Just about everybody knows what heartburn feels like. From indigestion to pregnancy, it’s a common symptom. But you might not know that persistent heartburn can sometimes be a sign of something more serious.

How are esophageal cancer and acid reflux related?

WHEN HEARTBURN COULD BE A SIGN OF CANCER 1

ACID REFLUX, also called heartburn, is the burning sensation you might feel in your chest or throat after you eat certain foods. Most people have probably experienced acid reflux at least once in their lives.

However, if you experience chronic acid reflux (acid reflux that occurs two or more times per week) you may be at risk of developing esophageal cancer.

The esophagus is the long tube that carries food from your throat down to your stomach. When you experience acid reflux, acid from your stomach comes up into your esophagus. Over time, this can damage your esophageal tissue and increase your risk of developing cancer in your esophagus.

There are two main types of esophageal cancer: adenocarcinoma and squamous cell. Acid reflux disease slightly increases your risk of developing adenocarcinoma.

WHEN HEARTBURN COULD BE A SIGN OF CANCER 2

Does acid reflux lead to esophageal cancer?

Doctors aren’t sure why, but people who experience frequent acid reflux are at a slightly increased risk for esophageal cancer.

WHEN HEARTBURN COULD BE A SIGN OF CANCER 3

Acid reflux causes stomach acid to splash up and into the lower portion of your esophagus. While your stomach has a lining that protects it from the acid, your esophagus doesn’t. This means that the acid can cause damage to the tissue cells in your esophagus.

Sometimes the tissue damage from acid reflux can lead to a condition called Barrett’s esophagus. This condition causes the tissue in your esophagus to be replaced with tissue similar to what’s found in the intestinal lining. Sometimes these cells develop into precancerous cells.

Even though Barrett’s esophagus is associated with a higher risk of esophageal cancer, the vast majority of people who have this condition never develop esophageal cancer. However, people who have both GERD and Barrett’s esophagus are more likely to develop esophageal cancer than people who only have GERD.

What are the symptoms of esophageal cancer?

The most common symptom of esophageal cancer is difficulty swallowing, which is also known as dysphagia. This difficulty tends to worsen as the tumor grows and obstructs more of the esophagus.

Some people also experience pain when they swallow, typically when the lump of food passes the tumor.

Difficulty swallowing can also lead to unintentional weight loss. This is primarily because it’s harder to eat, but some people also notice a decrease in appetite or an increase in metabolism because of the cancer.

Other possible symptoms of esophageal cancer include:

  • hoarseness
  • chronic cough
  • bleeding in the esophagus
  • an increase in indigestion or heartburn

Esophageal cancer usually doesn’t cause any symptoms in its early stages. Typically, people only notice symptoms once the cancer has reached a more advanced stage.

This is why it’s important to talk to your doctor about esophageal cancer screening if you are at a higher risk of developing it.

How is esophageal cancer treated?

The type of treatment depends in part on the stage of the cancer. The main treatments for esophageal cancer are surgery, radiation, and chemotherapy, or a combination:

  • Surgery. In the early stages of cancer, your surgeon can remove the tumor completely. Sometimes this can be done with the aid of an endoscope. If the cancer has spread to deeper tissue layers, it may be necessary to remove the cancerous portion of your esophagus and reattach the remaining portions. In more serious cases, your surgeon may also remove the upper portion of your stomach and/or your lymph nodes.
  • Radiation. Radiation therapy is the use of high-energy beams to kill cancer cells. Radiation can either be directed at the cancerous area from outside of your body or it can be administered from within your body. Radiation can be used before or after surgery and is most commonly used in combination with chemotherapy for people with esophageal cancer.
  • Chemotherapy. Chemotherapy is the use of drug treatment to kill cancer cells. This is often administered either before or after surgery or in combination with radiation.

You and your doctor will determine what treatment plan is best for you. You will likely be referred to a specialist to coordinate your treatment. This could be a gastroenterologists, a thoracic surgeon, a radiation oncologist, or a medical oncologist.

No matter what treatment you choose, you also need to focus on controlling your acid reflux. This will likely include making changes in your eating habits or staying upright for a few hours after eating.

Is there a way to prevent esophageal cancer if you have chronic acid reflux?

Controlling your acid reflux is one way to reduce your risk of esophageal cancer. Talk to your doctor to try to figure out what steps you should take. These may include:

  • losing weight
  • not lying down after eating (lying down flat makes it easier for stomach contents to back up into the esophagus)
  • sleeping propped up so your head and chest are above your stomach
  • taking an antacid
  • quitting smoking
  • drinking alcohol only in moderation
  • eating more fruits and vegetables

If you have Barrett’s esophagus and GERD, you’re at a higher risk for developing esophageal cancer than people who only have GERD. People with both of these conditions should see their doctors for regular checkups, and report any concerning symptoms that develop.

Fast facts on acid reflux

Here are some key points about acid reflux. More detail is in the main article.

  • Acid reflux is also known as heartburn, acid, indigestion or pyrosis.
  • It happens when some of the acidic stomach contents go back up into the esophagus.
  • Acid reflux creates a burning pain in the lower chest area, often after eating.
  • Lifestyle risk factors include obesity and smoking.
  • Drug treatments are the most common therapy and are available on prescription and over the counter (OTC).

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