Rare Esophageal Cancer Hides in Common Symptoms
In rare cases, seemingly harmless symptoms could mean esophageal cancer.
March 25, 2009 — -- Jeff Carpenter was having a little trouble swallowing and assumed it was acid reflux, a condition that ran in his family. But when the 41-year-old father of two went to the doctor, he got the shock of his life.
Carpenter was diagnosed with esophageal cancer, a rare but deadly form of cancer that attacks the throat.
Carpenter said he was floored by the news; the thought of cancer had "never even crossed [my] mind."
"It's surreal," he said. "You never think it's going to happen to you."
But Carpenter is just one victim in a recent surge of esophageal cancer that some experts believe is related to the nation's growing problem with acid reflux.
Esophageal cancer can develop when stomach acid backs up into the lower esophagus, in some cases damaging cells in the inner layer of the esophagus. This abnormal cellular change is known as Barrett's esophagus, which rarely becomes cancerous.
Unfortunately, however, the disease tends to be as deadly as it is rare. Only 16,000 new cases of esophageal cancer were reported in 2008 but more than 14,000 people -- 87.5 percent -- died from the disease, according to the National Cancer Institute.
Click here for more information on the causes, symptoms and treatment of esophageal cancer.
The disease often goes undiagnosed for long periods because its symptoms do not seem unusual.
"Sometimes it can manifest as having a cough that doesn't go away," said Dr. Allyson J. Ocean, an oncologist at New York-Presbyterian Hospital. "Sometimes it can manifest as [a] sore throat. Sometimes it can manifest as indigestion. And then a more ominous sign is difficulty swallowing."
Carpenter's difficulty swallowing, also known as dysphagia, is the most common symptom, but also one of the latest ones realized.
If the cancerous tumor has grown considerably, it will cause the opening of the esophagus to narrow to nearly half its usual width. By the time it begins causing a problem with swallowing, the cancer is often too large to cure easily.
Dr. Jonathan Aviv, director of the Division of Laryngology at the College of Physicians and Surgeons, Columbia University, defines chronic coughing as a cough that lasts more than six weeks. Then, he said, it's time to see the doctor.
Carpenter was lucky, however, and caught his cancer early. After some chemotherapy and surgery, he was back to work.
To detect the cancer, doctors have developed a fairly simple test that literally takes a look down the throat.
A Test to Save Your Life
The test, called a transnasal esophagoscopy, or TNE, is done by passing a flexible viewing tube through your nose and the back of your throat into the esophagus. The scope can even reach all the way down into the stomach without causing pain.
Once the tube is inserted, the doctor can literally see the cancer, if it exists there.
The simple test was performed on "Good Morning America" live and only takes about one minute.
"Our hope is that ... the heartburn may be throat burn," Columbia University's Aviv said. "We, hopefully, can detect these lesions very, very early and prevent disease."
Nick Tsaclas, the patient for the test on "Good Morning America," had been already diagnosed with Barrett's and a precancerous lesion in his throat was plainly visible during the test.
If a doctor discovers Barrett, the patient may have to go back for follow-up exams, "basically, for the rest of your life," "GMA's" medical contributor Dr. Tim Johnson said.
"Usually with a gastroenterologist, they will keep an eye on it, biopsy it," he said. "If it starts to change into early cancer, they will leap into action maybe with a surgical procedure."
Johnson said people can reduce their risk of cancer of the esophagus by watching their weight and their diet and by cutting back on excessive drinking and smoking.