A Barrett’s oesophagus diagnosis can be overwhelming, especially if you have high-grade dysplasia. Read on to learn about the risk of oesophageal cancer for Barrett’s patients and when we’ll recommend Barrett’s oesophagus surgery.
Barrett’s oesophagus treatment
The treatment for Barrett’s depends on the stage of your condition, as we explain in our blog: Barrett’s oesophagus stages and treatment options. They can vary from lifestyle and dietary changes to minimally invasive or invasive surgical procedures.
Watch Dr Sami, our Consultant Gastroenterologist, give an overview of Barrett’s treatment.
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As Dr Sami explains, we usually treat Barrett’s with medications unless we find abnormal cells (dysplasia). If you have low-grade dysplasia, we may perform a minimally invasive endoscopic therapy, such as Endoscopic Resection (ER). Or, we may recommend HALO radiofrequency ablation (RFA).
Book an appointment with our gastroenterologist to discuss each treatment option in detail.
What is the risk of developing oesophageal cancer?
Oesophageal cancer is rare, and many patients with Barrett’s oesophagus don’t get it. But, having Barrett’s is a risk factor for it.
People with high-grade dysplasia are more at risk of developing oesophageal cancer. If you have a long segment of Barrett’s, over 10cm, you are also more at risk. Some of the risk factors for oesophageal cancer overlap with Barrett’s risk factors.
Risk factors for oesophageal cancer:
- Obesity
- Achalasia
- Age – Between 45 to 70
- Previous cancer treatment
- Having GORD (gastro-oesophageal reflux disease)
- Oesophageal strictures (narrowing of the oesophagus)
- Gender – Men are twice as likely in the UK to develop this cancer than women
- Diet/nutrition – Not having enough fruits, vegetables, certain vitamins and minerals
- Other lifestyle factors; such as heavy alcohol consumption and tobacco use in any form
Human papillomavirus (HPV) may also be a risk factor for oesophageal cancer. Though, research to confirm this is ongoing.
If you have a high risk of oesophageal cancer, we may recommend an oesophagectomy. Read on to learn about surgery for Barrett’s oesophagus.
Barrett’s oesophagus surgery
Surgery options for Barrett’s oesophagus are fundoplication and oesophagectomy. Though, there are minimally invasive procedures available too, as we’ve mentioned above.
Fundoplication
During fundoplication, we create a sphincter by wrapping the upper part of the stomach around your lower oesophagus. We often use keyhole surgery (laparoscopy), though there are different methods. If we perform it laparoscopically, you should only need a couple of days in the hospital to recover, though open surgery techniques involve a week-long stay.
A fundoplication is an option for people with no dysplasia to prevent stomach acid from going back up the oesophagus (acid reflux), correcting GORD.
Oesophagectomy
An oesophagectomy is sometimes used to treat high-grade dysplasia and early cancer in Barrett’s oesophagus. It involves removing the affected sections of your oesophagus and rebuilding your oesophagus with a part of your stomach or large intestine. We also use an oesophagectomy to treat oesophageal cancer.
We can perform an oesophagectomy with laparoscopy or a larger open-skin incision. An open-skin approach is more traditional, but laparoscopy offers a quicker recovery time, smaller scars, and less risk of infection.
After the procedure, you might stay in the hospital for 7-14 days to recover. Though, Barrett’s oesophagus can still return after surgery. You should pay attention to any symptoms of GORD that you experience and seek medical advice if you are concerned.
If you have other medical problems, an oesophagectomy may not be suitable. Our gastroenterologist will discuss your circumstances with you.
Is surgery for Barrett’s oesophagus necessary?
Barrett’s oesophagus surgery isn’t a necessity for everyone. Fundoplication may be suitable for those with uncontrolled acid reflux or GORD. But, an oesophagectomy is usually only recommended for those with oesophageal cancer or those at high risk with Barrett’s. For example, people with high-grade dysplasia.
Then again, if your symptoms worsen or you develop cancer, surgery may be the best option to treat your condition. We can also use surgery to prevent oesophageal cancer. Other treatment options for oesophageal cancer include chemotherapy and radiotherapy.
Our gastroenterologist can assess your symptoms and run staging tests to determine the stage of your Barrett’s. Then, we can decide if surgery is appropriate.
Book an appointment
If you are experiencing severe symptoms due to Barrett’s, you may consider surgery for a more permanent solution.
Our gastroenterologist can discuss all the treatment options for Barrett’s with you. You can discuss your priorities and the risks and benefits of each treatment.
Book an appointment with our gastroenterologist to determine if Barrett’s oesophagus surgery is right for you.
