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Prof. Dr. Sebastian Schoppmann: Esophageal cancer and reflux

Esophageal cancer is linked to gastric reflux. Don't ignore the burns!

Esophageal cancer has become more common, according to experts. There is two types of neoplasms of the esophagus, and the most dramatic increase in the number of cases is associated with esophageal adenocarcinoma.
Its best known risk factors are gastroesophageal reflux disease and obesity. Therefore, doctors recommend that you do not ignore reflux disease and heartburn, even if they seem to be minor symptoms because, untreated, they can cause injuries to the esophagus which can turn into cancer.

The esophagus is a muscular tube that is responsible for transporting food from
throat in the stomach. Esophageal cancer can occur when a malignant tumor forms in the lining of the esophagus.
Esophageal cancer, more and more common as the tumor grows, it can affect the deep tissues and muscles of the esophagus. A tumor can occur anywhere along the esophagus, including at the meeting point between esophagus and stomach.
Prof. Univ. Dr. Sebastian F. Schoppmann, General Surgery Specialist at Wiener Privatklinik hospital, explains how we can timely diagnosis, treat and effectively prevent esophageal cancer.

How often do you meet patients with esophageal cancer?
Dr. Schoppmann: We treat over 200 patients a year at our center. In recent years I have observed an increased incidence rate of esophageal cancer, especially in patients diagnosed with esophageal adenocarcinoma.

How this type of cancer manifests, what signs and symptoms it should have
are we careful?
Dr. Schoppmann: Unfortunately, early-stage esophageal cancer is asymptomatic, in most cases. These patients present rather with the typical symptoms of risk factors (gastroesophageal reflux disease, heartburn, regurgitation). In the advanced stages, dysphagia (difficulty swallowing normally) and, in some cases, pain Retrosternal are specific symptoms in addition to the general signs of cancer as well weakness, fatigue, weight loss and chronic anemia.

Who is most at risk of developing esophageal cancer?
Dr. Schoppmann: People at high risk of developing esophageal cancer should
differentiated into two groups:

  • The first group includes patients who are at risk of developing squamous cell carcinomas of the esophagus. This type of cancer is, of usually located in the upper part of the esophagus. Proven risk factors his smoking, excessive alcohol consumption and HPV infection. But I noticed a clear decrease in the incidence of this type of cancer in the last 15 years.
  • The other form of esophageal cancer - esophageal adenocarcinoma, on the other hand, is a cancer with a dramatic increase in incidence of over 400% in recent years. the Its best known risk factor is gastroesophageal reflux disease. Its typical symptoms - heartburn, chronic cough or regurgitation. Another risk factor is obesity.

Reflux disease and heartburn, warning signs!
Today we know that esophageal adenocarcinoma develops against the background of premalignant lesions.
If gastric reflux is not treated - by anti-reflux surgery, in some cases it is possible
develops dysplasia, the localized precursor of cancer. This risk depends on the amount of reflux, as well as other risk factors, hitherto unknown.
The typical patient at high risk for esophageal adenocarcinoma is overweight and has a history of heartburn or heartburn.

What are the modifiable and unchangeable risk factors for the two
subtypes of esophageal cancer?
Dr. Schoppmann: The main modifiable risk factor is reflux disease
Gastroesophageal. Today there are precise methods for assessing its severity and spectrum wide range of treatments, available in specialized centers.

Foods and drinks that are too cold or too hot can increase the risk the development of this type of cancer? But repeated infections in the throat?
Dr. Schoppmann: We don't know for sure if the food temperature is really high
a significant risk factor. However, in countries where food consumption
hot is usual, higher incidences of esophageal cell cancer have been observed
carcinomas. Throat infections are often induced by reflux disease and therefore can be considered an indirect risk factor.

How is esophageal cancer diagnosed?
Dr. Schoppmann: The main diagnostic methods are gastroscopy, scanning (PET-) CT and, in some cases, endoscopic ultrasound.

What are the treatment methods for esophageal cancer and the chances of
lead a normal life after the end of therapy?
Dr. Schoppmann: Today, about 30% of patients with esophageal cancer are candidates for surgeon treatment.