Barrett’s Esophagus: Surgery May Reduce the Risk of Progression to Cancer

Barrett’s Esophagus: Surgery May Reduce the Risk of Progression to Cancer

A condition called

Barrett’s esophagus is associated with a high risk of developing cancer of the esophagus; however, the specifics of which factors cause which persons with Barrett’s esophagus to develop cancer are not known. Researchers in Vermont have found that some persons who receive surgery for their condition may reduce their risk of developing cancer of the esophagus.

Barrett’s esophagus is a condition that develops when acids and other contents from the stomach escape back up into the lower part of the esophagus (the tube that connects the throat to the stomach), over a long period of time. This process is called

reflux. Continued reflux causes the cells in this part of the esophagus to change, causing an increase in the risk for developing pre-cancerous cells (called

dysplasia), and then cancer cells in this part of the esophagus. If a person is diagnosed with Barrett’s esophagus, his or her doctor may wish to perform regular tests to monitor for any further changes in the esophagus cells, and to ensure that any cancer that may develop is treated early. Tests that may be performed include barium tests (patient swallows a liquid and then undergoes x-ray tests) and endoscopy.

Endoscopy is a test that allows the doctor to use an endoscope, a lighted flexible tube, to view the esophagus. Researchers in Vermont recently conducted an evaluation to determine whether certain risk factors for the development of dysplasia and cancer could be identified.

From 1970 to 1994, 102 persons with Barrett’s esophagus at the Veterans Administration Medical Center in Vermont received monitoring by endoscopy for the development of dysplasia or cancer. Of these, 3 persons developed cancer, 4 years or more after their diagnosis of Barrett’s esophagus. Twenty-three persons developed precancerous cells, or dysplasia. Importantly, some of the 102 patients had undergone surgery to stop the reflux into the esophagus, and none of these persons developed dysplasia or cancer.

These findings suggest 2 conclusions. First, in persons who do not have dysplasia initially, it appears that the development of dysplasia and cancer may be delayed at least 2 years. Second, it is possible that surgery for reflux disease may be effective in preventing the progression of Barrett’s esophagus to dysplasia and cancer. (American Journal of Gastroenterology, Vol 93, No 4, pp 536-541, 1998) Copyright © 2018 CancerConnect. All Rights Reserved.

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