Esophageal cancer?

[MariaSt]

It has been 17 months of acid reflux, intermittent nausea, painful tightness around my lower ribs that starts from the LES area. The third gastroscopy showed mild swelling on lower LES, the biopsy showed only esophagitis. The CT scans that were done twice, the first one last year and the second one recently, also showed swelling of the lower esophagus. I wonder if I can have esophageal cancer that they just fail to recognize. I read that esophageal cancer can have very slow progression over years. Any thoughts?

[Bunny69]

Hi Maria,

It happened in my case that the tumour was not seen but we think the reason was the first two endoscopies reported a sliding hiatus hernia and barretts but ct scan didn't include the oesophagus and barium study showed possible achalasia due to narrowing and birds beak at junction. Manometry was consistent with achalasia according to one consultant but another consultant said it was not consistent. Tumour was found on 3rd endoscopy as scope could not pass junction. I hope my experience is not the normal.

Best of luck

Bunny

[MariaSt in reply to Bunny69]

Hello, Bunny! I am sorry you had such an experience! How long did it take for you to be properly diagnosed? What were your symptoms?

[Bunny69 in reply to MariaSt]

It took 8 months, first symptom was food sticking firstly chicken then bread. Symptoms other than food sticking at sternum level and regurgitating chewed food wrapped in thick saliva. Thickly cough in middle of night, hiccups . Only really had reflux after alcohol otherwise never had it. Sleeping on left seemed to stop that so never used gaviscon or ppis . Was biopsies in December 2017 which confirmed barretts but no dysplasia. By that time I couldn't eat any solid food. The biopsies did not take from goj and were from 2cms above. When scope could not pass through junction in April 2018 biopsies were taken from junction and adenocarcinoma at junction was confirmed . I had a 65mm tumour at junction. As I say I hope my case is not normal and you are not suffering from this but we were told everything was ok and I would probably need botox injections or fundoplication. My wife was told to stop worrying as they would make me better and we were 80% through diagnostic pathway. Cancer was not mentioned until it was found and all tests following endoscopy seemed to refer to that as a definitive and accurate assessment. The first two endoscopies were poorly tolerated .

[Revdel]

Hello Maria

I'm sorry you're having such a difficult time. Like you, I just don't know the answer to your question and I say that having considerable experience of cancer of the oesophagus as my husband suffered from that. My understanding is that one of the problems with the disease is that diagnosis tends to be difficult due to vague symptoms. The fact that this is so means it is very reasonable for you to keep asking questions until you are satisfied that a full answer to your symptoms has been found. How about seeking a second opinion from a different consultant at a different hospital? Having said this I hope you have as good an experience as did my husband and I with our local hospitals and consultants as the treatment was first class. Every good wish.

Della

[MariaSt in reply to Revdel]

Hi, Revdel! I am sorry your husband had to go through this too. I have done 3 gastroscopies with 3 different gastroenterologists. Only the last one took one biopsy from the esophagus, the first two took biopsies only from my stomach. While omeprazole cured my stomach burning, the pain in the esophagus is the same and that’s what startles me. And yes, you are right, the symptoms are vague and noone takes me seriously. How long did it take for your husband to get diagnosed? What were his symptoms?

[Revdel in reply to MariaSt]

By the time my husband went to the doctor he was feeling that food was getting stuck. That was enough for him to be sent for an endoscopy and the tumour was found within a couple of weeks. He had suffered some indigestion initially which progressed to the feeling that food was sticking - which it was. He also had a pain which went through his sternum to his back. This would wake him during the night and he thought it was angina. We later learned that this is a typical pain for cancer of the oesophagus.

[Mauser1905]

Reading in between the lines here.

If you had cancerous cells developing it would have been diagnosed by now. So if I were you I would stop worrying for what you don't have.

What you have is acid reflux and anxiety issues. Assuming you have been tested for H Pylori and its negative.

Tissue irritation is direct result of acid damage.

Opa.org.uk has reflux awareness information in various formats please visit the website.

On the contrary the advancement of the adenocarcinoma, ( observed at the lower oesophagus due to acid reflux mainly) is very aggressive once its established.

If I were you I would ask for treating root cause issues than persisting long term daily management of the symptoms.

Mainly potential of Nissen fundoplication or LINX band depending upon the low or high grade of herniation.

Your constant anxiety is never going to help, whatever PPI or H2 blockers you take.

Focus should be on not letting stomach acid sit in oesophagus (where jt shouldn't be all the time) rather attempting to reduce the acid production.

[MariaSt in reply to Mauser1905]

Thank you for your response. I also thought that the progress of the cancer would be fast, but when I looked into it, I read that can be actually very slow. There are 3 histological types of esophageal cancer, each one hs different progression. In your opinion, the only way to keep the the acid away from my esophagus would be a surgery?

[Mauser1905 in reply to MariaSt]

Its depends upon the root cause to be honest, which in your case I can only speculate.

Nissen fundoplication (either partial or full 360 degrees) can fix larger hernia, and LINX band placement can help with lesser degree of hernia or lax sphincter.

Having said that the successful outcome of the surgical fixes will vary depending upon the recipient.

Long term acid management only beats around the bush.

[Popsic]

Hi there, I suffered heartburn for 20+yrs until I finally went docs, I had an endoscopy which confirmed I had Barrett's oesophagus, that was 2009, in 2012 on a routine endoscopy they found I had early stage cancer, in fact I had 2 appointments missed/ cancelled, it was the 3rd appointment it was found. I was told had I gone for either of the previous appointments it wouldn't have been found. I have my oesophagus and part of my stomach removed in 2013.

[The_OPA Partner]

Hi Maria please log onto our website opa.org.uk there is a wealth of information about reflux and many symptoms. There is also a diagnostic tool questionnaire on the first page of our website. Also lots of free downloads and we can send you a pack of information all about reflux disease if you send us your address and details to [e-mail] Hope this helps! take care

[mgloughran]

Have they performed an EGD with biopsy yet? That is how they found mine.

[MariaSt in reply to mgloughran]

Is it the same as gastroscopy? I had 3 of them, they took a biopsy from my esophagus during the last one. It was negative. I hope they didn’t miss the correct spot.