The Cancer Risk

Esophageal Cancer

  • GERD causes esophageal cancer
  • The incidence of GERD-induced cancer of the esophagus is rising dramatically
  • If discovered early, cure of this deadly cancer can be achieved

Gastroesophageal reflux disease (GERD) causes cancer of the esophagus. In fact, the incidence of this deadly cancer has increased dramatically over the last 35 years and there is no sign of it diminishing. Some refer to it as an epidemic. Approximately 20,000 people will develop reflux-induced esophageal cancer in the United States this year. A total of 80 to 90 percent will die of their disease. That translates into 55 cases per day or almost 2 ½ cases per hour! Yet many physicians ignore this calling it extremely rare or even not anything to worry about. If you have reflux and you get cancer, it indeed is something to worry about and it is happening to more and more people each year.

Cancer of the lower esophagus is called adenocarcinoma and is caused by GERD. Its frequency is increasing at an alarming rate, faster than any solid tumor ever measured. In fact, this frequency has increased 600 percent in the US and 800 percent in Europe since 1975! The graph below illustrates the frequency of GERD-induced esophageal cancer compared to other cancers. The difference is dramatic. Most other cancers are stable or decreasing in frequency. However the incidence of cancer of the esophagus continues to rise.

Why is this happening? Although we do not know for sure, there is evidence to suggest that the increased use of powerful acid suppressing drugs to treat reflux symptoms may be contributing. Since the early 1970s, GERD has been treated using acid suppressing medications. They have become more and more powerful and are used more frequently. During this time, we have seen more and more esophageal cancers. In terms of cancer, it can be said that since the early 1970’s our treatment of reflux has been a complete failure.

Why might this be? The powerful acid suppressing medications such as Nexium, Prilosec, Aciphex, Prevacid and others are in a class of drugs called PPIs. They decrease the acid production in the stomach but have no effect on the reflux. The reflux continues with stomach contents bathing the lower esophagus. The material contains the chemicals that cause the cancers. The drugs do not cure or decrease the reflux. They just cover it up and decrease symptoms. Cancers continue to develop. It is even thought possible that as the drugs become more powerful, they further “activate” the cancer-causing chemicals providing further explanation for the increasing cancers.

If you have GERD, you should be concerned about it causing cancer. You might even be concerned about taking PPIs and allowing the reflux to continue.

Barrett’s Esophagus

A precancerous change in the cells lining the esophagus called Barrett’s esophagus is present in 10-15 percent of people with GERD. Barrett’s carries with it a risk of cancer approximately 100 times that of the general population the yearly cancer risk is between 0.3-0.5 percent per year. Barrett’s esophagus is diagnosed by endoscopy with optical microscopy and taking small tissue samples of areas from the lining of the lower esophagus. We also know that once Barrett’s esophagus is diagnosed, regular surveillance can detect progression and early intervention can reduce the rate of cancer up to 90 percent.

The Minnesota Heartburn & Reflux Center performs the most sophisticated screening for Barrett’s esophagus utilizing the newest technology available, endomicrocospy, to visualize the lining of the esophagus at the cellular level for early detection of pre-cancerous changes. Once identified, an endoscopic procedure called radio frequency ablation can be employed to “burn” the precancerous cells and halt the progression of Barrett’s Esophagus. However, acid exposure to the esophagus must be eliminated or Barrett’s Esophagus can recur.

An additional strategy is to select a treatment that actually stops the reflux rather than allowing the cancer-causing chemicals to continue to damage the esophagus. Understand your options. Unlike PPIs, minimally invasive anti-reflux surgery can stop the reflux. Several procedures are available at the Minnesota Heartburn & Reflux Center including the new LINX Reflux Management System.

Call us today.
Let’s personalize a plan for your relief.

Contact a nurse coordinator

Crosby: Lea carlson, RN
Aitkin: Dawn Harcey, RN