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http://www.abc.net.au/pm/content/2013/s3868736.htm
Genetic breakthrough in oesophageal cancer research
Lucy Carter reported this story on Monday, October 14, 2013 18:18:00
PETER LLOYD: New Australian-led research is linking a certain type of heartburn to oesophageal cancer.
It's a small breakthrough in combating a stubbornly fatal disease whose incidence is on the rise.
Hope for a treatment lies in the idea that it may be possible to switch off problem causing genes that cause both oesophageal cancer and a particular type of acid reflux.
Lucy Carter.
LUCY CARTER: Oesophageal cancer is Australia's fastest rising cancer type and one of the hardest to treat.
David Watson, an oesophageal cancer expert and professor of surgery at Flinders University, says the disease is not as common as breast or bowel cancer, but it is more deadly.
DAVID WATSON: Well it tends to present late. It affects the oesophagus, which is an organ deeply located within the chest, and it's hard to get to. And by the time it actually causes any symptoms, it has to have grown to the point where it's starting to block the oesophagus. And when it's grown to that point it's already been there for a year or two, and it's at an advanced stage.
LUCY CARTER: Today, an international team has revealed new research which shows that some people may have a predisposition to the cancer.
Led by Australian Professor David Whiteman, from the QIMR Berghofer Medical Research Institute in Brisbane, the team identified four genetic variants associated with an increased risk of oesophageal cancer and its precursor, a reflux condition called Barrett's Oesophagus.
DAVID WHITEMAN: We had thought that there was probably some sort of genetic susceptibility underlying these conditions. But this is the first time we've been able to use high throughput genotyping to show clearly that there are a number of genes that significantly increase a person's risk of these cancers.
LUCY CARTER: Professor Whiteman says it's hoped this breakthrough could lead to a way to screen people for the high risk genes.
DAVID WHITEMAN: The immediate benefits will be some way off. I mean, what this has done, though, is given us some targets to now focus our attention on. Previously we didn't know where to look in the genome for the genes that convey risk of this cancer.
So now we have three targets, and we can now focus on understanding how those genes work to cause oesophageal cancer. We can try and work out ways in which their actions might be blocked or channelled into, you know, more useful exercises. We may even be able to find drugs in the future that can stop these genes from having a bad effect.
LUCY CARTER: But as with most cancers, it doesn't all come down to genetic predisposition.
Professor David Whiteman says lifestyle risk factors more commonly lead to oesophageal cancer.
DAVID WHITEMAN: The risk is quite small just if you have those three genes. And, in fact, we do know from our other research that there are much stronger risk factors out there in the environment, such as smoking, being overweight or obese, or having acid reflux.
LUCY CARTER: Being born a man is also a significant risk factor. Men are up to eight times more likely to develop the disease; something researchers can't explain.
Professor David Watson from Flinders University says it may be due to links with other risk factors.
DAVID WATSON: Men are probably more likely to get more severe gastro-oesophageal reflux, but also there is the pattern of obesity in men is different to the pattern of obesity in women. So when women get too much fat on board, they gain weight predominately in areas like the hips, the legs, the arms, and the breasts, and less so around the organs inside the abdomen, whereas men tend to put their fat on internally, particularly around the organs inside the abdomen.
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