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Saint Joseph Mercy Health System

Esophageal Cancer Cases on the Rise
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Saint Joseph Mercy Health System experts urge public to heed the signs and symptoms of this deadly cancer linked to obesity.

The holiday season is often a time of indulgence at the dinner table. In fact, the traditional Thanksgiving dinner contains between 2,000 and 4,500 calories. Pushing away from table when satisfied may help more than someone’s waistline... it could help save their life.

Twenty-nine percent of people in Michigan are obese, having a body mass index of 30 or higher. This epidemic of obesity carries with it many serious health concerns, including cardiovascular disease, diabetes and some types of cancers. There is increasing evidence that incidence of Barrett’s esophagus and esophageal cancer is linked to the obesity epidemic.

According to Dr. Naresh Gunaratnam, gastroenterologist for Saint Joseph Mercy Health System, “New cases of esophageal cancer are increasing faster than any other cancer in the U.S. It occurs in approximately 14,500 Americans per year, causing about 12,000 deaths.”

“Most patients are diagnosed in their 50s or 60s, with approximately four times as many diagnoses in men than women. Cancers of the esophagus tend to be more common in Caucasian males and it is thought that the majority of the cases develop from Barrett’s esophagus,” he says.

Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD). GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn. Over time, the lining of the esophagus may change to resemble the lining of the stomach or the intestines. When those cells change, that is known as Barrett’s esophagus.

“There are many minimally invasive treatment options if Barrett’s esophagus is caught early including endoscopic mucosal resection and radiofrequency ablation,” explains Gunaratnam. “If Barrett’s esophagus has progressed, surgery may be necessary coupled with radiation and/or chemotherapy. Medical advances such as robotic surgery and research studies are creating more options for esophageal cancer treatment.”

Reflux is the strongest risk factor for Barrett’s esophagus and esophageal cancer. Other major symptoms include heartburn, difficulty swallowing, inability to swallow solid foods, pain with swallowing, food sticking in esophagus, regurgitation of undigested food, vomiting blood or passing old blood with bowel movements.

Mel Pastula, 63, realized that the heartburn he thought he had been controlling for years had caused stomach acid to create changes to his esophagus that led to cancer.

Pastula sought Dr. Gunaratnam for treatment and together they decided on the best care plan for Pastula. Dr. Gunaratnam was able to preserve Pastula’s esophagus, while treating him with state-of-the-art endoscopic mucosal resection (EMR) and radiofrequency ablation.

“The EMR procedure is very non-invasive. Luckily I have not had any kind of post-op experiences that were unpleasant. I’d have a sore throat for that day but pretty much by that evening I was comfortable, and the next day everything was back to normal,” shares Pastula.

Today, Pastula is on the path to being cancer free.

“I’ve got a good life and I’m just I’m glad I could be here with my family.”