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ESOFINAL

Recent publication by International Agency for Research of cancer (IARC) has included consumption of hot beverages as the ‘probable cause’ of Esophageal cancer. To quote..

“…The Working Group noted that the epidemiological evidence for very hot beverages and human cancer has strengthened over time, with positive associations and trends in studies that considered qualitative gradations of temperature. Additionally, new studies in experimental animals show that hot water above 65°C can act as a tumour promoter. Although the mechanistic and other relevant evidence for very hot beverages is scant, biological plausibility exists for an association between very hot beverages and cell injury and the 10 sequelae that might lead to cancer. On the basis of these considerations and on the totality of the evidence, drinking very hot beverages at above 65°C was classified as “probably carcinogenic to humans” (Group 2A).”…..

Cancer of esophagus, the food pipe between stomach and throat is a common one, representing about 10 % of all cancers in the world. Each year about 4.5 lakh new patients are diagnosed in the world. In India about 50000 patients are diagnosed with this cancer. Males are predominantly affected than females (70: 30). Common causes are

• tobacco consumption,
• alcohol,
• Acid and bile reflux
• Certain food articles such as red and processed meat
• Consumption of less fruits and vegetables
• Obesity
• Exposure to corrosive agents, lye present in house cleaning agents, dry cleaning agents
• Human papilloma virus infection
• Conditions such as achalasia, Plummer Vincent syndrome

To this list is now added : consumption of ‘HOT’ beverages. The temperatures and frequency of consumption have not been defined but it is observed that scalding temperatures (above 60-70 degrees Celsius) predisposes one to esophageal cancer. It is recognized as the probable cause of esophageal cancer by WHO based on the several studies done in the past.

An Iranian study (2009) indicated that those who drink very hot beverages are eight times more prone and those who take hot beverages are two times more prone to esophageal cancers than those who take warm or lukewarm beverages.

It is actually the repeated injury that is caused by the heat in the mucosal lining of the esophagus, similar to reflux of acid or bile that is responsible for the conversion of a normal cell to a cancer cell over many years. During this injury, mutations occur in the genes of the cells.

Dont’s for prevention of esophageal cancers

• Don’t indulge in tobacco
• Don’t consume excessive alcohol
• Avoid red meat and processed meat products
• Don’t eat too much and gain weight
• Don’t hide symptoms of indigestion, difficult in swallowing
• Don’t drink HOT beverages!!

Do’s

• Do consume sufficient fresh vegetables and fruits
• Do discuss your problems if any with a doctor
• Do go for a regular annual through medical check up

Remember : Forty to fifty percent of cancers are the result of lifestyle changes and are thus preventable. here is another example.

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