Treatment of Barrett's oesophagus may lower risk of oesophageal cancer

New guidelines issued by the American Gastroenterological Association (AGA) support the use of radiofrequency ablation (RFA) to remove precancerous cells in patients with Barrett's oesophagus, a condition most commonly caused by chronic acid reflux, or GERD. Barrett's oesophagus is the leading cause of oesophageal cancer and affects an estimated two million Americans. While traditionally managed through watchful waiting, experts at Northwestern Medicine's Centre for Oesophageal Disease have been among the pioneers of ablation treatment and have long seen the benefits of early treatment.

Frequent heartburn, regurgitation, and trouble swallowing are common symptoms of GERD (gastrooesophageal reflux disease), which experts believe is the result of stomach contents washing back into the oesophagus leading to the development of Barrett's oesophagus. Repeat exposure to stomach acids can result in damage to the oesophagus and cause healthy cells to transform into these precancerous cells. Unfortunately, many patients with Barrett's oesophagus can be asymptomatic.

'The incidence of oesophageal cancer is increasing more rapidly than any other type of cancer in the United States and survival rates remain low,' said Northwestern Medicine gastroenterologist Srinadh Komanduri, MD. 'Barrett's oesophagus is a precancerous condition, and while the majority of people who suffer from the disorder will never develop cancer, the risk is present. Early treatment with RFA would likely reduce a patient's chance to develop cancer.'

RFA burns away layers of abnormal cells and effectively eliminates the disease in 90-100 percent of patients. Doctors use a flexible tube (endoscopy) inserted into the oesophagus to reach the treatment area, which also provides access for taking biopsies or endoscopic resection of suspicious lesions.

Northwestern's Centre for Esophageal Disease is the top program in Chicago and has treated more than 130 patients with endoscopic therapy.

'We have seen great results using RFA therapy,' said Komanduri who is also an assistant professor of medicine at Northwestern University Feinberg School of Medicine. 'It effectively cures Barrett's oesophagus in most patients, leads to fewer surgical procedures for the disease, and contributes to lowering the growth rate of oesophageal cancer.'

The new AGA guidelines recommend RFA treatment for patients with low to high grade dysplasia due to Barrett's oesophagus and suggest it as an effective option for high-risk patients without dysplasia. Speak with your physician to determine if you are a candidate.