Key information people need to know
Those who experience chronic heart burn may be setting themselves up for more than just discomfort. Acid reflux associated with heart burn can lead to a pre-cancerous condition called Barrett’s esophagus which affects 11.5 million Americans. Left untreated the condition can increase the likelihood or esophageal cancer by 50 percent. This year an estimated 16,980 in the US will be diagnosed with esophageal cancer.
In an effort learn more about esophageal cancer and what people can do to help lower their risk; I recently spoke with Dr. Indraneel Chakrabarty, MD, gastroenterologist along with patient Ronald Yates, former foreign correspondent for the Chicago Tribune and Dean Emeritus of the College of Media at the University of Illinois.
DN: Dr. Chakrabarty, What is esophageal cancer?
DC: Esophageal cancer are abnormal cells in the lower part of the esophagus the slowly invade the organs around and take over your body and cause death.
DN: Dr. Chakrabarty, What are the key risk factors associated with esophageal cancer?
DC: Esophageal cancer is one of the fastest growing cancers in the US right now; it’s a six fold increase since 1970’s. The risk factors for this are several no one knows exactly why its increasing but we think it’s just because of the diet in the US and obesity and this causes people to have more acid reflux, the chronic acid going to the lower esophagus that eventually causes the cells to change, then you get a pre-cancerous condition called Barrett’s esophagus that can lead to esophageal cancer. Other risk factors include age over 50, obesity I talked about. If you have a family history of esophageal cancer, smoking is a big part of it, if you have an entity called hiatal hernia that also puts you at risk. A hital hernia is just a loose end or esophageal valve where the stomach contents easily gets into the esophagus and that needs to be addressed to control the acid reflux.
DN: Mr. Yates can you tell us a little about your experience with Barrett’s esophagus?
RY: Yes, I was diagnosed with barrettes esophagus about eight years ago. At the time it was not considered or at least I was told it wasn’t something I didn’t need to worry too much about but then over the years as this began to progress I began to feel I needed to do something more. I just couldn’t and didn’t want to accept this. So I began to do some research myself and I went onto a website called treatbarretts.com and on that website I learned a lot more about barrettes esophagus and I also found physicians in my area and Dr. Chakrabarty in particular who treats this problem. And I went and underwent a endoscopy and found that I had a more serious form of barrettes than I originally thought. So, but in my case, it’s the fact that I done this and got it to this point. I got it under control now and we’ve done some procedures in which that actually helped solve this problem.
DN: Dr. Chakrabarty, what should people do if they are concerned about esophageal cancer?
DC: If you’re having heartburns more than one or two times a week on a regular basis and/or taking anti-reflux medications for a long period of time especially over five years Immediately go to your doctor and see about getting a test for Barret’s esophagus which means they go down with a scope an endoscopy and taking a look and seeing if you have this condition. The only way of diagnosing it is by doing an endoscopy and by getting biopsies of the tissues there in that area.
DN: Mr. Yates. What should people do if they think they are at risk?
RY: Well the first thing you want to do is not ignore it because if you have this condition it can lead to esophageal cancer and the survival rate for that form of cancer is only about 17 percent. So you don’t want to ignore this. You want to get to your doctor. The endoscopy procedure is very simple it takes only about 20 or 30 minutes at the most its barley invasive at all and you come out of it with the knowledge you need to have in order to treat this condition.
DN: Dr. Chakrabarty, just what is esophageal dysplasia?
DC: Yes, esophageal dysplasia is a pre-cancer condition and to different degrees. So dysplasia is just a way of describing abnormal cells in the lower part of the esophagus but we call it barrettes esophagus. Now barrettes’ esophagus has different degrees of dysplasia. So if there is no dysphagia which puts you at a risk for esophageal cancer at 2.9 percent over ten years. But there is intermediate and high-grade dysplasia. High-grade dysphagia is right before it becomes esophageal cancer and Ronald had high-grade dysphagia. That puts you for risk for esophageal cancer at 10 percent per year which is a lot higher. So ten years ago people would just go and get their esophagus cut out and imagine that part of your stomach up in your chest and it makes it very difficult to eat, it’s a very morbid surgery. But now we have this new treatment route that you can go down that you can burn the tissue down called radiofrequency ablation, burn the cells down to the stem and awhile later it generates new tissue that is normal and healthy and basically prevents you from getting esophageal cancer.
DN: Mr. Yates you had recently shared your story about being diagnosed with Barret’s esophagus and due to dissatisfaction with standard passive treatment you decided to take a more active role in you r treatment Can you tell us a few ways a person can take an active role in their treatment plan regardless of the disease?
RY: Well I think the first thing you need to do is to make sure you had the endoscopy and that you are familiar with exactly what is going on within your esophagus. And then I myself , had a hital hernia so then after I had gone under the three radiofrequency operation procedures that Dr. Chakrabarty had explained I had my hital hernia repaired and as a result of that I have not had any symptoms at all of acid reflux since last June. I’m not taking any kind of medication; I’m not taking any kind of heart burn medication at all since I had this done. So in my case that is how i dealt with it and I think I feel pretty good about it now.
DN: Dr. Charabarty is there anything you would like people to know about esophageal cancer?
DC: Well esophageal cancer is as I see very dangerous because it’s one of the fastest growing cancers. And you can only imagine now, that this tumor is growing in your lower esophagus and food is getting stuck or your vomiting blood, your losing weight you can’t even enjoy the food now that you are eating. And you know we take that on a daily basis for granted. You need to asses if you’re having chronic reflux signs. Now there are numerous kinds of reflux signs that people need to be aware of, in fact the thing you hear about is heart burn which is like burning in the lower chest and that’s the classic sign that has to do with fatty foods and spicy foods. And you have atypical heart burn too or reflux that’s where people may feel like food is coming up into their chest or they have sear chest pain and they think they’re having a heart attack and they get it assessed and they find it’s not their heart it could actually be acid reflux or they have laryngitis or chronic cough or even asthma. That is because the acid coming up so high into the esophagus that’s going down your airway and irritating your lungs. And those are the signs you need to be aware of and for having those symptoms you may need to be assessed for reflux and to get it under control. It can be silent you may not know you have it.
Dr. Indraneel Chakrabarty BIO
Raised in Hemet, Indraneel Chakrabarty received his BS, Biochemistry from UCR in 1998, his MA in Medical Sciences from Boston University School of Medicine (BUSM) in 2000, his MD from BUSM in 2004, and his fellowship in Gastroenterology and Interventional Endoscopy in 2011 from Lahey Clinic. He was on staff as a Hospitalist and Teaching Associate at Massachusetts General Hospital (MGH) at Harvard Medical School. Dr. Chakrabarty is board certified in Internal Medicine and Gastroenterology. Read full bio here.
Patient-Ronald E. Yates
Ronald E. Yates is Professor Emeritus and former Dean of the College of Media at the University of Illinois. Yates was appointed Dean in August 2003 after heading the College of Media’s Department of Journalism. He joined the University of Illinois as Journalism Department Head in 1997 following a 27-year career with the Chicago Tribune as an award-winning foreign correspondent, senior writer and editor. He stepped down as Dean in September 2010 to concentrate on writing projects. Read full bio here.
Yates writes a blog entitled “ForeignCorrespondent” that can be found at: http://ronaldyatesbooks.com/category/foreign-correspondent/ His Website and authors pages can be found at: http://www.ronaldyatesbooks.com/ and at the Authors’ Guild: http://www.ronaldyates.com/index.htm and on Amazon’s Author Central page: http://www.amazon.com/-/e/B001KHDVZI.