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Heartburn or reflux may seem normal, but frequently suffering from either can be warning signs of esophageal cancer.
This cancer of the long tube that runs from the throat to the stomach can be rather rare: esophageal cancer accounts for just 1% of cancer diagnosed each year in the U.S., but the survival rate is grim with about 88% of cases resulting in death. Researchers are working to improve early detection of esophageal cancers and increase the patients鈥� chances of successful treatment, said , Director of Esophageal Surgery at .
There are several factors than can lead to esophageal cancer. The No. 1 cause of it in the U.S. is reflux 鈥� which is commonly associated with unhealthy diet and obesity, Dr. Khaitan said. The stomach typically produces 1.5 liters of gastric acid to digest food, and occasionally the acid may move from the stomach to the esophagus, which causes irritation, inflammation and pain.
鈥淲hen reflux is left untreated, it bathes the esophagus in acidic juice. And although the stomach is resistant to acid, the esophagus is not,鈥� Dr. Khaitan said. 鈥淭his uncontrolled reflux and constant inflammation of the esophagus then becomes a gateway to reflux esophagitis and esophageal cancer.鈥�
While reflux is not a definite sign of cancer, leaving it untreated can cause serious health issues.
鈥淭he more vigilant and aggressive we are about treating reflux, the more malignancies we can avoid,鈥� Dr. Khaitan said.
Adenocarcinoma is the most common type of esophageal cancer in the U.S. Adenocarcinoma is associated with genetic markers, and strong research is underway to refine that science, Dr. Khaitan said.
Squamous cell carcinoma is another type of esophageal cancer. It is more commonly associated with tobacco consumption. Squamous cell carcinoma can also occur due to frequent consumption of hot beverages that can burn the inner lining of the esophagus, as well as cured and pickled foods.
Another risk factor for esophageal cancer is achalasia, which occurs when the contents of the esophagus fail to empty into the stomach due to a muscular defect where the lower esophageal sphincter fails to relax.
鈥淭he esophagus is not meant to contain food for long periods鈥攊f food becomes lodged there, inflammation and fermentation can occur,鈥� Dr. Khaitan said. 鈥淭his can indeed foster the development of cancer.鈥�
And consumption of chemicals can lead to esophageal cancer, too. Swallowing household chemicals can lead to burns that predispose people to develop cancer down the line. That鈥檚 why it鈥檚 so vital to keep those dangerous chemicals away from children who could accidentally ingest them.
When heartburn hits, many people reach for over-the-counter remedies such as Tums or Maalox. While they may provide temporary relief, they are not a solution to the long-term problem, Dr. Khaitan said. Prescription drugs can help reduce stomach acid production at the cellular level. Also, there is a surgical fix where the stomach is brought down into the abdomen from the chest and the lower esophageal sphincter is reconstructed.
鈥淚f you experience heartburn more than twice a week, or if it persists over weeks or months, consult your healthcare professional,鈥� Dr. Khaitan said. 鈥淭his condition is often easily treatable by a physician, so don鈥檛 risk trying to manage it long-term on your own.鈥�
Monitoring symptoms and an endoscopy help with the diagnosis of esophageal cancer. An endoscopy is a procedure where a camera goes down a patient鈥檚 food pipe so it can examine the esophagus and stomach, Dr. Khaitan said.
Medication or surgery can often treat some pre-cancerous conditions, Dr. Khaitan said.
鈥淲ith surgery, we can often correct precancerous problems like reflux and achalasia. In a very limited number of cases, squamous cell cancer鈥攚hen discovered early鈥攎ay even respond well to radiation and chemotherapy, with no need for surgery,鈥� Dr. Khaitan said. 鈥淚n some cases, minimally invasive surgery鈥攃alled endoscopic resection鈥攐f the esophagus is possible, depending on the patient鈥檚 overall health and the stage of the disease.鈥�
Most esophageal cancers require the removal of part or the majority of the esophagus. This tactic often includes the use of chemotherapy and radiation. After removing the esophagus, it鈥檚 important to reestablish GI continuity, Dr. Khaitan said. That often means reconstruction using the stomach to pull it up in the chest.
There are some times when the esophagus may need to be removed. In those cases, there are serious lifestyle challenges such as a feeding tube for at least the first few months after surgery. Also, patients can鈥檛 eat larger meals because the stomach can no longer store and process as much food.
鈥淐learly, esophageal surgeries are life-changing events and not without potential complications鈥攁ll reasons why it鈥檚 vital to help prevent this cancer from occurring and to recognize early signs,鈥� Dr. Khaitan said.
She recommends patients take steps to reduce their risk. That includes quitting smoking, consuming alcohol in moderation, keeping weight under control, and consulting a physician if long-standing GI issues such as heartburn, indigestion, diarrhea or constipation are present.
鈥淥ur Lung & Esophageal Center team provides comprehensive care for patients with the full range of benign and malignant thoracic conditions, with a focus on diagnostics and surgical treatments,鈥� Dr. Khaitan said. 鈥淲e also work closely with other specialists鈥攄ietitians, social workers, rehabilitative experts鈥攖o help each patient maintain the best possible quality of life, as they manage or recuperate from aspects of this difficult disease.鈥�
Read more from Dr. Khaitan in a blog post on .
