February: Oesophageal Cancer Awareness Month

Guts UK is an active member of Action Against Heartburn and we’re all very busy in February spreading the word about the risk factors for oesophageal cancer, the sixth most common cause of cancer death in the UK.

The oesophagus is the food pipe that leads from the throat to the stomach, where the body generates strong acid as a natural part of a healthy digestive system. But when the acid rises up past the diaphragm, something known as reflux, the lining of the oesophagus cannot cope with the acid, and can result in chest pain known as heartburn.   Many people suffer heartburn.   The temporary feeling after over indulging is not important; but if it lasts for more than three weeks, you should see a GP to discuss underlying causes.

Around 10% of persistent heartburn sufferers who have longstanding reflux problems may develop a condition called Barrett’s Oesophagus where the cells start to change colour.   This can lead to a condition called dysplasia which is a precursor to cancer and which can successfully be treated to prevent cancer occurring.   This gives an opportunity to tackle the problem now regardless of any future research into cancer.

So the message is for persistent heartburn sufferers who may be using over-the-counter heartburn remedies.   “Don’t keep taking Gaviscon or Nexium for month after month without seeing your GP to discuss underlying causes. This disease tends to affect men aged 50 and over, and some men are reluctant to visit their doctors, so this is also a message for womenfolk”.

Over February, volunteers will be visiting a number of pharmacies with information leaflets for their regular heartburn remedy customers.   “Sometimes dentists notice that the reflux affects the tooth enamel, so dentists can also help to spread the word.   GPs often prescribe medication to help with heartburn, but when this is not effective, there may be a need for the hospital to conduct an endoscopy examination to check for anything wrong.   Having an endoscopy at an earlier stage can make a dramatic difference to the outcome.  Apparently Britain has the highest rate of oesophageal adenocarcinoma in the world, so we must all do something to help this problem”.

FACTS: 

• Each year in the UK, around 8,800 people are diagnosed with oesophageal cancer, and 7,600 die from it.   The 5 year survival rate is around 15%, and it is classed as a less survivable cancer.   The 5 year survival rate for breast cancer, by contrast is 87%.

• 70% of oesophageal cancer in the UK is adenocarcinoma, which is associated with reflux disease. Obesity is relevant, and other factors affecting the lower oesophageal sphincter, the valve by the diaphragm between the oesophagus and the stomach because stomach contents tend to be put under upwards pressure.   For oesophageal adenocarcinoma men are affected more than women by a ratio of 4:1.

• A person with newly-developed Barrett’s Oesophagus aged 30 years may have a 12 – 25% risk of developing adenocarcinoma by the age of 80 years.    The only certain way of diagnosing Barrett’s Oesophagus is through an endoscopy, a miniature camera passed down the throat, a procedure that can take biopsy samples.   If the biopsy sample finds low grade dysplasia, the risk of adenocarcinoma rises to 5% in the following eight years; for high grade dysplasia, the equivalent risk is as high as 50%.

• The problem arises most often arises when people are 50 years of age or older, but the Barrett’s Oesophagus condition starts much earlier, when people may be in their twenties or thirties.

• Radio Frequency Ablation is available in some parts of the country.   This process can remove the cells that are affected by dysplasia and can prevent cancer developing.

Guts UK has funded a range of research into Barrett’s Oesophagus and oesophageal cancer. More information on these can be found here:

• Research on Barrett’s Oesophagus and Gastrooesophageal Reflux Disease
• Professor Laurence Lovat’s research to develop a SPIT test

Guts UK is also a founding member of the Less Survivable Cancers Taskforce (LSCT), a coalition of six charities to campaign for a better survival rate of the six less survivable cancers: brain, stomach, oesophagus, liver, lung and pancreas.