Although esophageal cancer is still relatively rare compared to other cancers, there has been a staggering 600% increase in the disease over the last three decades. The number of people diagnosed with esophageal cancer, and the number of deaths from the disease, have increased more rapidly than any other gastrointestinal tumor. Esophageal cancer is one of the most deadly cancers. Only 18% of patients diagnosed live 5 years, as many cases are diagnosed after the disease has spread. The dramatic increase in esophageal cancer has been linked to the increased incidence of GERD (gastroesophageal reflux disease). If you have been diagnosed with GERD, keep reading…
The esophagus is a tube that connects the throat to the stomach. There are two types of esophageal cancer – squamous cell and adenocarcinoma. Squamous cell is normally seen in the middle of the esophagus, and is associated with smoking and alcohol use. Adenocarcinoma typically occurs in the lower esophagus, closer to the stomach, is associated with GERD, and is the more common of the two types of esophageal cancer in the U.S. When individuals have reflux, acid from the stomach enters the esophagus. Over time, the stomach acid changes cells in the lining of the esophagus. This condition is called Barrett’s esophagus. When Barrett’s esophagus is left untreated, the risk of developing esophageal cancer is increased 40-50x. However, if detected early, Barrett’s esophagus can be treated.
Our physicians periodically monitor patients with GERD to watch for the cellular changes of Barrett’s esophagus. Monitoring is done by performing an endoscopy. An endoscopy is a quick, 20 minute procedure. During an endoscopy the physician passes a flexible tube into the patient’s esophagus. He or she takes samples of cells that are studied in the laboratory to determine if there are any abnormalities in the cells. If Barrett’s esophagus is diagnosed, the physician will implement a patient-specific surveillance plan to watch for other cellular changes that could indicate a progression to esophageal cancer.
This formal surveillance is critically important, even if the patient has no symptoms. A lack of symptoms doesn’t mean no damage is occurring. The esophagus may get used to the reflux, and, as a result, discomfort lessens or disappears entirely.
What can you do to limit your risk of developing esophageal cancer?
First, watch your weight. GERD occurs 50% more often in overweight patients.
Second, don’t ignore symptoms of heartburn or reflux. It is important to both treat these symptoms, as well as ensure routine surveillance , to identify damage to your esophagus early.
Third, take medication prescribed by your physician as he or she directs. Do not change the dose, decrease frequency of taking the medication, or stop the medication without consulting your physician. Although you may no longer feel the heartburn or reflux, there may still be a negative effect of stomach acid impacting the cells of your esophagus.
Fourth, watch for symptoms that may indicate a change in your condition. If you experience difficulty swallowing, feel food stuck in your throat or chest, choke on food, have unintentional weight loss, worsening heartburn, coughing, hoarseness, or loss of appetite schedule a visit with your physician.
The bottom line:
• Increased weight may result in GERD
• Reflux from GERD may result in Barrett’s esophagus
• Although rare, Barrett’s esophagus may lead to esophageal cancer
• Esophageal cancer diagnosed at later stages has a high rate of death
But, GERD can be controlled with medication, and both Barrett’s esophagus and esophageal cancer can be detected early with routine monitoring.
Our physicians have many years of combined experience diagnosing and treating GERD and Barrett’s esophagus. We are available to answer questions about your particular situation.