Early Diagnosis

Congratulations to Tim Underwood on an excellent interview on the BBC's Inside Health programme about oesophageal cancer. Tim managed to put all the issues over very clearly in a short space of time in the last few minutes of the programme. For those who missed it, you can listen again through the BBC website bbc.co.uk/programmes/b019dl1b

Getting those who suffer from persistent heartburn to go to their GP, and then to have an endoscopy, is a crucial public health issue, because diagnosing and monitoring Barrett's Oesophagus is a great opportunity to make a diagnosis at a much earlier stage for those cases that do turn into cancer.

12 Replies

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  • It was interesting to hear.When are we likely to hear about change to the Nice guidelines

    for patients under the age of 55yrs, which is under review ,and who currently have difficulty

    getting an endoscopy. Sally

  • The Working Party is still sitting, and we have not had any feedback yet, but Tim Underwood did suggest that they would be likely to be made more flexible on the issue of age and the importance of persistent heartburn, so either he has better information or was doing some wishful thinking on behalf of a great many people.

  • Thank you for alerting us to this Alan. I missed it when it was first broadcast and it is an excellent interview. For those trying to navigate the iplayer it starts about 20 minutes into the programme. Best wishes, Martin

  • It was a very informative programme. I particularly liked Tim's comment when he said having an oesophagectomy is akin to running a marathon without any training! I know that's very true as I watch my husband, Russ, trying to regain his strength 13 weeks post surgery, knowing he still has a long, long way to go.

  • At 13 weeks post surgery your husband will obvioulsy still be very weak. Its like a marathon you just have to pace yourself and gradually he will get stronger. If you try to do too much in the early months you may find that you hit a walll after 6 months or so which was my problem. I am 62 and 8 months post surgery and I still need to an hours rest most afternoons. There will be many frustrations as on certain days you feel really good but then at other times you can be really tired. I was up a ladder yesterday chopping down trees so it will come right!

  • I listened to the programme which concentrated on the connection between acid reflux and cancer. I had my oesaphagectomy three years ago, but I had never had indigestion in my life. My one and only indication that anything was amiss was when a piece of meat got stuck while eating on holiday in Spain. The blockage eventually cleared itself but a Spanish doctor advised me to see my GP who arranged an endescopy which revealed the T2 cancer. Could I have had acid reflux without any symptoms or did something else cause my cancer? Are there any statistics, have any surveys been carried out regarding lifestyles or digestive historys, or am I just the exception that proves the rule?

  • I had my oesophagectomy, three and a half years ago, and like Graham39, I had never had indigestion. I had no symptoms at all from the cancer. It was discovered by chance. I was prescribed meds for a neurological condition, and they caused my mouth and tongue to twitch, so I told my GP I was having difficulty eating. He insisted on an endoscopy, although I said it was just the meds causing it. A few days later the meds were stopped, and all the symptoms stopped, but the endoscopy went ahead, and found a T1 adenocarcinoma.

    I never had indigestion, but the Docs still insist that was the cause.

  • Hi all, I too have never had indigestion or reflux.

    I also read on this and the Macmillan site that none of us seem to be the smoking, heavy drinking obese stereotype that would be predisposed to this disease.

    Also I have not so far suffered from any reflux post-surgery, so whilst initially I raised my bed head with wooden blocks, I soon removed those and just sleep with pillows as before.

  • Hi Hilr

    you are very lucky not have been bothered with reflux and I'm glad for you. I'm 62 now but in my early 20's I had about 10 years or more problems with Indigestion and an ulcer. my doctor used to prescribe Asilone which is like milk of magnesia and I used to drink it by the bottle, so i suppose I was a prime candidate. I was a moderate too heavy drinker and used to smoke also although don't do either now, but I was never obese. I think i must have been a classic case-lol.

    Kind Regards

    Steve

  • I do not think that there is any association between alcohol and oesophageal adenocarcinoma, but there is something of a link with smoking on the basis that this may relax the lower oesophageal sphincter and allow more acid to rise up from the stomach. With squamous cell carcinoma the alcohol / smoking links are stronger.

    The obesity issue is to do with the upward physical pressure that the body creates, squeezing stomach contents up into the oesophagus - pregnant women will also suffer this for a few months.

    There is also a school thought that some food ferments more in the stomach and rises more easily.

  • Hello All,

    I had heartburn for most of my adult life, for which I took Rennies just before going to bed each night. I was also diagnosed with a hiatus hernia but at no stage did anyone alert me to what might eventuate. I suppose that this was par for the course those years ago. Then, in early 2011, I was scoped and cancer was discovered. I had my oesophagectomy 2.5 years ago and whilst I understand why Tim Underwood describes it as something akin in life impact terms to running a marathon on no training, the reality is that it is far, far worse. I went into hospital as a reasonably fit late-middle ager, not overweight, and came out 3 weeks later as an old man. I was shattered - there is no other way of describing it - and whilst I would accept that recovery after a marathon is not immediate, it is unlikely to take the many months it took me to get to somewhere vaguely like normality. And when I say that, I think that I am one of the reasonably lucky ones.

    Incidentally, my surgeon describes this foul disease as an "explosion" in the Western world and thoughts lean towards food preservatives as a possible cause.

    Best wishes,

    Speakman.

    .

  • You do indeed feel old after the surgery, but there are many people who gradually recover and attain a reasonably good quality of life afterwards. They all say that it does sap the stamina, but getting to where they have managed to get is a goal worth aspiring to.

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