested themselves much earlier,” he says, “such as difficulty swallowing or reflux, the backflow of stomach acid into the esophagus. But I didn't pay any further attention to it. " But over time, eating became more and more problematic. "I felt more and more resistance when swallowing and subsequently ate less and less." Maier has lost 25 kilograms within six months. “I couldn't look at myself in the mirror anymore. I was a rattle, I lost a lot of muscle in addition to the fat. "

The doctors persisted
Maier finally went to the family doctor; he immediately referred him to a nearby regional hospital. There the doctors did an endoscopy and discovered a foreign body at the lower end of the esophagus, right in front of the stomach entrance. Cancer? During the biopsy, the doctors only diagnosed healthy mucous membrane. “The whole family was relieved. We had a party, ”Maier remembers. But then the doctors ordered another examination. As a rule, growths localized in this way are malignant tumors. But the second biopsy did not confirm the suspicion either. The Maier family breathed a second time. And a third time after the third biopsy. «The emotional ups and downs were very stressful. The back and forth made us extremely insecure, ”says Maier. And the doctors did not give up. They sent their patients to the visceral oncological center of the Aarau Cantonal Hospital (KSA), where its director, Mark Hartel, took care of him. The proven expert with many years of experience at large clinics in Germany shared the suspicions of his colleagues. But even a fourth gastroscopy with biopsy in the KSA did not reveal any cancer cells; and there were also none in the lymph glands, where offshoots are traditionally the first to form. "I suspected a malignant, but thickly encapsulated and therefore hardly metastatic tumor, as it is rarely described worldwide," explains Hartel. He recommended surgical removal of the suspected tumor, which would, however, involve removal of the stomach and lower esophagus. “I was very skeptical,” says Maier. "A life without a stomach - you can't even imagine that!" But after long discussions with family members and Hartel, Maier decided to have the operation - there was hardly anything else he could do: "In the end I couldn't even drink." He did everything to ensure that he entered the operating theater as vigorously as possible, says Maier and emphasizes: “I knew for myself from the start that this was not the end. I was ready to do everything I could to get well again as quickly as possible. And with the decision to have surgery, I also expressed my full confidence in Professor Hartel. I think he noticed that too. "

"Trust is extremely important"
Yes, he did, says Hartel and emphasizes how important the relationship of trust is for both sides: “If the patient does not trust the doctor or the treatment, questions everything, is always skeptical and negative, then a doctor can do the same sometimes make mistakes that he would otherwise never make. “Maier was a critical patient, and that was justified. "But I was able to talk to him openly and he did not ignore logical arguments." A relationship of trust soon developed. "It was important to the patient that we had a step-by-step plan and only did what was absolutely necessary," continues Hartel. In the standard operation, he would have opened the abdomen and chest cavity and completely removed the esophagus and stomach. “We agreed to see whether the tumor could be reached and removed from the abdomen. This is only possible if we can be certain during the operation that the tumor is actually a rare, non-metastatic tumor. And that we deposited it in healthy tissue. " This was only feasible because there is an institute for pathology in the hospital, where the tissue samples were examined immediately. The analysis confirmed Hartel's suspicions and showed that he had completely removed the tumor. He reconstructed the received esophagus and stomach with the small intestine. The operation lasted around four hours and the tumor measured 3.5 centimeters.

Take complaints seriously
“Today I can eat almost normally again,” says Maier happily, “that is unbelievable. “For a month now, the weight has also been stable at 71 kilograms. But it took a lot of time and even more patience. After the operation, he initially lost another five kilograms. “I had to struggle with that enormously,” says Maier. That is normal, ”says Hartel, the small intestine must first get used to its new task. "It takes the body up to a year for everything to stabilize and normalize again." Maier is considered to be cured of the tumor. There is little risk that such a tumor will reappear in another location, according to Hartel. "But it would grow extremely slowly and this time the patient would react faster and allow himself to be examined." And that is crucial: "If detected early, esophageal cancer can be cured, even the classic aggressive form." It is therefore extremely important to face the problem early and to take signs such as swallowing disorders, weight loss, pain or bleeding seriously and to have them clarified. Complex cases, according to Hartel, belong to the experienced specialist in a center where all-round care is guaranteed.

The Aarau cancer specialists

The KSA now has six tumor treatment centers that are fully certified by the German Cancer Society. This means that the Oncology Center Mittelland continues to be one of the four largest certified cancer treatment centers in Switzerland.
The Oncology Center Mittelland (OZM) operated by the Aarau Cantonal Hospital is advancing the certification process for its tumor treatment offerings. The skin cancer center, the uro-oncological tumor center and the dysplasia center (preliminary stage of cervical cancer) were audited by the German Cancer Society (DKG) in autumn 2017. Full certification for the treatment of pancreatic cancer ("pancreatic carcinoma") also took place in autumn 2017. In addition, the breast cancer center, which is run together with the Olten Cantonal Hospital, has been recertified by the German Cancer Society and the European certification company Eusoma (European Society of Breast Cancer Specialists). This means that six OZM tumor treatment centers now have full certification.

These are:
Breast cancer center, gynecological cancer center (uterus, cervix, ovaries, vagina and labia) and dysplasia center, visceral oncological center (intestine, pancreas), skin cancer center, leukemia and lymphoma center, prostate cancer and uro-oncological tumor center (testicles, penis, kidneys),
"With the full certification of a total of six tumor centers with a broad range of treatments, the oncology center of the Aarau Cantonal Hospital remains one of the four largest certified cancer treatment centers in Switzerland," emphasizes Prof. Dr. Christoph Mamot, chairman of the OZM. Only the Inselspital Bern (12 tumor centers), the University Hospital Zurich (8) and the Cantonal Hospital Lucerne (7) have more certifications in this area. And the OZM should continue to grow: "We are working flat out to obtain certifications for further tumor treatments," says head Dr. Martha Kaeslin and explains: "The certifications guarantee the highest possible quality standards in the treatment of cancer, in particular consistent patient treatment paths and processes, high case numbers and the associated experienced doctors and nurses as well as an interdisciplinary network of specialist experts."