“Meat. That’s what I miss most.”
My friend’s dad was diagnosed with oesophageal cancer two years ago. The tumour was large, but thankfully hadn’t spread and was successfully removed by the surgeon… along with most of his oesophagus, the pipe that takes food from your mouth to your stomach. The surgeons had to pull up his stomach and connect it to the lower section of his throat. This essentially left him without a stomach and unable to process hard-to-digest foods. He’s now only able to eat simple carbohydrates and liquid foods such as yogurt. No more summer barbeques. No more Christmas turkey. No more meat.
As I sit at my kitchen table tucking into a bacon sandwich, it’s a prospect I can’t quite comprehend. Over 400,000 people globally were diagnosed with oesophageal cancer last year, and many more who would have received similarly debilitating surgery due to physical injury or trauma, face the rest of their lives unable to enjoy some of life’s simplest pleasures.
But science might have found a way to help. There have been great advances in the field of regenerative medicine in recent years, where human tissue and organs are replaced, engineered or regenerated to restore normal function. Researchers around the world have been working to hone our ability to regrow many different tissues in the body and have begun to see some success. Replacement oesophagi have been successfully regrown in animals and in people, but attempts have involved unique equipment and specific surgical expertise that would not be possible to replicate in most hospitals.
Now, surgeons at the Medical College of Wisconsin think they have found a way to make this procedure more widely available. Using an unlikely mixture of donated human skin, wire mesh tubes and the patient’s own blood, they were able to connect the lower segment of a patient’s throat to the stomach, regrowing the full length of the oesophagus.
These “off-the-shelf”, readily available materials are used every day in medical practice. The main structure of the new oesophagus came from a commercial product called AlloDerm, which is created by removing the cells from donated human skin, leaving behind the fibres that hold skin cells together. This biological scaffold acts as a trellis on which new cells and blood vessels can grow, and is already used in breast reconstruction for a similar purpose. For extra support, the surgeons also incorporated wire mesh tubing, known as a ‘stent’.
During surgery, the biological scaffold and stent were inserted into the wound, re-joining the stomach and the throat. Surrounding muscle was placed around the scaffold, and the surgeons sprayed on a gel containing the patient’s own platelets – blood cells that encourage healing and regrowth by producing chemicals called growth factors.
The metal stent was eventually removed, revealing a natural looking, fully functioning, regenerated oesophagus. The patient – who had his oesophagus removed after a car crash at only 24 years old – could eat normally and maintained a healthy weight, even four years after surgery.
It’s too late to help my friend’s dad and it may be some time before the procedure has been tested in clinical trials and available to patients. But this study, published in medical journal The Lancet, and others like it, could spare patients the life-altering side effects of surgery and fill their futures with their favourite foods.
Dua K.S., Hogan W.J., Aadam A.A., Gasparri M. Lancet. 2016 Jul 2;388(10039):55-61