Beijing, February 25 (Xinhuanet) -- "Esophageal cancer is a high incidence of gastrointestinal tumors in the mainland, and with the continuous progress of drug research and development, immunotherapy has brought new hope to patients with esophageal cancer." Recently, Xu Jianping, deputy chief physician of the Department of Internal Medicine of the Cancer Hospital of the Chinese Academy of Medical Sciences, was a guest of Xinhua Net's "Health Science Popularization" column. She said that a variety of factors are easy to induce esophageal cancer, vigilance against gluttony "disease from the mouth", when the body sends an early warning signal, it is necessary to seek medical treatment in time, early detection and early treatment will achieve good treatment results, and will not affect the normal life in the future.
Xu Jianping (left), deputy chief physician of the Department of Internal Medicine of the Cancer Hospital of the Chinese Academy of Medical Sciences, visited Xinhua Net
A variety of factors can easily induce esophageal cancer Experts remind that the diet is moderate and too late
Xinhua Net: Statistics show that half of the world's esophageal cancer patients are in China. Why does esophageal cancer "prefer" Chinese?
Xu Jianping: Esophageal cancer is a high incidence of gastrointestinal tumors in the mainland, and the data shows that in 2020, the number of esophageal cancer patients in China is about 324,000, the number of deaths is about 301,000, and the number of cases and deaths accounts for more than half of the world. From the numbers is still quite shocking, this is because there are many factors that induce esophageal cancer, such as unhealthy lifestyle, long-term consumption of pickled foods with high nitrite content, often like to eat hot, spicy food, etc., there are many young and elderly friends have long-term smoking, alcoholism and other bad habits, if not changed, it may lead to the occurrence of esophageal cancer. In addition, there are some other factors, such as genetic factors, family members have a history of esophageal cancer that needs more attention, it is recommended that other members if they are over 35 years old, they should have regular physical examinations every year, especially for esophageal problems, such as some symptoms such as poor eating, to see a doctor in time. At the same time, in daily life, try to avoid some risk factors in the diet.
Therefore, good living habits are the first step towards health, so that everything is measured and too late. For example, pickled food, spicy food, fried food is not not to eat, but to be moderate, be wary of gluttony "disease from the mouth".
Be vigilant against the "early warning signals" of the body to achieve early detection and early treatment
Xinhua Net: For esophageal cancer, how can we achieve early detection, early diagnosis and early treatment?
Xu Jianping: In the clinic, most patients are already in advanced stages when they come to the clinic, which is due to the fact that the early signs of esophageal cancer are not very obvious, such as fatigue, chest and abdomen discomfort, swallowing difficulties, etc. Many people may not care much when symptoms appear in the early stage, do not see the doctor in time, and miss the best treatment time. Here, we also remind everyone that when there are early warning signs such as fatigue fever and slight difficulty in swallowing in daily life, it is necessary to seek medical treatment in time.
In addition, many friends, especially those who do not understand this disease, will have a fear psychology, and even if there is some discomfort in the body, they dare not face it and dare not go to the examination. In fact, early detection and early treatment will achieve good treatment results, and the future will not affect everyone's normal life.
Xinhua Net: If you are unfortunate enough to be diagnosed with esophageal cancer, what are the current treatment methods?
Xu Jianping: The treatment method generally has two major aspects: local treatment and systemic treatment. Local treatment is first of all a surgical radical treatment method, for early solid tumors, including esophageal cancer, if you can detect early radical resection early, you can achieve the purpose of cure. Secondly, topical treatment includes radiation therapy, interventional therapy, radiofrequency, etc. Systemic therapy includes chemotherapy, targeted therapy, immunotherapy, etc.
In addition to the treatment of Western medicine, I also hope that everyone will pay attention to the treatment of traditional Chinese medicine, the word "cancer" has existed as early as the oracle bones of the mainland, so such a disease is not a modern society, but a disease that has existed for a long time. Our ancestors have also accumulated a lot of experience in the treatment of tumors in traditional Chinese medicine, so when treating tumors, we also advocate the combination of traditional Chinese medicine and Western medicine.
Xu Jianping, deputy chief physician of the Department of Internal Medicine, Cancer Hospital, Chinese Academy of Medical Sciences
Immunotherapy brings new hope to patients with esophageal cancer
Xinhua Net: Among the domestic PD-1 drugs, carellizumab is representative. At present, what are the latest and most cutting-edge research results on carellizumab?
Xu Jianping: From a historical point of view, the traditional treatment method is chemotherapy, and many friends have a fear of chemotherapy, such as causing hair loss, vomiting and a series of other problems. With the development of the times and the continuous progress of drug research and development, internal medicine treatment, including chemotherapy, can play a very good role in tumor control. The emergence of targeted therapy has made the treatment of tumors more accurate, and the control of tumors has taken a big step forward. In the later stage, there was a discussion of the more popular treatment method - immunotherapy. Traditional immunotherapy is also familiar to everyone, such as interleukin, interferon and other drugs that enhance immune function, the previous application of immunotherapy is to try to improve the body's immune function, to fight disease, but if you want to achieve a sufficient therapeutic dose, such as interleukin, interferon these drugs may appear high fever, pulmonary edema response, the emergence of these conditions, but also restrict its clinical development. By changing the train of thought, the vast majority of tumor patients are in the state of immunosuppression, we can lift its inhibition state, can make its own immune function, that is, the defense system play a role in killing tumors, so as to develop the immune checkpoint inhibitor PD-1/ PD-L1.
In recent years, immunotherapy has made rapid progress in most solid tumors, especially in esophageal cancer, through a series of clinical studies, in just a few years, immunotherapy in esophageal cancer from back-line treatment to second-line treatment, first-line treatment.
At present, patients with esophageal cancer have achieved eye-catching results on the basis of traditional chemotherapy plus immunotherapy.
Xinhua Net: In the clinic, what are some of the more impressive cases you can share?
Xu Jianping: There is one patient who really impressed me, this patient was already in the advanced stage of esophageal cancer when he came to the doctor, and even had subcutaneous metastasis. In the case of this patient, if the traditional treatment methods are followed, his survival period is about one year. Relying on the Carellizumab study, we have seen that Pd-1 combined with chemotherapy can achieve survival in patients with advanced esophageal cancer to more than 15 months. We applied immunocommune chemotherapy for patients, so that the doctor was excited that after only two cycles, the tumor was completely disappeared from the film, although in the past it was subcutaneous metastasis, but after two cycles of immune combination chemotherapy, when the tumor completely disappeared, we further considered the primary esophageal cancer to be removed, after the diagnosis of pathological cytology, there was still no malignant cancer cells found, and the result was very exciting. After such a miracle appeared, we continued to conduct research in this area, and more clinical cases also consolidated the efficacy of such an immunocomposed chemotherapy in esophageal cancer.
In addition, while we focus on drugs, we also pay attention to the adverse events of drugs. Immunotherapy is characterized by mobilizing its own T cells to kill tumors according to its own immune cells, so it will not cause very serious bone marrow suppression and digestive tract reactions.
Xinhua Net: At present, what is the burden on patients with drugs for the treatment of esophageal cancer? Have you ever clinically encountered patients whose treatment was delayed due to financial problems?
Xu Jianping: This disease, whether mental or economic, can bring great burden and pressure to patients and families. When the immune checkpoint inhibitor was just developed and listed, the annual cost would exceed one million, and indeed the vast majority of families could not afford the number, so it was very fortunate that our domestic national enterprises, especially the carried out by Hengrui research and development of carriizumab, after the price reduction through medical insurance, now a cost of only more than 2,000 yuan, greatly reducing the pressure on the economy of the masses.
Our national pharmaceutical enterprises have made indispensable contributions in this regard, and at the same time, our state and the medical insurance bureau have also made great efforts in this regard, demonstrating the mainland's concern and love for the masses.
Patients need to be regularly reviewed during the recovery period and communicate with the doctor in time if they are unwell
Xinhua Net: For patients who have adopted immunotherapy, what do you need to say?
Xu Jianping: It should be said that the medicine is three points of poison, I hope that patients and friends in the treatment, to actively cooperate with the clinician, have any physical discomfort, must communicate with the doctor in time, and at the same time to ensure regular review of the hospital.
Now due to some special reasons of the epidemic, sometimes patients may be inconvenient to come to the hospital, but most hospitals have carried out Internet consultation, and patients can communicate with the doctor in charge at any time through the Internet platform.
Because although immunotherapy is an effective method, sometimes once the immune storm is set off, it will also cause a series of attacks on the body, and the patient does not expect adverse events of the drug, so he cannot evaluate whether such a serious consequence will be caused. It is hoped that the majority of patients will communicate with the doctor in charge in time during the treatment period, whether it is face-to-face consultation or Internet communication, regular review is still very important.