Q&A Topic: Esophageal Cancer

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Dr. Darren I. Rohan, FACS

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Q. What is esophageal cancer?

A. Esophageal cancer is cancer of the esophagus, the muscular tube that moves food and liquid from the throat to the stomach. It’s the fastest growing cancer diagnosis in the United States with an increased rate of more than 400 percent in the past 20 years.

Q. Am I at risk?

A. If you smoke or drink heavily, you’re at risk. If you’re overweight or obese, you’re also at risk. Excess abdominal fat puts pressure on your stomach which weakens the valve between your stomach and esophagus. When this valve, called the lower esophageal sphincter, becomes weak, corrosive stomach acid can splash back, or reflux, into the esophagus. This increases your risk for gastroesophageal reflux disease (GERD). Five to ten percent of those with GERD develop Barrett’s esophagus, which increases the risk of developing esophageal adenocarcinoma, a serious, potentially fatal cancer of the esophagus.

Q. I take medication for GERD daily. Won’t this lower my cancer risk?

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A. You may be surprised to learn that, if you’re self-treating symptoms of GERD, you may be doing damage to your esophagus. Using anti-reflux medications known as proton pump inhibitors (PPIs) may help you feel better, but they’re not stopping the refluxing (splash-back) action. They’re only reducing the amount of acid in your stomach. These drugs were never meant to be taken for more than a few weeks at a time.

Q. Why is it important to lower my risk and how can I do that?

A. Symptoms of esophageal cancer can easily be confused with something less serious and it’s often diagnosed at an advanced stage. Instead of people relying heavily on PPIs, make lifestyle changes to reduce your symptoms as well as your risk of Barrett’s esophagus and esophageal cancer.If you’re a smoker, the best thing you can do is to quit. At Northern Westchester Hospital, we offer a free four-week smoking cessation program for community residents. Smokers are taught how to track smoking habits, deal with cravings, and use stress relief practices like relaxation therapy, aromatherapy, and acupuncture as an alternative to smoking.Caffeinated products like coffee, soda, and tea are typical culprits of reflux. If you find they aggravate your symptoms, drink water instead. You can also try following a Mediterranean diet high in fruits, vegetables, nuts, beans, grains, olive oil and fish. This will help you lose weight and lower your risk for esophageal cancer. It’s also easy on the taste buds.

Q.How is esophageal cancer treated?

A. Most patients are treated first with a combination of high-energy radiation beams and chemotherapy drugs to shrink the tumor, followed by surgery. At Northern Westchester Hospital, we use the most advanced treatment available for esophageal cancer, known as robot-assisted minimally-invasive esophagectomy. I remove the diseased portion of the esophagus and lymph nodes, if necessary. The stomach is then attached to the remaining part of the healthy esophagus. With robotic surgery, my patients have less scarring and less pain, which allows them a faster return to their daily activities. But, it takes ongoing lifestyle changes – better diet, increased activity level, healthier choices – to fully recover.

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Learn more about Dr. Rohan
Westchester Regional Director, Thoracic Surgery Program
Northern Westchester Hospital

Northern Westchester Hospital is a proud member of Northwell Health.

Read Past Topics from Dr. Rohan 
Finding Relief from Acid Reflux Disease


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