Dr. Ivana Dzeletovic is a gastroenterologist specializing in endoscopy at Banner MD Anderson Cancer Center in Gilbert.
Question: Is there a link between Barrett's esophagus and esophageal cancer?
Answer: Barrett's esophagus is a condition where the lining of the esophagus undergoes tissue changes most often resulting from gastroesophageal reflux disease (GERD). The condition is considered a risk factor for developing esophageal cancer.
When the esophageal tissue is damaged by GERD, tissue changes known as dysplasia may result. The level of dysplasia is determined during an endoscopy, where a small tube is inserted into the esophagus to take a tissue sample, called a biopsy. The tissue is then placed in one of three categories: no dysplasia, low-grade dysplasia and high-grade dysplasia. In both low and high-grade dysplasia, the cells of the esophageal tissue have changed, a sign that the tissue is precancerous. Low-grade dysplasia means only small precancerous changes exist, but high-grade dysplasia is more serious.
While the vast majority of people with Barrett’s esophagus will not develop esophageal cancer, the primary goal of treating the condition is to decrease cancer risk. Certain medications or surgery can control GERD, but they cannot reverse the presence of Barrett’s esophagus or eliminate the risk of cancer. In patients with no precancerous cells present in the initial tissue sample, regular endoscopic monitoring every three years is recommended. If dysplasia is present, a doctor will evaluate its severity and might recommend more frequent endoscopies, one of several minimally invasive treatments that focus on destroying the Barrett’s tissue, or surgery.
Because no standard screening is available for esophageal cancer and it can develop without symptoms, it is important for patients who have been diagnosed with Barrett's esophagus to talk with their doctor about monitoring their condition. Any precancerous changes associated with Barrett's esophagus can then be identified and addressed in their earliest stages.