Top Doctors: Esophageal cancer

Dr. Alan Spielberg, chairman of the gastroenterology section Dr. Alan Spielberg, chairman of the gastroenterology section at St. Catherine of Siena Medical Center in Smithtown. (Nov. 30, 2011) Photo Credit: Newsday/Audrey C. Tiernan

advertisement | advertise on newsday

Esophageal cancer is one of the deadliest types of cancer, and the prognosis is usually grim. What's important, then, is to do what you can to prevent it, which medical experts say includes taking heartburn, sore throat and coughs seriously.

Here's what you should know:

1. ESOPHAGEAL CANCER IS COMMON

The U.S. National Cancer Institute estimates that 16,980 people in the United States will be diagnosed this year with esophageal cancer, and 14,710 will die from the disease. The diagnosis rate for men is 1 in 125 and for women, 1 in 400, said Dr. Maurice A. Cerulli, an associate professor of medicine at Hofstra North Shore-LIJ School of Medicine.

advertisement | advertise on newsday

There are two types of esophageal cancer -- squamous, which is almost entirely linked to smoking and alcohol consumption, and adenocarcinoma, which is associated with acid reflux. "The increasing incidence of acid reflux has led to the increase in adenocarcinoma, especially in white, middle-aged men," Cerulli said.

2. LIFESTYLE HABITS CAN BOOST YOUR RISK

Smoking, drinking and overeating that leads to obesity are all risk factors, but smoking is the riskiest, said Dr. Alan Spielberg, chairman of the gastroenterology section at St. Catherine of Siena Medical Center in Smithtown.

@Newsday

Another risk factor is infection with the human papillomavirus, or HPV, a sexually transmitted virus that has been linked to esophageal and head and neck cancers, Cerulli said. "Therefore, the HPV vaccine might also reduce the number of patients with esophageal cancer," he said. The federal government recommends the vaccine, marketed as Gardasil and Cervarix, for young women and young men before they become sexually active.

3. TAKE ACID REFLUX, SORE THROAT AND COUGHS SERIOUSLY

"People should pay attention to daily heartburn and not take medication to control it without being sure that they do not have damage to the esophagus, especially if they are over 50," Cerulli said.

advertisement | advertise on newsday

Chronic heartburn, or acid reflux, can lead to a condition called Barrett's esophagus in which the esophagus becomes continually inflamed, Spielberg said. The condition greatly increases the risk for esophageal cancer, he said, apparently because of the chronic inflammation.

People who have acid reflux on a regular basis, such as a few times a week, should be screened for esophageal problems, Spielberg said. The same goes for those who have unexplained coughs, hoarseness and regurgitation of fluid or acid, even without burning, he said.

4. SEEK CARE IF YOU HAVE OTHER SYMPTOMS

advertisement | advertise on newsday

"Any difficulty in swallowing solid food could be a warning sign of narrowing of the esophagus, which could be due to esophageal cancer," Cerulli said. "Weight loss is often associated with the difficulty swallowing."

5. EARLY TREATMENT CAN BE SUCCESSFUL

If someone is diagnosed with Barrett's esophagus and tests show precancerous cells, they can be removed through burning, cutting or freezing, Cerulli said. Early cancers can be cut out using an endoscope, he said.

However, the prognosis for people diagnosed with esophageal cancer is not good. Spielberg said that although chemotherapy and radiation are also used to treat the cancer, they won't cure it but can slow its progression.

The National Cancer Institute reports that the five-year survival rate for people with localized esophageal cancer is just 37 percent, falling to 18 percent if the cancer has spread nearby and 3 percent if it has spread to distant parts of the body.

Gastroenterologists

This is the 24th installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

Dr. Robert Bartolomeo

1103 Stewart Ave.

Garden City

516-248-3737

Dr. David Bernstein

North Shore University Hospital

Div. Gastroenterology

300 Community Dr.

Manhasset

516-562-4281

Dr. Meyer Blumstein

158 Hempstead Ave.

Lynbrook

516-593-3541

Dr. William Caccese

700 Old Country Rd.

Plainview

516-681-1200

Dr. Maurice Cerulli

270-05 76th Ave.

New Hyde Park

718-470-7281

Dr. William Cohn

3400 Nesconset Hwy.

Setauket

631-751-8700

Dr. Bethany DeVito

North Shore University Hospital

4 Levitt Pavilion

300 Community Dr.

Manhasset

516-562-4281

Dr. Joseph Duva

887 Old Country Rd.

Riverhead

631-727-6122

Dr. David Eskreis

2001 Marcus Ave.

Lake Success

516-326-2700

Dr. Charles Farber

146A Manetto Hill Rd.

Plainview

516-822-4404

Dr. Barry Glanzman

152 E. Main St.

Huntington

631-421-2185

Dr. Lester Goldblum

850 Hicksville Rd.

Seaford

516-796-9000

Dr. Ira Goldman

310 E. Shore Rd.

Great Neck

516-487-7677

Dr. Perry Gould

1103 Stewart Ave.

Garden City

516-248-3737

Dr. Ronald Greenberg

270-05 76th Ave.

New Hyde Park

718-470-7281

Dr. James Grendell

222 Station Plaza N.

Mineola

516-663-2066

Dr. Aaron Harrison

375 E. Main St.

Bay Shore

631-968-8288

Dr. Seymour Katz

1000 Northern Blvd.

Great Neck

516-466-2340

Dr. Robert Lazar

48 Route 25A

Smithtown

631-862-3680

Dr. Matthew McKinley

2800 Marcus Ave.

Lake Success

516-622-6076

Dr. Seth Miller

206 W. Park Ave.

Long Beach

516-432-8021

Dr. Perry Milman

2001 Marcus Ave.

Lake Success

516-775-7770

Dr. Melissa Palmer

Hepatology Associates

1097 Old Country Rd.

Plainview

516-939-2626

Dr. Gary Schwartz

1103 Stewart Ave.

Garden City

516-248-3737

Dr. Alan Spielberg

48 Route 25A, Smithtown

631-724-1178

Dr. Arthur Talansky

233 E. Shore Rd.

Great Neck

516-487-2444

Dr. Gary Weissman

2800 Marcus Ave.

Lake Success

516-622-6076

How they were picked

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

You also may be interested in: