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Barrett’s Esophagus-EDG, EMR, Risk of Esophageal Cancer?

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“It has also been shown to be safe and effective for early adenocarcinoma arising in Barrett’s esophagus. The prognosis after treatment with EMR is comparable to surgical resection.”

Dear Cancer Coach- Thanks for the great info! I’ve had Barrett’s Esophagus (BE)  for about 10 yrs. During  EGD in Dec. ’18 they found high & low grade dysplasia. I underwent an EMR (endoscopic mucosal resection) April 2nd.

I’m a little confused as to what they did; I originally thought is was to remove some of the dysplasia. They removed a non-dysplacic polyp. I’m thinking there was some kind of miss-communication between the two gasto-drs I’ve been working with.

I’m scheduled for a halo ablation July 18th. (I’m thinking this is the same thing as a Radio Frequency ablation.)

I would appreciate it if you could help me untangle some of some of the confusion I have. IE: what did the EMR accomplish? Was it necessary? Will the RFA remove high grade dysplacia? Any other comments welcome!

 

I’ve also been drinking a little aloe vera juice in the hopes that would help. FYI, I’ve been a vegan for about 10 years. I eat a little herring or sardines every day in hopes of getting enough Omega 3’s. Plus I eat flax & other seeds & nuts every day. I also eat turmeric with every meal.

Please let me know if you have any short-term advice.

Thanks again!! Gus


Hello Gus,

I am sorry to read of your Barrett’s Esophagus issues but my read is that you and your doctors are working hard to make sure your BE does not progress to esophageal cancer. I will try to answer your questions below.

“I underwent an EMR (mucousal resection) April 2nd. I’m a little confused as to what they did; I originally thought is was to remove some of the dysplasia. They removed a non-dysplasic polyp. I’m thinking there was some kind of miss-communication between the two gasto-drs I’ve been working with.”

My understanding of an EMR, (see the article below), is to remove pre-cancerous tumors. My understanding is that a polyp is a pre-cancerous growth. I think that the vocabulary used by M.D.s is very confusing. Technically polyps, BE, other growths are considered “pre-cancer” because they increase the risk of becoming cancerous.

I don’t know what your M.D. said to you about the purpose of EMR but removing the polyp will reduce your risk of developing EC. This is good.

“I’m scheduled for a halo ablation July 18th. (I’m thinking this is the same thing as a RF ablation.”

You are correct. HALO is a type of ablation.

“IE: what did the EMR accomplish? Was it necessary? Will the RFA remove high grade dysplacia?”

To confirm, yes, removing the polyp in your esophagus reduced your risk of EC. Just like removing polyps in one’s colon reduces the risk of colorectal cancer.

Also, yes, radio-frequency ablation will reduce your risk of your BE becoming EC. Two different procedures for two different types of growths that increase the risk of EC.

For the record, the risk of BE becoming EC is small (.5 to 1.0 percent). But since esophageal cancer is difficult to cure, reducing your risk of EC is useful.

Lastly, your non-conventional therapies such as Aloe Vera juice, omega-3 fatty acids, flax, nuts and turmeric are also excellent therapies to reduce your risk of esophageal cancer.

I encourage you to exercise regularly and quit tobacco if you haven’t already. Reduce any alcohol consumption as well. While I’m at it, I will encourage you to eat more fruits and veggies and reduce your consumption of animal fat.

Let me know if you have any other questions, Gus. Good luck.

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


How should patients with Barrett’s esophagus be monitored?

“Some patients who have been diagnosed with Barrett’s esophagus will develop dysplasia and, in some cases, esophageal carcinoma (strength of recommendation [SOR]: A, based on consistent cohort studies). Endoscopic surveillance is recommended for all patients with Barrett’s esophagus as it is superior to other methods for detecting esophageal cancer…”

Endoscopic mucosal resection

“It has also been shown to be safe and effective for early adenocarcinoma arising in Barrett’s esophagus. The prognosis after treatment with EMR is comparable to surgical resection. This technique can be attempted in patients, without evidence of nodal or distant metastases, with differentiated tumors that are slightly raised and less than 2 cm in diameter, or in differentiated tumors that are ulcerated and less than 1 cm in diameter. The most commonly employed modalities of EMR include strip biopsy, double-snare polypectomy…”

Current Controversies in Radiofrequency Ablation Therapy for Barrett’s Esophagus

“Barrett’s esophagus (BE) is the most important risk factor for esophageal adenocarcinoma. Through the sequence of no dysplasia to low-grade dysplasia (LGD) and high-grade dysplasia (HGD), eventually early cancer (EC) may develop.

The risk of neoplastic progression is relatively low, 0.5–0.9 % per patient per year. However, once diagnosed, esophageal adenocarcinoma is often irresectable, and 5-year survival is only 15 %. Therefore, non-dysplastic BE patients are kept under endoscopic surveillance to detect early neoplasia in a curable stage.

In case of LGD confirmed by an expert pathologist, risk of neoplastic progression is high. In these confirmed LGD patients, prophylactic ablation using radiofrequency ablation (RFA) of the Barrett’s segment has proven to significantly reduce risk of neoplastic progression…

 

 

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