Early testing for esophageal cancer can prevent disease
by Patrick McCreless
pmccreless@annistonstar.com
Apr 07, 2012 | 6119 views |  0 comments | 11 11 recommendations | email to a friend | print
Dr. Clifford Black of the Anniston General Surgery Center explains a device doctors use in a procedure called Barrx radio frequency ablation Friday at Stringfellow Memorial Hospital. (Anniston Star photo by Stephen Gross)
Dr. Clifford Black of the Anniston General Surgery Center explains a device doctors use in a procedure called Barrx radio frequency ablation Friday at Stringfellow Memorial Hospital. (Anniston Star photo by Stephen Gross)
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Beverley Shelley’s father died of esophageal cancer when he was 60 years old. Once reaching the same age, she decided to go in for a checkup for the disease, even though she had no symptoms.

Shelley was shocked by what she learned.

“Basically, I was heading down the same road as my dad but with no symptoms,” Shelley said.

Shelley of Anniston had not developed esophageal cancer. But she did have gastroesophageal reflux disease, typically referred to as chronic heartburn, along with Barrett’s esophagus — two conditions which are precursors to esophageal cancer.

According to the National Cancer Institute, esophageal cancer is one of the disease’s deadliest forms. However, medical experts encourage testing, saying patients who receive the latest treatments for the precursors to the cancer can usually avoid it.

“People say it’s just heartburn when they have it because it is such a common problem, but no, it’s not just heartburn,” said Dr. Clifford Black, who runs the Anniston General Surgery Center. “Reflux disease increases the risk of cancer by about 30-fold and many people don’t even realize you can do anything about it.”

Two years have passed since Shelley received treatment for her ailments and she is still cancer-free. Shelley said she would be meeting with Black at Stringfellow Memorial Hospital next week to undergo treatment through a relatively new procedure called Barrx radio frequency ablation, which should wipe out her Barrett’s esophagus completely and keep her from developing esophageal cancer.

Barrett’s esophagus is when genetic changes occur to cells of the esophagus. The changes are triggered by years of untreated reflux disease, which exposes the esophagus to stomach acid. The alteration of the cells is how cancer can eventually form, Black said.

Black said the Barrx radio frequency ablation device, which Stringfellow obtained about 4 months ago, uses a tube that slides down a patient’s throat to the affected area.

“The device allows you to deliver a very measured dose of radiation and destroys the lining of the esophagus for about 1 millimeter,” Black said. “It’s very precise.”

To date, Black has performed about 10 procedures using the device.

“It’s all gone very well,” he said.

Dr. James Hixon, chief of staff at Regional Medical Center in Anniston, said his hospital has been using the device since 2006. Lisa R. Bichsel, director of marketing for Covidien, the company that makes the device, said it first came on the market in 2005 and only about 21 physicians in Alabama are currently certified to use it.

“It’s becoming more and more frequent,” Hixon said of the technology.

Hixon said the device has a high success rate at removing Barrett’s esophagus, which is crucial since there is little a physician can do once a patient develops esophageal cancer.

“People who get esophageal cancer — 95 percent are dead in one year,” Hixon said. “It’s important we get rid of the precursors to this.”

National Cancer Institute statistics show that patients with esophageal cancer can live five years at the most, which is comparable to death rates with pancreatic cancer. Also, it is estimated about 17,460 adults will be diagnosed with the disease this year.

Hixon added that incidents of the cancer have increased in recent decades, which he attributes partially to the increased rates of obesity.

“Part of the problem is our lifestyle … we eat a lot of fast food … that can cause acid reflux,” Hixon said.

In addition to the Barrx radio frequency ablation, Black uses another recent technology called the Esophyx transoral incisionless fundoplication procedure, or TIF, to fix a patient’s acid reflux, which further lowers the risk of developing esophageal cancer. The incisionless procedure is based on established principles of surgical repair of the valve, except it is surgery performed through the mouth instead of cutting into the abdomen.

A small tube with tiny pinchers is sent down the throat along with a camera to let the doctor see what he or she is doing. The procedure creates a valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent reflux.

“When you come in, you should have not only the ablation done to abate Barrett’s, but you also need to stop the reflux which causes it,” Black said.

Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star
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