Esophageal cancer is a cancer that occurs in the esophagus and can occur anywhere along the esophagus.
Smoking, heavy alcohol use, and Barrett esophagus can increase your risk of developing esophageal cancer.
Some signs and symptoms of esophageal cancer can be weight loss and painful or difficult swallowing.
Listen in as Indraneel Chakrabarty, MD, known throughout the region for his care in advanced and interventional gastroenterology, discusses esophageal cancer and how you might reduce your risk.
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Esophageal Cancer Prevention
Featured Speaker:
Dr. Chakrabarty is known throughout the region for his expertise in advanced and interventional gastroenterology. These are highly specialized procedures performed by specially trained and experienced gastroenterologists to prevent, detect, diagnose, and treat complex conditions such as Barrett's esophagus, liver and biliary disease, pancreatic cysts, gastrointestinal bleeding, and gastrointestinal cancers.
Learn more about Indraneel Chakrabarty, MD
Indraneel Chakrabarty, MD
Raised in Hemet, Indraneel Chakrabarty received his BS, Biochemistry from UCR in 1998, his MA in Medical Sciences from Boston University School of Medicine (BUSM) in 2000, his MD from BUSM in 2004, and his fellowship in Gastroenterology and Interventional Endoscopy in 2011 from Lahey Clinic. He was on staff as a Hospitalist and Teaching Associate at Massachusetts General Hospital (MGH) at Harvard Medical School. Dr. Chakrabarty is board certified in Internal Medicine and Gastroenterology. Upon completing his education and training, Dr. Chakrabarty returned to his roots and has joined his father, Dr. Milan Chakrabarty in forming GI Excellence, Inc., Southwest Riverside County's most advanced gastroenterology medical center. He has brought notable progress to the practice with the introduction and implementation of the center's GI laboratory; and, the advancement in procedure technology. Of significance is the introduction of the 1.23 million pixel power endoscopic i-Scan technology.Dr. Chakrabarty is known throughout the region for his expertise in advanced and interventional gastroenterology. These are highly specialized procedures performed by specially trained and experienced gastroenterologists to prevent, detect, diagnose, and treat complex conditions such as Barrett's esophagus, liver and biliary disease, pancreatic cysts, gastrointestinal bleeding, and gastrointestinal cancers.
Learn more about Indraneel Chakrabarty, MD
Transcription:
Melanie Cole (Host): Not all esophageal cancers can be prevented, but the risk of developing this disease can be greatly reduced by avoiding certain risk factors. My guest today is Dr. Indraneel Chakrabarty. He’s medical director for the Gastroenterology Services Program at Temecula Valley Hospital. Welcome to the show, Dr. Chakrabarty. Tell us a little about esophageal cancer and what are some of the risk factors for it?
Dr. Indraneel Chakrabarty (Guest): Esophageal cancer, there’s two different kinds. There’s squamous cell and adenocarcinoma. Both are increased risk from smoking. However, adenocarcinoma, which is one of the fastest growing cancers in the country is increasing because of chronic heartburn as well. People often take over the counter medications and mask this with over the counter medications and put themselves at risk for this cancer as they’re not seeking help.
Melanie: Is this a silent cancer? Are there some things that would signal that somethings going wrong? Or, if you have heartburn do you always know that you have it?
Dr. Chakrabarty: Heartburn is a symptom of the main condition which is gastroesophageal reflux disease or GERD. GERD can cause various types of symptoms and the classic is heartburn. The severe burning pain in the chest that people get after a fatty meal or eating a tomato-based sauce type food like pizza or pasta sauce. However, you can have atypical symptoms and those are commonly not recognized as GERD but they may have a sensation of a lump in their throat; they may have hoarseness because their vocal cords are being hit by acid and lose their voice; they may have wheezing, trouble breathing because the acid is going down their airway; or, they have severe chest pain where they think they are having a heart attack but it’s actually reflux disease. The other atypical symptom is food getting stuck in the chest and that may be a sign of reflux as well.
Melanie: Can cancer of the esophagus be found early? Is there a screening for it?
Dr. Chakrabarty: There is no standardized screening for reflux or esophageal cancer. Usually, what happens is we try to use questionnaires that describe how long a patient may be having symptoms. The most commonly done right now is, if they have reflux disease for over five years, they should get an endoscopy done. When we do any endoscopy, we look for something called Barrett’s Esophagus which is a pre-cancer condition which can lead to esophageal cancer. If Barrett’s is found, then there’s way to treat that. In the past, there was no treatment and people were just brought in for repeat endoscopy until the cancer was found but now there’s some treatment for it.
Melanie: What about some symptoms of esophageal cancer? Trouble swallowing? Are there certain things you want people, if they have these to come see you?
Dr. Chakrabarty: Yes. If they have progressively worsening what we call “dysphasia symptoms” which means food getting stuck in their chest and it’s getting worse with smaller pieces of food and they’re also vomiting blood or they see black colored stools, those are maybe signs of bleeding from the cancer and/or weight loss. If they start to lose weight, those are red flags. If they have any of the reflux symptoms that I described that have been going on for a while, they should also seek help and get checked out to see if they have this Barrett’s Esophagus or pre-cancer condition.
Melanie: What’s your best advice for prevention of esophageal cancer or GERD or Barrett’s Esophagus?
Dr. Chakrabarty: Commonly, the biggest thing you can do is not smoke. That is the biggest thing. If you have symptoms of GERD – all the symptoms I have described – you want to find out what the triggers are. If you have certain foods that you eat that cause those symptoms, but you really enjoy eating those foods, you may want to avoid them. These kinds of food are commonly fatty foods or greasy foods, tomato-based sauces like I mentioned with pasta or pizza sauce, excessive caffeine, too much chocolate or mint. Those are most of the common types of food. Excessive alcohol can do it as well.
Melanie: Do the antacids that people take and so many of the medications we see today, do they help prevent esophageal cancer or are they mainly to take charge of GERD?
Dr. Chakrabarty: They are mainly to take charge of GERD but it depends on which medicines you are taking because there are several different classes of antacids. There’s medications that temporarily relieve your symptoms immediately and last for maybe 15-20 or 30 minutes. Those are like Tums, Alka-Seltzers. You make take Pepcid or Pepto-Bismal, those are very quick but they don’t protect you from the chronic acid that t may be coming up. The definitive medication that people often use is a class called “proton pump inhibitors” which is like Prilosec, Nexium, Protonix, Asaphex, Dexilant, and those kinds of meds. Those work a lot better to depress the acid and prevent that acid from hitting the distoral part of the esophagus and causing a burn and those cells die and regenerate at a faster rate from that acid, eventually getting mutations made from too much rapid turnover of cells and then they get a pre-cancer mutation. If they get enough mutations, they get cancer. So, when you suppress the acid it prevents that from happening.
Melanie: Dr. Chakrabarty, is obesity related with esophageal cancer and/or GERD and Barrett’s?
Dr. Chakrabarty: Obesity is linked to many types of diseases including GERD and Barrett’s Esophagus and esophageal cancer, mostly because when people gain excessive weight their diaphragm gets stretched and they get what we call a “hiatal hernia”. Now the valve, the junction of the esophagus and stomach is lose. When that happens, there’s more acid that comes up and it puts them at higher risk for getting Barrett’s. So, definitely losing weight helps as well.
Melanie: Tell us about some of the treatments available. If you have endoscopy and you’re diagnosed with esophageal cancer.
Dr. Chakrabarty: If you’re diagnosed with esophageal cancer, it needs to be staged first. Staging is very important because that determines your treatment. If you are Stage 1, which means it hasn’t spread anywhere and it’s within the esophageal lining, that has the best prognosis and rapid surgery in a timely fashion is key for survival. Then, there’s other stages. Stages 2, 3 and 4 and depending where it is, they will decide about chemo and possibly even radiation treatment. If you’re having food getting stuck and you’re nearly blocked off from the tumor and you can’t eat food, then there’s palliation treatment with stents where they open up the esophagus with an esophageal stent so that you can eat food or we put a feeding tube in the stomach if they cannot tolerate the stent. As for Barrett’s Esophagus, there is a treatment called “radio frequency ablation” where people can actually go in there and burn the tissue down to the stem cells and that regenerates new tissue and reduces your risk for esophageal cancer.
Melanie: In just the last few minutes, Dr. Chakrabarty, what should people who want to prevent esophageal issues think about and why should they come to Temecula Valley Hospital for their care?
Dr. Chakrabarty: People should think about how long they’ve been having their symptoms of GERD or acid reflux. If they’ve been having poor control over it, they should definitely seek help. Get proper education in consultation with their doctor to know how to manage it. Changing their diet and lifestyles – what they can do. Esophageal cancers is a very poor prognosis once you have it. You can imagine, the things we take for granted like eating regular food cannot be done and it can be very debilitating and, obviously, very difficult for the patient and their family. We are seeing a lot of young patients now coming in with this because they take over the counter medications and they have family and young children so, definitely, going and seeking help is very important.
Melanie: Thank you so much, Dr. Chakrabarty, for being with us today. It’s such great information. You’re listening to TVH Doc Talk with Temecula Valley Hospital. For more information, please visit temeculavalleyhospital.com. Physicians are independent practitioners who are not employees or agents of the Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks for listening.
Melanie Cole (Host): Not all esophageal cancers can be prevented, but the risk of developing this disease can be greatly reduced by avoiding certain risk factors. My guest today is Dr. Indraneel Chakrabarty. He’s medical director for the Gastroenterology Services Program at Temecula Valley Hospital. Welcome to the show, Dr. Chakrabarty. Tell us a little about esophageal cancer and what are some of the risk factors for it?
Dr. Indraneel Chakrabarty (Guest): Esophageal cancer, there’s two different kinds. There’s squamous cell and adenocarcinoma. Both are increased risk from smoking. However, adenocarcinoma, which is one of the fastest growing cancers in the country is increasing because of chronic heartburn as well. People often take over the counter medications and mask this with over the counter medications and put themselves at risk for this cancer as they’re not seeking help.
Melanie: Is this a silent cancer? Are there some things that would signal that somethings going wrong? Or, if you have heartburn do you always know that you have it?
Dr. Chakrabarty: Heartburn is a symptom of the main condition which is gastroesophageal reflux disease or GERD. GERD can cause various types of symptoms and the classic is heartburn. The severe burning pain in the chest that people get after a fatty meal or eating a tomato-based sauce type food like pizza or pasta sauce. However, you can have atypical symptoms and those are commonly not recognized as GERD but they may have a sensation of a lump in their throat; they may have hoarseness because their vocal cords are being hit by acid and lose their voice; they may have wheezing, trouble breathing because the acid is going down their airway; or, they have severe chest pain where they think they are having a heart attack but it’s actually reflux disease. The other atypical symptom is food getting stuck in the chest and that may be a sign of reflux as well.
Melanie: Can cancer of the esophagus be found early? Is there a screening for it?
Dr. Chakrabarty: There is no standardized screening for reflux or esophageal cancer. Usually, what happens is we try to use questionnaires that describe how long a patient may be having symptoms. The most commonly done right now is, if they have reflux disease for over five years, they should get an endoscopy done. When we do any endoscopy, we look for something called Barrett’s Esophagus which is a pre-cancer condition which can lead to esophageal cancer. If Barrett’s is found, then there’s way to treat that. In the past, there was no treatment and people were just brought in for repeat endoscopy until the cancer was found but now there’s some treatment for it.
Melanie: What about some symptoms of esophageal cancer? Trouble swallowing? Are there certain things you want people, if they have these to come see you?
Dr. Chakrabarty: Yes. If they have progressively worsening what we call “dysphasia symptoms” which means food getting stuck in their chest and it’s getting worse with smaller pieces of food and they’re also vomiting blood or they see black colored stools, those are maybe signs of bleeding from the cancer and/or weight loss. If they start to lose weight, those are red flags. If they have any of the reflux symptoms that I described that have been going on for a while, they should also seek help and get checked out to see if they have this Barrett’s Esophagus or pre-cancer condition.
Melanie: What’s your best advice for prevention of esophageal cancer or GERD or Barrett’s Esophagus?
Dr. Chakrabarty: Commonly, the biggest thing you can do is not smoke. That is the biggest thing. If you have symptoms of GERD – all the symptoms I have described – you want to find out what the triggers are. If you have certain foods that you eat that cause those symptoms, but you really enjoy eating those foods, you may want to avoid them. These kinds of food are commonly fatty foods or greasy foods, tomato-based sauces like I mentioned with pasta or pizza sauce, excessive caffeine, too much chocolate or mint. Those are most of the common types of food. Excessive alcohol can do it as well.
Melanie: Do the antacids that people take and so many of the medications we see today, do they help prevent esophageal cancer or are they mainly to take charge of GERD?
Dr. Chakrabarty: They are mainly to take charge of GERD but it depends on which medicines you are taking because there are several different classes of antacids. There’s medications that temporarily relieve your symptoms immediately and last for maybe 15-20 or 30 minutes. Those are like Tums, Alka-Seltzers. You make take Pepcid or Pepto-Bismal, those are very quick but they don’t protect you from the chronic acid that t may be coming up. The definitive medication that people often use is a class called “proton pump inhibitors” which is like Prilosec, Nexium, Protonix, Asaphex, Dexilant, and those kinds of meds. Those work a lot better to depress the acid and prevent that acid from hitting the distoral part of the esophagus and causing a burn and those cells die and regenerate at a faster rate from that acid, eventually getting mutations made from too much rapid turnover of cells and then they get a pre-cancer mutation. If they get enough mutations, they get cancer. So, when you suppress the acid it prevents that from happening.
Melanie: Dr. Chakrabarty, is obesity related with esophageal cancer and/or GERD and Barrett’s?
Dr. Chakrabarty: Obesity is linked to many types of diseases including GERD and Barrett’s Esophagus and esophageal cancer, mostly because when people gain excessive weight their diaphragm gets stretched and they get what we call a “hiatal hernia”. Now the valve, the junction of the esophagus and stomach is lose. When that happens, there’s more acid that comes up and it puts them at higher risk for getting Barrett’s. So, definitely losing weight helps as well.
Melanie: Tell us about some of the treatments available. If you have endoscopy and you’re diagnosed with esophageal cancer.
Dr. Chakrabarty: If you’re diagnosed with esophageal cancer, it needs to be staged first. Staging is very important because that determines your treatment. If you are Stage 1, which means it hasn’t spread anywhere and it’s within the esophageal lining, that has the best prognosis and rapid surgery in a timely fashion is key for survival. Then, there’s other stages. Stages 2, 3 and 4 and depending where it is, they will decide about chemo and possibly even radiation treatment. If you’re having food getting stuck and you’re nearly blocked off from the tumor and you can’t eat food, then there’s palliation treatment with stents where they open up the esophagus with an esophageal stent so that you can eat food or we put a feeding tube in the stomach if they cannot tolerate the stent. As for Barrett’s Esophagus, there is a treatment called “radio frequency ablation” where people can actually go in there and burn the tissue down to the stem cells and that regenerates new tissue and reduces your risk for esophageal cancer.
Melanie: In just the last few minutes, Dr. Chakrabarty, what should people who want to prevent esophageal issues think about and why should they come to Temecula Valley Hospital for their care?
Dr. Chakrabarty: People should think about how long they’ve been having their symptoms of GERD or acid reflux. If they’ve been having poor control over it, they should definitely seek help. Get proper education in consultation with their doctor to know how to manage it. Changing their diet and lifestyles – what they can do. Esophageal cancers is a very poor prognosis once you have it. You can imagine, the things we take for granted like eating regular food cannot be done and it can be very debilitating and, obviously, very difficult for the patient and their family. We are seeing a lot of young patients now coming in with this because they take over the counter medications and they have family and young children so, definitely, going and seeking help is very important.
Melanie: Thank you so much, Dr. Chakrabarty, for being with us today. It’s such great information. You’re listening to TVH Doc Talk with Temecula Valley Hospital. For more information, please visit temeculavalleyhospital.com. Physicians are independent practitioners who are not employees or agents of the Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks for listening.