Do I have pre-cancer of the stomach or Barretts Esophagus
Here is a paragraph from my biopsy report. If anyone can help me undertand what they are saying in plain English I would appreciate it.
MICROSCOPIC DESCRIPTION: Slide "b" contains gastic cardiac muscosa with a few scattered goblet cells. No dysplasia is seen. This may represent intestinal metaplasia of gastric muscosa or alternatively short segment Barretts esphagus. Clinical and endoscopic correlation are suggested.
Here is the diagnosis for Slide "b" by the way....
Esophagus, tongue under island @ 11:00, biopsy: Gastric cardic mucosa with chronic inflammation and focal goblet cells, see Mircoscopic Description. Squamous mucosa with basal cell hyperplasia.
Okay....my doctor basically said that I did not have Barretts (like we thought from the previous endoscopy 6 month earlier) but most probably pre cancer of the stomach. I read this diagnosis as being not 100% either way.
My doctor called me last night, really late (I was 1/2 asleep) and my phone line was having static so I did not have the best opportunity to ask questions and understand clearly. I did get a copy of my pathology report and now I am concerned.
If I do have Barretts I know I can get it removed and I know it's a slow growing cancer and my chance of getting cancer even with Barretts is low. I know nothing about having INTESTINAL METAPLASIA of the stomach. Is this pre-cancer reversable? What are the odds in getting full blown cancer from this pre condition. Can it be removed BEFORE it gets potentionally worse like Barretts with the EMR and/or Barrax options.
Any info you can offer in addition to my questions above would be so appreciated. I got the impression that my condidtion at present is not to worry so much about and that not all pre-cancers become cancer but I am not the type of person that can have something like this inside of me and not worry and am able to take a wait and see approach. I am more pro-active and need to know everything I am up against. Thank you for any and all posts.
First off, this is not my field. I am a MD/PhD student and I study lung cancer, so please take me with a big grain of salt. Secondly, I probably know just enough to help you ask a few questions of your doctor.
Intestinal metaplasia is not cancer. End of story. But it can progress to cancer. Hypothetically, metaplasia can return to normal cells if the stressor is removed. But some of the time, if the stressor is removed, the metaplasia will remain and not progress to cancer.
Intestinal metaplasia has two main causes: Barretts esophagus and infection with H. Pylori.
I do not know much about barrets, but I do know that many people elect to have it cut out to avoid the possibility of it progressing into cancer. Some people feel Barrets is a low grade cancer.
Heliocobacter pylori (H. Pylori) is a bacteria that lives in the stomach of many people. It can cause gastritis, ulcers and metaplasia (among other nasty conditions, rearely lymphoma!). Remove the H. pylori and most of the time the metaplasia will not progress to cancer. How to you remove H. pylori from your stomach? Simple antibiotics, heartburn medicine and pepto bismol (actually I was diagnosed with a nasty ulcer a few years ago and this was my treatment-not bad at all).
Again, ask your doctor if you are positive for H. pylori. It may make this alot easier for you.
Cancer is not a single disease, but billion diseases. Each cell is a disease that has the potential to become a million different diseases. It is complicated, but not unconquerable.
I am the master of my fate:
I am the captain of my soul
~William Ernest Henley
REPLY BACK...Thank you!
Thank you for your post. I really appreciated it.
I don't have H.Pylori. It was negative.
I was told I had Barretts 6 months ago. Now six months later and another endoscopy, they are saying that I don't have barretts (intestinal metaplasia of the esophagus) but I probably have intestinal metaplasia of the cardia/gastic - stomach. The inflammation was at the bottom of my esophagus/top of stomach on the z line and they are not 100% sure but at this point are leaning towards it being a stomach issue and not an esophagus one.
The lining of my stomach within this Z line has some "scattered goblet cells" that are considered abnormal. I know that I don't have cancer, and for that I am thankful. But ABNORMAL changes have happened to my stomach area and I am not a very happy person about that. I don't know what the statistics say...what percentage of the people with this condition do end up with cancer afterall, is it reversable (I don't have H.Pylori or heartburn) but am on Nexium and have been for 6 months now and my biggest question, can it be CUT out or LASERED out like Barretts can be?
I will be seeing my doctor next week so I will be better informed. I know he doesn't think I have anything to worry about at this point and has many others under his care that are alot worse off and probably thinks I am a nut worrying so much. I also know that not all pre-cancer becomes cancer but I am a very proactive individual and will not sit by until I know all the answers and feel comfortable that I am doing the right thing by my body and MIND.
I know that it has been some time since you posted your concerns regarding intestinal metaplasia of the gastric cardia. I too have been given a diagnosis of IM - but of the gastric antrum. It is of the focal type. I am like you and want to be proactive and like most people given this information am worried about having a "precancer", sitting in my stomach. I have been told by some doctors that it is not a great concern. Some say to have a gastroscopy every 3-5 years for survellence. One gastro- said that it was not cost effective to do so. It has left me very confused and anxious. I am in my mid 40's -live a healthy lifestyle and have children to care for so I would love to have this worry put to rest.
How are you doing and have you learned anything more about this condition?
Anny, I do not know if any of the previous members who posted to this topic will reply. The last one to post anywhere did so back in May 2007 so I do not even know if they are still reading the forum. Unfortunately, I do not have any knowledge about this subject. What I recommend to you is to start a new topic with your story. I could spit off your reply but just in case any of the previous posters is still watching, I will just let you do whatever you feel is best.
I am very sorry about your cancer. You are in my thoughts and prayers.
Thanks for your reply. I have either Barretts (if it's in the esophagus) or IM if it's in the stomach. They are not 100% sure which one because it's in the middle between the two.
My doctor said if it's in the stomach that there is typically less of a chance of it turning to cancer and if it does it is more curable. But on the flip side, since I am watching it closely, if it's indeed Barretts and it turns, he can zap it out. Either way, I feel I am in good hands and lucky to have found whatever it is at this early stage.
My doctor (one of the best in the USA) who treats Barretts and is trained in the removal of Barretts called the Barrax procedure. He isn't so concerned with what he see's inside me to date. Says I could also wait and do endoscopies every 2-3 years but I opt to do it yearly.
Forget about being "cost effective", I'd rather be safe and couldn't care less about saving my insurance company money. I pay a heatfy premium every month. I deserve to have piece of mind.
I am also in my mid 40's like you and have small children. And mostly because of this I have made a decision to watch this more closely then my doctor suggests. I don't want to be one of "those" people that have it suddely turn for the worst. I'm catching it before/if it does.
If you want to chat with me more about this we can keeo in touch via e-mail. I can be reached at EldaMail@MSN.com.
Also here's a web site by John Hopkins where people only talk about Barretts and I have found lots of answers, support and guidence.... http://pathology.jhu.edu/beweb_chat/
Either way, God bless and keep pushing for more...don't reply and believe in everything the doctors say. Your gut will tell you want to do and always listen to yourself.
Elda125, glad to see that you are still around .
It makes it easier when an e-mail notification is sent my way. This way I know I need to respond.
Do I have precancer of the stomach or Baretts esophagus
Yes, I agree that my posting might work better under a new heading. I am concerned however that no one will ever search it as so few people have even heard of IM of the stomach.
I appreciate your words of support, but for my own sanity I must correct you in your comment regarding my "cancer". The condition is in fact considered a "precancer" and by others a "paracancer" and by still others nothing of concern. I am referring to those in the medical community. Meta simply means that the cells have changed and it is not until they become dysplastic that one is concerned about a follow-up change to cancer. Of course this all can be very unsettling and that is why I am looking for information which is a little more definitive.
I will think about another way of posting my queries.
Thank you for your response and concern.
Anny, it is not a big deal... especially since I never know who is still reading replies to this topic... Edna125 is still getting email notifications of replies to this topic. So, I suggest you just keep it all here. Hope you find the help and support you need.