Anyone suffering from chronic acid reflux could be at risk of developing esophageal cancer. Over 16,000 new esophageal cancer cases are diagnosed each year in the United States. By the time the majority of cases are diagnosed, the cancerous tumors have grown to the point of inoperability. Sadly, the survival rate in these cases is only 10 percent. The best medicine is to raise patient awareness about potential conditions that, if left untreated, could progress into esophageal cancer and encourage them to see their physician about appropriate care.
Most people are now aware that smoking increases the risk of developing esophageal cancer but there are other common contributing risk factors; excessive alcohol consumption; obesity; lye ingestion; and, Gastroesophageal reflux disease (GERD), commonly known as acid reflux or heartburn.
A recent Gallup poll revealed that 44% of adults in the U.S. have heartburn at least once per month and that approximately 30 percent of esophageal cancer cases can be linked to GERD, a condition in which acid (with some pepsin and bile) splashes up from the stomach into the esophagus. These three fluids are potentially dangerous to the sensitive esophageal tissue, as they can inflame and damage the lining of the esophagus, a condition known as esophagitis. Patients may notice this back up as burning (from the acid) and regurgitation (bitter liquid in the back of the throat). Regurgitation of stomach contents into the esophagus and throat causes a range of damaging effects.
Symptoms include chronic cough, a raspy voice, gagging, damage to tooth enamel, worsening of asthma or emphysema, ear infections and sleep disturbances. The damaging effects can even occur without any of the "usual" symptoms of "heartburn" so often patients do not even realize that acid reflux is the underlying cause of their symptoms.
When acid reflux becomes a chronic condition, Barrett's esophagus may develop, a precursor to esophageal cancer. Barrett's esophagus is a condition in which the composition (and even color) of the cells lining the lower esophagus change because of repeated exposures to harsh stomach acids. The repeated injury to the lining of the esophagus causes inflammation, ulcerations and scarring. Though few people with chronic acid reflux actually develop Barrett's esophagus, once it is diagnosed patients should meet with their physician regularly as they are at a greater risk of developing esophageal cancer.
People with severe acid reflux and Barrett's esophagus often require aggressive treatment and prevention methods including medications, other nonsurgical medical procedures such as endoscopic therapies, or even laparoscopic and open surgeries. Often times, swallowing difficulty (known as dysphagia) and other symptoms can be treated if identified early.
Unfortunately, because of the aggressive nature of the disease, the majority of patients who have esophageal cancer are not surgical candidates. In these situations, the primary focus becomes palliative care - providing comfort measures to help maintain quality of life. This may include treating the dysphagia and restoring the patient's ability to swallow food and drink liquids by opening the stricture within the esophagus.
To open the barriers caused by tumors physicians may use an esophageal metal stent. Prior to the stent placement the patient may require dilation of the stricture to allow room for the stent to be positioned, thereby expanding the lumen of the esophagus. Traditionally, the placement of the stent can be a painful process for the patient, though innovative new delivery systems enable accurate deployment and recapturability of the stent. These new procedures also reduces movement of the stent or migrating into the stomach and thus the need for repeat procedures to replace or reposition the stent, one of the more common complications.
According to the ACS, prevention of Barrett's esophagus can begin with controlling GERD by making some simple lifestyle changes:
Raising awareness about the primary pre-cursors to esophageal cancer - acid reflux and Barrett's esophagus - will encourage patients with these conditions to consult their physicians for monitoring the conditions and maintaining treatment options. Better being on guard for the warning signs of esophageal cancer than palliative care.
By Mortin - Copyright 2009
Last modification 31/12/2009
Acid Reflux & Barrett's Esophagus: Warning Signs of Esophageal Cancer - References