Persistent Heartburn Could Signal Deadly Cancer as Late Diagnoses Soar
Medical experts are issuing an urgent warning that dismissing recurring heartburn could have fatal consequences, as cases of advanced oesophageal cancer surge dramatically across England. Analysis by the charity Action Against Heartburn reveals a concerning trend: diagnoses at stage 4, when the disease has already spread to other organs, increased from approximately 25% of cases in 2014 to over 36% in 2022.
The 'Forgotten Cancer' with Catastrophic Consequences
The charity describes this rise in late-stage diagnoses of what they term the 'forgotten cancer' as both disproportionate and catastrophic for patient survival rates. Oesophageal cancer remains one of the deadliest forms of the disease, closely associated with risk factors including poor diet, smoking, and excessive alcohol consumption.
Acid reflux, which causes that familiar burning sensation in the chest, affects around one in five people. This common condition occurs when stomach acid travels back up the oesophagus toward the throat, irritating the lining of the gastric tract and increasing the risk of abnormal cell growth that can eventually develop into cancer.
Why Detection Proves Increasingly Difficult
Specialists warn that oesophageal cancer is becoming harder to detect because its symptoms are not easily recognisable and are frequently mistaken for simple indigestion until the disease reaches an advanced stage. Persistent acid reflux stands as one of the most common symptoms of this aggressive cancer.
Jill Clark, chair of Action Against Heartburn, explains: 'Oesophageal cancer is the forgotten cancer. Incidence in the UK is disproportionately high and late diagnosis means that it is often fatal.'
'The reasons for the increase in late-stage diagnosis are unclear but are likely to be due to a combination of strain on the NHS, referral delays, unhealthy lifestyles, an aging population and poor symptom awareness.'
Survival Statistics Paint a Grim Picture
Approximately 9,200 new cases of oesophageal cancer are diagnosed in the UK each year, with fewer than 20% of patients surviving beyond five years. The devastating disease has a ten-year survival rate of just 12%, though this rate rises to over 50% if the cancer is detected at its earliest stage.
Professor Sheraz Markar, a consultant oesophago-gastric surgeon at Oxford University Hospital NHS Trust, emphasises that awareness of symptoms represents the crucial first step toward early diagnosis. 'There are good treatment options if it's caught early, but it becomes much more difficult once it has spread,' she notes.
'Symptoms can be vague but a common sign is persistent heartburn. Other symptoms can include problems swallowing, feeling or being sick, unexplained weight loss or chronic indigestion.'
One Patient's Harrowing Experience
Andrew Stanley, a 67-year-old from Milton Keynes, experienced this diagnostic challenge firsthand when he was diagnosed with stage 4 oesophageal cancer in 2023. 'I had heartburn for years and didn't realise it could be the sign of something more serious,' he recalls.
'I saw a doctor when I was having difficulty swallowing food but it took some time for me to be diagnosed. It was a terrible shock to find out I had cancer, especially as I was told it had spread and I'd only have around two years left to live.'
Fortunately, Mr Stanley received the opportunity to participate in a clinical trial at Churchill Hospital in Oxford and is now cancer-free. However, he recognises that others may not be as lucky, particularly if diagnosed at later stages. Together with the charity, he now urges anyone continually taking medication for heartburn to consult their GP.
The Medication Masking Effect
While these drugs do not cause cancer, recent research indicates that Proton Pump Inhibitors such as omeprazole can mask the classic symptoms of oesophageal cancer. Around 10.5 million people in Britain are thought to take PPIs, making them the second most common prescription after statins.
These medications work by reducing the amount of stomach acid the body produces, providing symptom relief for people with chronic reflux but potentially delaying crucial cancer diagnosis.
Innovative Screening Technologies Offer Hope
The warning coincides with hundreds of people in England being offered a revolutionary 'sponge on a string' test in high-street pharmacies last year to detect a precursor of the disease. Patients with persistent heartburn were invited to take this 'game changer' tablet, which expands in the stomach when swallowed.
The capsule is then retrieved using a string, allowing captured cells to be analysed for Barrett's oesophagus, a condition that significantly raises cancer risk. This test is already widely used in hospitals to reduce the need for invasive endoscopies.
Jill Clark advocates for comprehensive improvements: 'To improve survival there must be increased public awareness of key symptoms as well as faster routes to diagnosis, better use of innovative screening technologies - such as capsule sponge tech - and more research.'
Treatment Options and Prevention Strategies
When detected in its early stages, oesophageal cancer is usually treatable, though outcomes depend on multiple factors including the cancer's size and type, location, spread, and the patient's general health. Treatment may include surgery, chemotherapy, radiotherapy, targeted medicines, and immunotherapy.
While the disease cannot always be prevented, the NHS recommends healthy lifestyle changes to reduce risk, including:
- Maintaining a healthy weight
- Reducing alcohol consumption
- Quitting smoking
- Being vigilant about persistent digestive symptoms
The combination of increased public awareness, improved diagnostic pathways, and innovative screening technologies offers the best hope for reversing the troubling trend of late-stage diagnoses and improving survival rates for this devastating disease.
