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Tuesday, October 16, 2007

About esophageal cancer and me . . . or . . . Yes, you can get cancer from heartburn

How the heck did I get this cancer? I was really shocked to learn. I say this because the common source is really twofold.

My form, which hits the lower esophagus, is caused primarily by acid reflux, GERD and the like. But I haven't had heartburn since leaving a previous job in the Tampa Bay area more than eight years ago. Truly, heartburn pain ended when I joined the staff at the Orlando Sentinel. Coincidence? Until recently I thought not.

Now I know that's not the case. I thought it was a new job, less stress, creative workplace all added up to an end to my dependence on the high-tech pills of the day, Extra Strength Tums.

But it turns out the heartburn probably went away because my lower esophagus was one in transition. Barrett's esophagus is the result of long-term acid reflux and heartburn. Basically, the acids force the esophagus to fight back, and it does so by defending itself with changes to its cell structure. It takes on some characteristics of a stomach lining. And these changes can lead to cancer of that region.

So had I known I was still having heartburn I probably would have taken action years ago. Rather, I found out there was a problem this past summer during a trip out West. And I was diagnosed just a few weeks ago, after having an endoscopic exam.

(Another form of the disease affects mostly the upper esophagus, and it mainly is caused by the one-two self-inflicted punches of heavy smoking and heavy drinking. This form also can cause other problems further downstream in the gastro-intestinal tract, so if you do a lot of either my uneducated advice is to quit both, or at least cut back on both and cut out one. But enough preaching.)

I also would like to encourage you to seek medical advice if you have long-term heartburn, if you take a bunch of Tums or the like, if you recently lost the sensation of heartburn after a lengthy problem, or if you are having a difficult time swallowing foods that you normally could swallow.

Again, I'm no doc, but esophageal cancer is one of the fastest-growing forms of cancer. Here are some current numbers from the American Cancer Society:
  • About 15,600 people will be told they have esophageal cancer this year.
  • About 14,000 Americans will die of esophageal cancer this year. Because the cancer is usually found at an advanced stage, most people who have it will die of it. An advanced stage of the cancer means it has spread to places far from the esophagus. And that makes it harder to treat.
  • Men are about three times more likely to get esophageal cancer than women.
  • African-American people are more likely to get esophageal cancer than Caucasian people.
  • Survival rates are improving. During the early 1960s, only 4% of white people and 1% of African-Americans with esophageal cancer lived 5 years after finding out they had it. Now, 16% of white patients, and 9% of African-American patients live 5 years after diagnosis.

OK, so some of those stats are grim. But there is good news. The team of doctors who are treating me, Dr. Z and Dr. Diamond, were part of a lengthy study run out of a Tennessee hospital with very promising results. So promising, in fact, that the treatment -- even before its publication in any major national doctors' mag, has become the default form of treatment. Survivability has increased to the upper 70 percents for one year out and mid-40s long-term.

I plan to be among the surviving 40 percent types. And I have a halfway decent chance. That's because I don't have any other major medical issues to deal with, which many of the overall study group patients did. I'm younger than most, at 47, OK almost 48. And my cancer has not spread.

I alluded to this in one of my early entries. I made fun of the fact I've lowered the bar for good news that now good news consists of having cancer, requiring seven weeks of chemo, seven weeks of radiation and then, very likely, surgery and six weeks or so to recover. Woo hoo. But both docs said that is good news. Because the cancer didn't reach the lymph nodes, didn't reach any other organ in my body. If that remains true after the chemo and rads, my chances go up that I will be a cancer survivor. I see no other option. It simply must remain true.

So, that's what I can tell you about my condition and a little about me. In future blog posts I'll do mini biographies of the doctors treating me and maybe some of the nurses if they're game. I have a brief copy of the unpublished study, which I'll type in, and I'll also scan in some of my blood work reports so you can see how they're holding up.

If I'm posting too much information, let me know. I'll ratchet back some. I promise if I mention nausea I won't get into too many details. That'd be tmi, in my humble opinion.

Well, I'm off to the radiation, so I'll update later.

But I do promise that I will fight this thing -- sadly, to the death if necessary.


Anonymous said...


Thanks for this post. I think you may save some lives with this information.

Please know that all of us at work are eagerly awaiting your return.

-- Mark Skoneki

Bo said...

Keith, your blog is amazing. We can't wait to see you back at the Sentinel soon. Keep up the good fight and know that we're all rooting for you!

Keith W. Kohn said...

Mark, Bo,

Thanks for the comments. Can't wait to return. Truly. I miss the place. More and more each day. I think I'll win the fight and I hope this is helping others. That, and keeping my sanity, are the key goals.