How to prevent cancer: esophagus, stomach, colon

The key is to treat the precancerous conditions before cancer develops.  These conditions include:

1. Reflux esophagitis with intestinal metaplasia or Barrett’s esophagus.

   Barrett’s esophagus is diagnosed by endoscopy and biopsy.  It cannot be successfully treated with medications.   Barrett’s esophagus can nowadays be treated by chromoendoscopy to show up the lesion, followed by endoscopic mucosal resection of the lesion.  Thereafter, Barrett’s esophagus can be prevented from coming back by reducing the acid secretion of the stomach, using medications.  Acid reduction in this situation is analogous to reducing blood pressure in patients with hypertension to prevent complications.

2. Helicobacter pylori, a stomach germ that can cause stomach cancer.

   This bacteria can be detected, for example, by a simple breath test.  It is now known that Helicobacter pylori needs to be got rid of at a relatively young age, before the stomach develops intestinal metaplasia, which may lead to cancer.  Like, Barratt’s esophagus, intestinal metaplasia of the stomach cannot be cured with medications, but can be treated by endoscopic mucosal resection, following chromoendoscopy.

3. Colonic adenoma

   Colonic adenoma is a benign polyp, which frequently occurs in patients with a family history of colon cancer, and in people with a relatively advanced age.  Polyps may develop into colon cancer after an average of 15 years.  They can be detected and removed by simple procedures called polypectomy during colonoscopy; removing them could, therefore, prevent colon cancer.  Polyps may escape detection by examination of stools using fecal occult blood tests, which, however, may detect early colon cancer.  It has been suggested that people over the age of 50, particularly those with a family history of colon cancer, should have a colonoscopy examination and have their polyps removed if detected.

Author: sklammedicine

Former Dean, Chair Professor of Medicine, & Inaugural Simon KY Lee Professor of Gastroenterology, University of Hong Kong. Ranked 3rd most cited research author in the world in the field of gastroenterology & hepatology for the period 2009-2019 by Scholarometer.indiana.edu. Contact: Humanity & Health GI & Liver Centre (天下仁心腸胃及肝臓中心), Suite 2101, 9 Queen's Rd Central, HK. Tel 28776311, www.hnhmgl.com, carecare.lam@gmail.com View all posts by sklammedicine