GERD Linked to Esophageal Cancer

By: Shelagh McNally for Reflux1

According to a new report published in the Cancer Journal for Clinicians, the alarming rise in esophageal cancer may be linked to GERD and other gastrointestinal disorders. Esophageal cancer is the seventh leading cause of cancer worldwide and is the fastest growing cancer in the U.S. with approximately 3 – 6 cases per 100,000 persons. Of the new cases, 10,860 will occur in men and 3,390 will occur in women.

Take Action

Strategies for reducing acid reflux: Stop smoking. Nicotine in the blood can weaken the lower esophageal sphincter (LES). Improve your diet. Eat more fresh fruit and vegetables while cutting down on fatty foods, milk, chocolate, mints, caffeine, carbonated drinks, citrus fruits and juices, tomato products and alcohol. Eat smaller meals. Avoid food three hours before bedtime. Avoid tight clothes that restrict your middle. Lose weight. Too much fat around the middle puts pressure on the LES. Elevate your head at night at least six to eight inches. Check your medication. Certain drugs can cause acid reflux.

The esophagus is usually between 10 to 13 inches long and it carries food and liquid from the mouth to the stomach. The wall of the esophagus, known as the mucosa, has several layers and cancer usually starts from its inner layer and grows outward. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Since the esophagus is made up of squamous cells, squamous cell carcinoma can occur anywhere along the lining. Adenocarcinoma cancer occurs when these regular squamous cells are replaced by glandular cells and is usually found in the lower esophagus or at the gastroesophageal junction (GEJ), where the esophagus meets the stomach.

Until the 1970s, squamous cell carcinoma made up 90 percent of all esophageal cancer but in the last two decades, adenocarcinoma has increased and now accounts for more than 50 percent of most cases. Although the overall incidence of squamous cell carcinoma is declining, it remains six times more likely to occur in black males, while adenocarcinoma occurs primarily in Caucasian men. The survival rate is not high – out of the 14,250 Americans diagnosed annually, 13,300 will die of this malignancy with 80 percent dying within five years of being diagnosed.

After reviewing studies on GEJ cancers, researchers found the major risk factors linked to gastroesophageal reflux disease (GERD) and its associated conditions. Particularly worrisome was the condition known Barrett's esophagus where the normal mucosa is replaced with intestinal-type cells. This condition is thought to be an adaptive response to protect the esophagus from irritation caused by continuous exposure to acid and bile, which are also common symptoms associated with heartburn and GERD.

Take Action

If you have a long-standing case of GERD and experience any of the following symptoms, contact your doctor immediately. Frequent vomiting Unexplained weight loss Poor appetite Pain in your throat, mid-chest of shoulder blades Chronic cough with blood Hoarseness Difficulty swallowing

Actually one in 10 patient with GERD will eventually develop Barrett's esophagus and since this condition involves pre-cancerous changes those diagnosed with the disease must be monitored through regular endoscopic surveillance by a gastroenterologist. The report found a higher risk of developing esophageal cancer with those suffering from Barrett's esophagus. The limited ability to detect cancerous tumors early in this region has made it difficult for researchers to understand how to develop and create effective prevention strategies.

The report recommended more research into finding ways to prevent the disease, as well as detection and treatment. Currently diet and lifestyle changes are recommended since they can significantly reduce GERD and the chance of developing Barrett’s esophagus.

Last updated: 09-Jan-06