Did you have a history of heartburn before diagnosis with adenocarcinoma?

There is a new poll that we have just set up about heartburn. We did have one about Barrett's Oesophagus earlier that did show a large proportion of people who had oesophageal adenocarcinoma (OAC) and either knew they had Barrett's Oesophagus or suffered from persistent heartburn. The number who did not suffer from heartburn was much smaller. There is a school of thought that acid can cause problems without creating heartburn, and some people believe that this can manifest itself in the form of a persistent cough, for instance. Some people might have had a persistent cough as well, of course.

There is a strong apparent link between persistent heartburn, Barrett's Oesophagus and OAC, but I dare say that some people may have been diagnosed with squamous cell carcinoma when they had heartburn, so these things are complex. And not everyone knows which form of cancer they had anyway.

But thank you to all those who have responded to earlier polls, and we would be grateful if you would also have a go at this latest one. They are not very scientific, but can give some useful insights.

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  • A large proportion of those diagnosed with Barrett's claim never to have experienced the pain of heartburn but the evidence is there that it occurred. For some reason their oesophagi are less sensitive. Also Barrett's cells are less sensitive so once Barrett's has developed, people are less likely to experience heartburn.

    Whereas reducing the acid makes reflux less dangerous to the oesophagus (and probably less likelihood of progression), even non-erosive reflux (NER) can cause damage. Extra Oesophageal reflux (often called LPR) can aspirate into the respiratory system causing hoarseness, cough, sinus problems etc. and in extreme cases, pneumonia and bronchiectasis.

    Extra-Oesophageal acid reflux is now also shown to be a possible cause of some neck and throat cancers.

  • It has always puzzled me why I developed oesophagal cancer, I did not have a history of heartburn, rarely took ntacid, learned early on to avoid warm flaky pastry items such as sausage rolls etc. However I did have two separate encounters with bleeding stomach ulcers. Four years apart, it was during the treatment of the second instance that the specialist spotted the early T1 signs. Is there a connection.? I know I was extremely lucky as I am now five years on aged 77, thanks to a sharp eyed consultant.

  • The issue of heartburn is relevant primarily to adenocarcinoma, which is about 70% of the UK's oesophageal cancer cases; the other 30% is squamous cell cancer which is not particularly associated with stomach acid. It might depend on which one you had? I really do not know the answer to your question - we do not always know the reasons for these apparently random developments of the disease, but I imagine that the other things going on in your stomach probably did not help. But sharp-eyed consultants are life savers aren't they!

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