Barrett's Oesophagus
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RichardT
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Quote RichardT Replybullet Posted: 17 May 2011 at 1:11pm
> It is estimated that only 10% of those in the population with Barrett's
> are known to doctors - and they don't know themselves.

> It is possible their Barrett's was formed 20 years ago when they used to
> suffer heartburn which seemed to cure itself. (It didn't: they just don't
> feel it any more.)

Cats and dogs also get Barrett's: I wonder what the incidence of cancer there is? No, I'll probably not raise that one on Friday!

> These are the people at risk of adenocarcinoma who
> won't know it until it's too late.

Clearly we need also to autopsy people who don't die from cancer to get true statistics on Barrett's!

One of the questions I will ask is
"How sure are the team that Barret's is in itself a pre-cancerous disease and not simply, in many cases, a symptom of a lifestyle that may itself be leading to cancer?"

> How do we get that message across?

Until I know the response to the question, I am not convinced we need to! Barrett's is rising because of bad diet and obesity. So too is cancer. Personally I think the liklihood is that the bad diet is to blame for both, rather than the Barrett's causing cancer!
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org

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jcombs99
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Quote jcombs99 Replybullet Posted: 17 May 2011 at 1:34pm
RT
   The vetern hospital do a autopey EVERY time BUT it's just vets then . If you look at the barrx site it's 25% of them over 50 had it .Three yrs ago I thought heartburn was nothing but I got people emailing me,knocking on my door on Sunday about this . From day one I thought the mumbers were to low . Within 200 ft of my house one mans father died of cancer ,one has it and ones been ablated(ME)..NHS better get out front on this the data is already there and getting more every day.They should cut people a deal IF they want it ablated.. They already have machines and barrx has been shown to give better prices then do in the US .
   This is a funding thing not a time thing I'll take my Halo at 2 am to get it done.If you CATCH it early it's ONE treatment (cheap) NOT four like me..

HGD JEFF

Edited by jcombs99 - 17 May 2011 at 1:39pm
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chrisrob
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Quote chrisrob Replybullet Posted: 17 May 2011 at 1:47pm
Although I haven't had HALO, and am not considered at sufficient risk to contemplate it presently, I would have no qualms about it having see my consultant's operation videos. The HALO machine we bought for Southampton was used to treat 14 patients in the first two weeks from when it was delivered to them. That's one a day who won't get oesophageal cancer.
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jcombs99
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Quote jcombs99 Replybullet Posted: 17 May 2011 at 1:55pm
Chris
Thats very good for a start BUT that means it was used at MOST 14 hours in 2 weeks .I asked the sedition doctor the avg. EGD is ten mins in the US my doctor spends 20 mins on mine (hard case)..There has to be a way so partial paynent can be paid to the NHS WITHOUT going broke doing it private IF the person wants it..

HGD JEFF
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johnd
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Quote johnd Replybullet Posted: 17 May 2011 at 2:03pm
The science behind why Barrett's is probably is a pre-cancerous condition seems pretty complex. The way I understand it, cancer is when various genes go off the rails and various policemen genes fail to check the the errors.

It seems that in Barretts linings there are indeed one or two genes that have faults. If that's right, that is enough to say that Barrett's predisposes you to cancer.

There doesn't seem to be a word that says "predisposes you to cancer", so pre-cancerous has to do.

Poor lifestyle is bad for all cancers and of course obesity, and there is no harm in shining the spotlight on lifestyle, because if nothing else you have better treatment options with someone who is otherwise healthy.

Rather than simply lifestyle, I would look to other reasons for the growth in Barretts and cancer of the E.   Principal amongst these is simply that its more likely (but not likely enough) that its diagnosed now. But people are still discovering they have cancer too late, sometimes after its spread.

There may well be a question about whether Barretts is an pre-cancerous indicator or a pre-cancerous condition, which might mean that people feel less need to ablate it if its non-D. But if you've got it you should address the cause of it. I don't feel like testing the hypothesis that it doesn't matter.

In my case I think you can say its a congenital HH BTW.
55yo, diagnosed 2011 at 5cm Barrett's, 3cm as at 2013 (?), so far non-D
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chrisrob
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Quote chrisrob Replybullet Posted: 17 May 2011 at 3:10pm
There seems to be no argument as far as my consultant is concerned.
At the annual meeting of Barrett's Wessex last week, Dr Praful Patel (one of the country's leading gastroenterologists) showed many images down the endoscope looking for (and identifying) the cancer cells amongst HGD. (Which is why he accepts my wording of "potentially pre-cancerous). And, although it may be fair to say lifestyle can account for many of the cases, it is not the only cause by any means.
With incidences of Oesophageal Adenocarcinoma escalating at an alarming rate, the issue now is to bring the condition to the public's awareness. (And educate GP's.)

Chris
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RichardT
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Quote RichardT Replybullet Posted: 17 May 2011 at 5:52pm
Chris

Your input has caused me to re-word one question. It now is:
"How sure are the team that Barret's is in itself a pre-cancerous disease and not simply, in many cases, a symptom of a lifestyle that may itself be leading to cancer? I understand there is a genetic mutation in Barrett's cells - but is this genetic change present in all Barrett's cases or only in some?"
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org

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johnd
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Quote johnd Replybullet Posted: 17 May 2011 at 10:43pm
Richard - I think the direction you are going in is that you can see no clear evidential connection between Barrett's and cancer. That link may be a matter of opinion but the body of informed opinion is that there is a connection. What is the point of sowing seeds of doubt?

Most people get Barrett's from a HH they can do nothing about. It's a bit rich to infer criticism of their lifestyle.
55yo, diagnosed 2011 at 5cm Barrett's, 3cm as at 2013 (?), so far non-D
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bobby
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Quote bobby Replybullet Posted: 17 May 2011 at 11:10pm
I would be asking.
 
1. Why "Halo" isn't given on diagnosis of Barrett's epithelium rather than waiting until it reaches the dysplasia stage?
 
2. Given the advances in medicine available is there any way that the Barrett's cells can return back to normal cells?
 
 
 
 
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jcombs99
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Quote jcombs99 Replybullet Posted: 17 May 2011 at 11:16pm
BOBBY

      1) Funding (but MOST cases never turn to Cancer)
      2) No, not at this time . But it does happen once in a Great While..

HGD JEFF
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