When unmanaged heartburn turns cancerous

Your esophagus plays an important role in transporting food and beverages to your stomach. The esophagus is also behind uncomfortable heartburn. When left untreated, heartburn can turn into Barrett’s esophagus, increasing your risk for esophageal cancer.

Dr. Mohammed Qadeer, the medical director of endoluminal surgery at Aurora Health Care, answers common questions and concerns people may have about esophageal cancer:

How common is esophageal cancer?

There was a rapid increase in the incidence of esophageal cancer in the early 2000s, but the incidence has been falling due to increased awareness of the risk factors and better detection and management.

Though, there will be around 22,000 people newly diagnosed with esophageal cancer and about 16,000 people who will pass away from it in 2025, according to the American Cancer Society. The average 5-year survival rate is 22% but rises to 80% to 87% if detected and treated early, according to recent studies. Unfortunately, a vast majority of cancers are detected late. Hence, screening could be lifesaving for the at-risk population.

Who is at risk of developing esophageal cancer?

You are at an increased risk of developing esophageal cancer or Barrett’s esophagus if you meet three or more of the following criteria:

• Male
• White
• 50 years or older
• History of smoking or heavy drinking
• History of chronic gastroesophageal reflux disease for 5 years or longer
• Obesity
• Family history of Barrett’s esophagus or esophageal cancer

How are Barrett’s esophagus and esophageal cancer connected?

Barrett’s esophagus is the only known precancerous disorder to esophageal cancer. It develops when the esophagus has prolonged exposure to stomach acid from acid reflux, commonly manifested as heartburn. This causes the esophageal lining to change its native lining to stomach lining, which then advances to intestinal lining. This might initially be the body’s attempt to tolerate the increased acid exposure, but it eventually backfires and causes more problems.

Our understanding of Barrett’s esophagus has increased significantly over the last 2 decades, which has translated into improved prevention, early detection and better treatment options for Barrett’s esophagus, resulting in improved outcomes.

Why are males most at risk?

The cancer is predominately seen in white males – although no one is immune to it. The precise reasons are unclear, but many experts believe it has to do with abdominal obesity, the type of obesity that men are more likely to experience that increases the likelihood of gastroesophageal reflux disease.

Another possible reason includes sex hormones. Estrogen, a female sex hormone, seems to have a protective effect while androgens, a male sex hormone, may have the opposite effect.

Is esophageal cancer curable?

If detected in its early stages, esophageal cancer is eminently a curable disease due to improved treatment options.

Unfortunately, a significant number of people are diagnosed in later stages when they present symptoms, such as difficulty in swallowing (dysphagia) associated with unintentional weight loss. In this case, the cancer is usually incurable.

What are the treatment options?

There are now several minimally invasive treatment options for Barrett’s esophagus and early esophageal cancer with a cure rate in the upper 90%. My team and I perform several procedures to accurately diagnose and cure these conditions, including hot and cold ablation and endoscopic resection. Specifically, our team is well adept in performing endoscopic submucosal dissections (ESDs), a minimally invasive procedure that removes cancerous tissue in the gastrointestinal tract, to treat early-stage esophageal cancer.

If you need help managing acid reflux or want to learn more about your cancer risk, consult with your primary care provider or gastroenterology specialist who can help you decide if screening is right for you.

Find a cancer specialist near you: Illinois | Wisconsin.