Is Barrett’s Esophagus the Grim Reaper for Esophageal Cancer?

Barrett’s esophagus, also known as Barrett esophagus, can result from chronic, repeated back up of stomach acid and contents (also known as acid reflux) into the esophagus. As this process continues over time, the esophageal tissues are repeatedly injured.

The body has a wonderful coping mechanism when injured: It attempts to heal injuries with new cell production and the formation of scar tissue. But what happens when injuries occur over and over again for days, months, or years? Even the body, with its marvelous healing powers, has its limits; and in the case of Barrett esophagus, the cells in the esophagus change from normal to abnormal.

When the cells of the esophagus mutate (a process called metaplasia) they become more like those found in the stomach in order to cope with the constant barrage of stomach contents and acid. Anywhere from 9-15% of those who suffer chronic acid reflux will undergo this cellular submission and conversion.

The irony behind this change is that the acid reflux sufferer may actually feel some relief from his/her painful symptoms and may mistakenly think there is some improvement in the condition. The result? People who do not have pain from acid reflux or who have less of it are unlikely to seek medical attention, erroneously thinking their condition is improving.

As the damage to the esophageal tissues continues unchecked, the cellular mutation also advances to a new phase. The less healthy metaplastic cells develop into dysplastic cells, a precancerous condition which occurs silently. For a person who already has Barrett’s esophagus, the chance of getting esophageal cancer is 30-100 times higher than that of the person without acid reflux. The significance of this statistic should not be lost on anyone.

More sobering is this statistic: Esophageal cancer, as well as stomach cancer, is among the deadliest of all gastrointestinal malignancies, with a mortality rate exceeding 80% after five years. Perhaps that is due to a later diagnosis, which means a poorer prognosis.

However, there is hope. New technologies are being developed for early detection of esophageal cancer. Scientists are in the process of studying markers in the blood of those who have Barrett esophagus and comparing them to the markers in the blood of those who don’t have this condition. Also, new treatment options are being pursued to extend life without detracting from the quality of life.

Patient education, as well as early detection and effective intervention, is the key in the fight to reduce the mortality rate of esophageal cancer. Further study of Barrett’s esophagus is likely to yield the answers that will make this a reality.