WHEN doctors in Scotland needed people to eat fish and chips to assist cancer research, there was no shortage of volunteers.

 

Now the same team at the Western Infirmary, in Glasgow, is seeking assistance to investigate another intriguing medical phenomenon - only this time recruits will be served a Waitrose ready-meal.

It is hoped the study will throw light on why rising numbers of people in Scotland and other western countries are developing a deadly oesophagus cancer, at a time when cases of stomach cancer have fallen dramatically.

Scotland has the highest rate of oesophagus cancer in the world, according to the latest research. Almost eight people in every 100,000 will develop the disease each year. In 2012, 887 people were diagnosed with the illness north of the Border, compared to 598 in 1988.

Professor Kenneth McColl, consultant gastroenterologist for NHS Greater Glasgow & Clyde, said: "The oesophagus cancer we are looking at is known to be due to gastric acid refluxing from the stomach up into the oesophagus - which gives the symptoms of heartburn.

"The big questions is, why is this cancer increasing so much? We think the reflux is also increasing and so the question is why is the reflux and the associated cancer increasing?"

The first study, when volunteers ate fish and chips while their digestive system was monitored, investigated whether obesity around the waistline was causing more heartburn and increasing risk of the disease.

Professor McColl said while a link was identified, it could only explain part of the story.

He said: "The odd thing is that while oesophageal cancer has been rising markedly, stomach cancer has been simultaneously falling to a similar extent. They have mirrored one another. This is particularly unusual because the two cancers are in almost the same place.

"The other odd thing is the two cancers under a microscope look identical."

The main cause of stomach cancer is a bacterium called helicobacter pylorai which used to be present in the stomach of most people. It can cause inflammation of the lining of the stomach and ulcers, but Professor McColl said it is also known that the damage it leaves reduces the ability of the stomach to produce acid.

As helicobacter pylorai has become less common, perhaps as improvements in living conditions and personal hygiene have prevented its spread, fewer people have developed stomach cancer. But the team at the Western Infirmary want to explore if it has potentially exposed more people to oesophagus cancer instead.

They are seeking 100 healthy volunteers over the age of 55 to participate in a study which looks at the impact of the bacteria on stomach acidity. Recruits will be given a breath test to find out if they are carrying the bug. Small biopsies will be taken and the acidity in their stomach will be measured before, after and during a meal.

This time spaghetti bolognaise from Waitrose has been chosen as the dish.

Dr David Mitchell, research fellow, said this menu has replaced the take-away because the chippy was not always frying at the right time. Some patients had also said the portion was too large and the researchers need the portion size to be the same for every test.

The volunteers, who are being offered £125 plus expenses for participating, have to eat with tubes inserted down their nose. Computer screens continuously display the acid levels in their stomach and show what happens as they swallow.

Shirley Hollis, 45 from Cadder, has already eaten a chip supper, macaroni cheese and a cheese sandwich in the name of medical research.

One of the 20 who have participated in this latest study, she said: "I have always done research. If there is no-one willing to do research, they cannot move forward."

Professor McColl said: "Only by having an understanding of what is causing oesophagus cancer, and the rise in it, can you have an impact in preventing it."

Anyone who is interested in finding out more about taking part in the study should call 0141 2113248 or email dmitchell3@nhs.net.