Esophageal Cancer - Help!!

  : I am being treated for GERD. I'm taking Prevacid 15mg once a day. My condition causes aspiration. My breathing has much improved, but my cough is still very bad. I've been on Prev a little over three weeks. From what I've read, esophageal cancer is usually fatal. Can it be caught early enough to be treated, or is it always fatal? I'm wondering if I should have all those tests done ASAP, or should I give this medicine more time. I believe I've had this condition much longer than diagnosed...it was previously considered bronchitis. I'm starting to feel panicky. Please advise.
  P. S. My dosage is 30mg, not 15.
Dear Kay,
You are correct. Gastroesophageal reflux is a chronic condition that probably has been around for quite some time. Esophageal cancer (adenocarcinoma) that is associated with chronic gastroesophageal reflux is uncommon but usually arises from a pre-malignant lesion called Barrett's esophagus. This refers to a change in the lining of the lower esophagus. Instead of the lining appearing pink, it looks darker like the lining of the stomach. When biopsies are taken, the glands can appear like stomach or intestinal glands. If intestinal glands are present it is called intestinal metaplasia. Intestinal metaplasia is felt to be the pre-malignant lesion in Barrett's esophagus. When symptoms of gastroesophageal reflux have been present in an older patient (about 45 years old) for 5-10 years it is appropriate to have an upper GI endoscopy to look for the typical endoscopic findings of Barrett's esophagus. If these endoscopic findings are noted, biopsies are taken to look for intestinal metaplasia. If intestinal metaplasia is present, surveillance endoscopies are recommended every 2 years or so to look for dysplasia (glandular distortion-a sign that cancer is more likely to develop in these cells).
In your case you've only been treated for 3 weeks. If you do not respond to lansoprazole (Prevacid) and anti-reflux measures I would recommend an upper GI endoscopy to look for inflammation (esophagitis) and see if the typical findings of Barrett's esophagus and intestinal metaplasia are present. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you wish to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
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*Keywords: gastroesophageal reflux, Barrett's esophagus, intestinal metaplasia, dysplasia, upper GI endoscopy

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