UC HEALTH LINE: Reduce Esophageal Cancer Danger by Knowing Risk Factors

CINCINNATI—As the American obesity epidemic has increased the past two decades, so has the rate of esophageal cancers. Clinician-scientists affiliated with the University of Cincinnati (UC) Cancer Institute say enhanced public awareness about how the disease develops and what can be done to prevent it might help reduce this trend.  

The esophagus is a muscular tube that carries food and liquid from the mouth to the stomach. Among all cancer diagnoses, esophageal cancer is relatively rare—the American Cancer Society estimates that there will be 17,500 new cases diagnosed in the United States in 2012, and more than 15,000 deaths from the disease. 

"Esophageal cancer has a precancerous state (Barrett’s esophagus) that can be identified in advance through endoscopy and addressed to help reduce the risk that cancer will develop,” says Sandra Starnes, MD, a UC Healththoracic surgeon and chief of the thoracic surgery division at the UC College of Medicine. 

Barrett’s esophagus occurs when the lining of the tube is damaged by stomach acid and changes to be more similar to that of the stomach—most often as the result of gastroesophageal reflux, or GERD. 

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), include obesity, pregnancy, smoking and hiatal hernias are primary risk factors linked to the GERD. 

"Left untreated, GERD can cause stomach acid to repeatedly wash up into the esophagus, causing the changes that lead to Barrett’s esophagus. People with Barrett’s esophagus are up to 40 times more likely to develop esophageal cancer,” adds Starnes.  

Starnes says heartburn should never be considered "normal.” Although over-the-counter medications to treat heartburn are available, she stresses that chronic heartburn should always be evaluated by a physician to rule out more serious underlying diseases causing the symptoms. Difficulty swallowing should also be evaluated immediately. 

"Our main concern is people who self-medicate for a long time … you want to make sure heartburn is truly reflux versus something else. Having a physician involved to assess the symptoms and help guide decisions about medication is important,” says Starnes. "Some people have self-medicated for 20 years, but never had an endoscopy to gauge whether there were signs of underlying disease, like Barrett’s, which can result in esophageal cancers being diagnosed at later, less treatable stages.” 

The UC Health Esophageal Disease Center, an affiliate of the UC Cancer Institute, offers patients the convenience of coordinated patient appointments with all their physicians—in one location, the Barrett Center—Wednesdays from 2 to 5 p.m. The treatment team includes three dedicated thoracic surgeons, two surgical oncologists, three radiation oncologists, a general surgeon and medical oncologist as well as dedicated thoracic anesthesiologists, critical care nurses, pulmonologists and gastroenterologists.

To learn more about the UC Health Esophageal Diseases Center, visit ucphysicians.comor call 513-584-3502.