Like junk food? Acid reflux cancer on rise

Chennai:

Deep fried samosas, oily bajjis and cheesy burgers washed down with sugar-loaded aerated drinks lead not just to a bulging waistline, but can increase risk of food pipe cancer.

Over the past 20 years, ma ny hospitals across India have recorded a two-fold increase in cancer of the lower part of the food pipe caused by prolonged acid reflux disease linked to junk food.

“This kind of cancer is common in the west. Now we are seeing it more often in India. There is a link between high-fat, low-fibre food and cancer. Many people diagnosed with this type of cancer have been suffering from reflux,“ said Dr R Swaminat han, professor and head, biostatistics and cancer registry , Cancer Institute.

In people with reflux, the acid which the stomach uses to digest food escapes into the lower part of the food pipe.This constant backwash of acid can irritate the lining of the food pipe causing inflam mation and scars leading to gastroesophageal reflux disease (GERD). The commonest symptom is heartburn or chest pain. In the last two decades, doctors say, reflux has reached epidemic proportions.

Over a period of time, reflux can cause a kind of can cer called adenocarcinoma that develops in the gland cells. The Cancer Institute, Chennai, which maintains the Madras Metropolitan Tumour registry , has now decided to do a pilot study and register types and sites of foodpipe cancer for the city registry and national registry .

“This type of cancer occurs only in the bottommost part of the food pipe,“ Dr Swaminathan said.

In the 90s, gastroenterologists saw a rise in squamous cell cancer, mostly in the top and middle parts of the foodpipe, which is mainly caused by smoking or chewing tobacco. Now, nearly a quarter of foodpipe cancers are at the bottom of the food pipe. In some hospitals, the number is even higher. For instance in Coimbatore, gastroenterologists say at least 40% to 50% of food pipe cancers are caused by GERD. “In the mid-1990s, only 10% to 15% of cancers were adenocarcinoma. Last year we saw the trend nearly reverse,“ said the founder and chairman of Gem Hospitals, Dr C Palanivelu.

Senior gastroenterologists say dietary habits have played a huge role in pushing up cancer of the foodpipe.Two years ago, an ongoing study by Government General Hospital's department of surgical gastroenterology linked smoked meat -red meat or fish dipped in greasy oil, and covered with a mix of salt, chilli powder and spices before it is cooked directly over fire -to food pipe cancers. When meat or fish is cooked directly over fire, it gets covered with carcinogens, making it more dangerous than even smoking or consumption of alcohol, surgical gastroenterologist Dr S M Chandramohan who's studied more than 100 cancer patients.

The silver lining is that adenocarcinoma is relatively easier to treat than squamous cell carcinoma.“If reflux is detected in the early stages, it can be treated with medicines or endoscopic surgery ,“ said Dr V G Mohan Prasad. “We can treat reflux even when it goes into the next stage, which is called Barrett's disease. But, at present, smoking and chewing tobacco continue to be our biggest problem. Cancer caused by this reaches advanced stage three without symptoms and requires chemotherapy , radiation and surgery ,“ said Dr P Karthikeyan, gastroenterologist and hepatologist at Kovai Medical Centre and Hospital.