We enjoy receiving questions from both RefluxMD members and visitors to our website. In many cases those questions are triggered by one of our articles. One RefluxMD member recently read Pat’s story about losing her husband to esophageal cancer, known as oesophagus cancer in Europe – and that triggered some questions that RefluxMD thought we should share with you.
Pat’s story about Bob, Widow speaks out about the risk of esophageal cancer, is a beautiful account of their life together and Bob’s struggle with cancer. We hope that it raises awareness for many and that it serves as another reminder not to ignore symptoms until it is too late. Here is a question we received from one of our members after reading that article:
Regarding the Bob and Pat cancer story, it certainly is good to raise awareness, but there is no guarantee that anything could have been done. My husband had cancer detected and he had no symptoms. You have the responsibility to report accurately. No one knows why a young healthy guy gets cancer and obese older smokers do not. I can’t tell you how many guys I see walking around with big guts and yet they have no cancer. And can you tell me what evidence you have that PPIs cause cancer? I would like to review the studies.
Why Do Some People Get Cancer and Others Do Not?
This raises an interesting question as to why some people get sick and other do not. I don’t believe that there is an answer to that question today; we only know that certain actions and decisions increase the risk of illness or injury. For example, smoking tobacco does not always result in lung cancer, but it does increase the risk of that illness. An intoxicated driver may not have an auto accident, but there is an increased risk of such an occurrence. So it is with GERD and esophageal cancer. We understand the risky behaviors, but we can’t be confident if they will lead to any long-term complications.
Can We Avoid Oesophagus Cancer?
Was Bob’s cancer avoidable? What we know about esophageal cancer is that it is a slowly developing condition that goes through very defined stages. Diagnostic testing can identify these stages, and like most cancers, when found early, the chance of survival is much higher. According to the National Cancer Institute, colon cancer has an overall 5-year survival rate of almost 65%. However, if undetected and allowed to progress to Stage 4, the survival rate drops to 6%. Esophageal cancer has an overall 5-year survival rate of around 17%. Why the difference between these two cancers? It’s simple: in the US we screen for colon cancer. Our medical experts believe that screening would improve the 5-year survival rate for oesophagus cancer to a level consistent with colon cancer. Could Bob’s cancer been avoided? It’s hard to say for sure, but with screening it could have been detected and treated much earlier, possibly resulting in a different outcome.
Do PPIs Cause Cancer?
RefluxMD has never suggested that PPIs cause cancer. PPIs have an important role in treating GERD, and we recognize that fact. For those with reflux disease, PPIs can be very effective in symptom relief. However, since their introduction in 1989, the cost of this treatment has grown to over $11 billion dollars annually while adenocarcinoma, esophageal cancer that results from GERD, has become the fastest growing cancer in the US, Europe, Japan and Australia (The truth about acid reflux disease).
Research has proven that PPIs have been overprescribed: over 30% of adults using PPIs are NOT refluxing. We have found that very few people have been fully informed about the potential risks associated with the long-term daily use of PPIs, which include malabsorption of magnesium and calcium, higher rates of C. difficile infections, and a higher risk of pneumonia. Later research has found an increased risk of heart attacks and kidney disease. More importantly, PPIs only mask the symptoms of GERD and do not stop acid reflux, which can lead to Barrett’s esophagus and adenocarcinoma. Unfortunately, this is another fact not provided to many patients who believe that their medication has cured their disease. It has not.
The Relationship between Cancer and PPI Use
Dr. Tom DeMeester wrote an important article that was published in the Huffington Post where he commented on PPI use, Acid Reflux Problem? The Warning on the Pill’s Label Says Use for 14 Days. In that article Dr. DeMeester made the following statement about PPIs and esophageal cancer for those with erosive reflux disease:
In another ongoing long-term study conducted in Europe (Pro-GERD study), researchers determined that today’s treatment model, which is predominantly focused on drug therapy, does not stop the progression of the disease. More importantly, of all the risk factors studied, which included diet, obesity, smoking, alcohol use and family history, the one factor with the highest odds ratio associated with progression from mild to severe disease and leading to Barrett’s Esophagus was daily PPI use.
The Importance of Knowledge about GERD
RefluxMD’s primary mission is to put accurate information on our website to raise awareness and encourage all those seeking assistance to become more educated about their disease. We believe that anyone with GERD should see a GERD specialist and learn about all treatment options, which include diet and lifestyle changes, medications, and surgical intervention. Armed with the facts about GERD and understanding all treatment options, most people will make decisions that are right for them.
I also think an article written by Dr. Chandrasoma in response to an email from another member is important, too: Are we being honest with GERD patients?