Risk of cancer in Barrett’s esophagus

Dear Ms. Atwater,
Don’t let your weekend be ruined.  If you have Barrett’s esophagus, your risk of cancer is still low – it is just higher than your risk if you did not have Barrett’s esophagus. There are about 16,000 new cases of esophagus cancer in the US whereas, for example there are over 200,000 new cases per year of lung and prostate cancer.   In a way you are lucky since you know you are at risk so you can be monitored.  There ARE ways to have the Barrett cells removed but the reason your doctor will probably not suggest them is because these methods (called radiofrequency abblation – the trade name is BARRX) are not without complications and the risk of troubles from the treatment is higher than the risk of developing cancer. 
Elizabeth Montgomery, MD

4 thoughts to “Risk of cancer in Barrett’s esophagus”

  1. Too many doctors use the excuse “it’s so rare” as a reason not to inform their patients of the risks associated with acid reflux . . . and yet there are 16,000 new cases discovered each year. How many of those 16,000 lives could be saved IF doctors just educated their patients?

    My husband just passed away from esophageal cancer. He was 54 years old. And to be honest, I really am not interested in hearing how rare it is. That “statistic” sadly didn’t include us . . . and my husband, like every other person on the planet, was not a statistic. He was a husband, father, son, brother, nephew, friend. And we miss him.

    The medical community has an obligation to warn the public about acid reflux. Unfortunately, it’s too late for us . . . but think about the 16,000 new cases that will crop up next year and the year after that. Don’t you want to save them? Isn’t that why you took an oath . . . “first do no harm”?

    Trust me, rationalizing that there is no reason to educate the public because it’s so “rare” is doing harm. And for our family, more harm than you could possibly imagine.

  2. Hi Elizabeth,

    My I always have a sore throat and always do gargle almost every other day. Is there any relation with Barrett’s esophagus cancer?


  3. If you have a sore throat because you reflux your stomach contents into your throat, indeed there could be a relationship.

  4. Dr. David Fleischer of the Mayo Clinic in Scottsdale claims the incidence of cancer in patients with Barretts and metaplasia, if untreated is 0.5% to 0.9% *per year*. I’m 44 years old; if I live to be 80, then I have an *18% to 32%* of developing adenocarcinoma in my lifetime. Not at all “low risk”.

    And much riskier for a younger person, say someone in their low to mid 30s. Couple this with the fact of how deadly adenocarcinoma is – the 5-year survival rate of patients with adenocarcinoma is only 15%. My guess is that the remaining 15% don’t survive much longer.

    Furthermore, surveillance as a primary strategy hasn’t been shown to be effective. Some patients who follow the recommended surveillance schedule are diagnosed with esophageal cancer anyway. It can develop between regular checks, as quickly as going from non-dysplasia BE to cancer in as little as 6 months. And biopsies are not always accurate; a negative biopsy only proves that no dysplasia was found in the area of tissue where the biopsy was taken. Dysplasia could easily still be present in an unsampled area of the BE tissue.

    So, with all respect, I believe I’ll take my chances with the risks of RFA rather than spin the 0.5%-0.9% cancer roulette wheel every year for the rest of my life.

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