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Understanding the link between reflux and cancer can save lives

Hoag Memorial Hospital Presbyterian
Conditions
April 30, 2021
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People who find themselves reaching for antacid several times a month, might consider reaching out to their doctor instead.

Gastroesophageal reflux disease (GERD), the same condition that causes heartburn, is also linked to a deadly form of esophageal cancer, adenocarcinoma. Lack of awareness about the link between reflux and cancer has contributed to a 733 percent increase in adenocarcinoma in the last 30 years. That’s not a typo. Adenocarcinoma of the esophagus is the fastest rising type of cancer.

While genetics plays a significant role in the development of esophageal cancer – and not everyone with reflux will develop a more serious disease – it is important for people who experience frequent heartburn and other reflux-related issues to be aware of their risk.

If the lower valve of the esophagus weakens or if the stomach becomes herniated, reflux can occur, leading to caustic digestive enzymes washing up from the stomach into the esophagus. Stomach acids cause heartburn, and antacids help neutralize them. But over-the-counter medications don’t stop the stomach’s other enzymes, such as bile, from damaging the esophagus.

Over time, this damage can lead to a condition called Barrett’s esophagus, which is a precursor to cancer. If caught early, esophageal cancer is highly treatable. Unfortunately, people don’t think to see their doctor for heartburn or difficulty swallowing. As a result, most esophageal cancer is detected at a late stage, with an overall survival of 20 to 30 percent.

The more people understand their risk, the more likely they are to seek help early. Anyone who has had reflux for a few years or who has regular issues with food “sticking” in their mid or lower chest, should consider asking their doctor about an upper endoscopy, which can reveal any alarming damage to the esophagus or the diaphragm.

To stop reflux and prevent esophageal cancer, skilled surgeons can repair damaged valves or herniated stomachs. This can help keep cancer at bay, but it is important to seek out surgeons and specialists who offer minimally invasive surgeries for this type of procedure. Outcomes at Hoag, for instance, which has one of the highest volumes of robotic-assisted and minimally invasive esophageal surgeries on the West Coast, surpasses even the most respected academic institutions.

Centers of Excellence, such as Hoag’s, can also connect patients to the many medication and surgical breakthroughs of the last few years that are giving patients new hope. The FDA recently approved the use of immunotherapy for the treatment of esophageal cancer, for example, and the results are proving more effective than traditional chemotherapy.

All of these highly skilled experts and cutting-edge treatments are at the ready, but I realize that they are not as fast to access as a bottle of Nexium. That is the challenge that my colleagues and I hope to overcome by educating people about their risk.

So, if you find yourself experiencing heartburn several times a week, please put down the bottle of antacid and pick up the phone to call your doctor.

John Lipham is a general surgeon, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.

Image credit: Shutterstock.com

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Understanding the link between reflux and cancer can save lives
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