Heartburn Hid a Greater Problem

Thanks to a Special "HALO," Patient is Now Cancer-Free

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Ralph Gladbach has always loved sour cream. In salads, on sides, in a main dish, he loved the tang it added. So at dinner on the night of his adult daughter's college graduation, he couldn't resist adding a dollop to his baked potato.

Then disaster struck. "My acid reflux... it just erupted," he recalls. "It really spoiled the dinner."

At 81 years old, Ralph had experienced the pain of acid reflux only during the past few years. "I never had a single episode before that," he notes. He dealt with it by taking over-the-counter heartburn medication and avoiding creamy foods. He thought the episodes would eventually stop. But the dinner was a turning point. He decided to see his doctor for what he thought was a simple, though frustrating, problem – acid reflux.

He never dreamed it could be cancer.

The HALO procedure is also available at these locations:

Not Just Acid Reflux

After the graduation dinner, Ralph knew it was time to act. He went to his primary care physician, who put Ralph on Prilosec. When that didn't work, he was referred to Nimish B. Vakil, MD, a Gastroenterology Specialist. Dr. Vakil diagnosed Ralph with Barrett's esophagus. Barrett's esophagus occurs when the lining of the esophagus is damaged by stomach acid. The lining changes to be more like the stomach's lining.

Ralph Gladbach

Ralph Gladbach prepares to undergo the HALO procedure in 2011.

The exact cause of Barrett's esophagus is unknown, but gastroesophageal reflux disease (GERD) is a risk factor for the condition. GERD is a more serious form of acid reflux – the condition in which stomach contents flow back up into the esophagus.

Approximately 5 to 15 percent of patients who seek medical care for heartburn or GERD have Barrett's esophagus. It is considered to be a premalignant condition, and is associated with an increased risk of esophageal cancer.

Knowing this, Dr. Vakil did more testing. Within a short time, he had the startling results: Ralph's "acid reflux" was actually early esophageal cancer.

HALO – A New Option for Care

Dr. Vakil, MD

Namish B. Vakil, MD meets with a member of his team.

Ralph was shocked, but knew he was in good hands with Dr. Vakil. "He was very cordial – we had a good meeting," Ralph recalls. During that meeting, Dr. Vakil discussed treatment options.

The common treatment for esophageal cancer is to surgically remove some or all of the esophagus. Patients must later have reconstructive surgery to gain back their ability to swallow food. Even with the reconstructive surgery, the ability to eat and swallow may be compromised. Ralph thought this sounded "drastic."

A second treatment option was destruction of the cancer cells with heat, but Dr. Vakil explains, "The problem is that this can cause a very deep injury to the esophagus. The esophagus has a relatively thin wall."

However, Dr. Vakil told Ralph about a third option - the HALO procedure. During HALO (haemorrhoidal artery ligation operation), short pulses of energy destroy the cancerous tissue while keeping the esophagus intact. Recovery is faster and easier for patients than with other treatments.

For Ralph, it was an instant decision. "I wasn't interested in the other options."

Soon after the cancer was removed by an endoscopic device, Ralph scheduled the HALO procedure. It went well, and he recovered with nothing more serious than a scratchy throat.

"I took pills for two days, and a few days later the scratchiness was gone," Ralph states. "I've endured other pain much worse!"

Ralph is thankful to have had HALO as a treatment option. Patients who have undergone this ablation have, like Ralph, healed faster and have had fewer long-term side effects.

Knowing what his options would have been even 10 years ago, Ralph calls the HALO procedure "almost miraculous."

Acid Reflux – A Sign That Something Is Wrong

Ralph Gladbach

Ralph in 2012, discussing the "miraculous" HALO procedure.

These days, Ralph enjoys his standard, healthy diet. And though he doesn't have to, he stays away from the sour cream "just because," he says with a chuckle.

He encourages others to not ignore acid reflux, and instead have a doctor look at it. "Barrett's very frequently leads to cancer – don't mess with it," Ralph advises. "It's a sign that something's wrong."

Patients with chronic heartburn or GERD are more likely to develop Barrett's esophagus than those who do not suffer heartburn or GERD. Men ages 50 and older are the most at risk. Ralph was in his early 80s before he ever experienced acid reflux. He was able to enjoy a variety of foods without issue. "It came on pretty quick," he notes.

Dr. Vakil encourages patients not to ignore acid reflux, as well.

"One needs to treat reflux disease with some degree of respect in that you need to alter your lifestyle, modify some of your habits – perhaps some of your eating habits and when you eat dinner," Dr. Vakil states. "Once you have had reflux disease for some time – between five and ten years – that's the time you want to start thinking about getting evaluated to see if you have Barrett's esophagus. You need to take it seriously."

Thanks to Dr. Vakil and his care team, Ralph is now cancer free. "It's been painless, really," he says.

Ralph now sees Dr. Vakil for bi-annual check-ups, but says, "I don't think about the cancer. The Barrett's esophagus and the cancer are gone. We caught it in time."

April is National Esophageal Cancer Awareness Month. Aurora Health Care is known for successfully treating conditions that span multiple specialties. Barrett's esophagus is an issue that is treated by gastroenterology experts, but can eventually require cancer care services if esophageal cancer develops. If you suffer from chronic Gastroesophageal reflux disease (GERD), it may be time for preventative screening. Find a GI or cancer specialist in your area.