July 30, 2016

Barrett’s Disease

I have Barrett’s Esophagus. What is it and what are the chances I will develop cancer?

Barrett’s esophagus is a condition where the tissue lining the esophagus changes into tissue that is similar to that in your small intestine. That change is called intestinal metaplasia. Having GERD increases a person’s risk of developing Barrett’s with about 10 to 15% of GERD patients developing Barrett’s. 

Since you’ve been diagnosed with Barrett’s, it’s important to have regular examinations of your esophagus. Regular exams and biopsies help your doctor determine if you have dysplasia, or precancerous cells, which have a higher chance of becoming cancer. There are two types of dysplasia: low-grade and high-grade. Studies have shown low-grade dysplasia has a cancer progression rate of 1% per patient year while high-grade may be 10 times as high. There are several factors that also increase your risk: smoking, obesity, male, Caucasian, over the age of 50, severe and chronic GERD and the length or amount of diseased esophagus.

Esophageal cancer is considered relatively rare compared to other cancers. The National Cancer Institute estimates approximately 17,000 new cases of esophageal cancer will be diagnosed in 2017 or 1% of all new cancer cases in the U.S. Additionally, studies show less than 1% of people with Barrett’s esophagus develop esophageal cancer.  However, it is an aggressive cancer that has a low five-year survival rate overall and depending on the stage at which it is diagnosed.

Current medical treatment for patients who have Barrett’s with GERD symptoms is daily PPI’s and periodic screening. Other treatment options include radio frequency ablation, photodynamic therapy, endoscopic mucosal resection, and esophagectomy.