A few weeks ago, I attended a wedding and sat next to a man who told me all about his issues with Barrett’s esophagus. Barrett’s esophagus, which can lead to cancer is a change in the lining cells of the lower esophagus. It is usually caused by constant acid reflux from the stomach.
He was getting frequent endoscopies, which means that his doctor was looking down his throat at his esophagus to make sure he didn’t develop a cancer in his esophagus. As you may know (and I have written about this) cancer of the esophagus is a terrible disease. It is generally incurable and kills people by starving them. That is why he was getting these procedures. Hopefully if a cancer does arise and is detected early, he may be curable.
He had been dealing with gastric acid reflux into his esophagus (heartburn) for several years and ended up with a diagnosis of Barrett’s a few years ago. Since then he had been on treatment with drugs to block his acid production and reflux. But, he was terribly worried about developing esophageal cancer – and rightly so.
It is well established that Barrett’s esophagus can turn into cancer. But it hasn’t been clear how often this happens. Now doctors from Northern Ireland have published a study that could tell my wedding dinner partner his risk of developing esophageal cancer. It turns out that Northern Ireland has great statistics on Barrett’s esophagus. Every patient diagnosed with this problem is placed into a registry and followed.
There were 8500 patients in this study who were carefully watched for many years. After an average of about 7 years, 79 patients had been diagnosed with esophageal cancer. This is much less than we have thought. Most doctors thought the number would be much higher. The investigators estimated that the rate of development of cancer in the patients was a little less than one in five hundred every year.
This all means that if you have Barrett’s esophagus, your chance of developing cancer of the esophagus in 10 years is about one in fifty. Now this is still a high number but it isn’t as bad as the death sentence most people thought about Barrett’s esophagus. It may be that the newest drugs to treat acid reflux may make a difference. There is no way of knowing and I doubt anyone could put together a study of this.
Bottom line: It is better not to have Barrett’s esophagus but it clearly isn’t a death sentence; perhaps aggressive treatment to prevent acid reflux may help.
Subscribe to:
Post Comments (Atom)
8 comments:
This study from Ireland exploring the correlations between Barrett's esophagus and cancer is interesting. Thanks for the post.
Dear Dr. Herman Kattlove,
It’s a great pleasure to read your blog. I find your post very informative. First hand observations can be very helpful to many. Relevant studies not only lead to a better treatment but to a more efficient one as well.
As a reader, I consider your writing to be a great example of a quality and globally competitive output. It would be a great thrill and honor if you could share your genuine ideas and knowledge to our community, Physician Nexus. With this you can gain 1000 physician readers from over 62 countries on Nexus.
We would love for you to visit our community. It's free, takes seconds, and is designed for physicians only - completely free of industry bias and commercial interests.
Best,
Ruby Abarcas
On behalf of the Physician Nexus Team
www.PhysicianNexus.com
My dad has recently had a PET scan done and they found something on his lymph nodes in his lungs and something on his pancreas. Because of his age, 83, and other health issues they don't want to do any type of biopsy on him. The Dr's say it is too much for him. They are saying it is cancer but suspicious. If it is pancreatic cancer what should I look for. I am his primary care taker. Any help would be appreciated. Sandi
My Dad has recently had a PET scan that showed he has something suspicious on his lymph nodes in his lungs and something on his Pancreas. Because of his age 83 they don't want to do any type of biopsy on him. He has alot of other health issues going on. What type of things should I look for? I am his primary care taker and feel so bad for him. Anything you can help me with I would appreciate. Sandra
I would pay attention to his eating and weight. Weight loss is often a sign of a problem. Also, naturally any pain should be investigated if it is new.
I have had an endoscopy a few years ago due to bad reflux...I did not have Barretts, but is it something i could still develop it? My brother in law currently has esophagial cancer and i am scared.
This week's New England Journal, October 13, 2011, carries an article from Denmark that confirms the findings of the Irish group. The risk of cancer in people with Barrett's esophagus is not as high as previously thought. The Danish numbers were almost identical to those I quoted from Ireland.
I was just diagnosed with Barret's and my dad has esophagus cancer stage 2.... any correlation here!
Post a Comment