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Friday, February 29, 2008

Barrett's Esophagus

Barrett's esophagus is the most severe complication of chronic gastroesophageal reflux disease (GERD) and would be of no real importance were not for the well recognized association of Barrett's esophagus and adenocarcinoma of the esophagus. The incidence of adenocarcinoma of the esophagus due to Barrett's Esophagus and GERD is on the rise and the five year survival rate for this cancer remains dismal. However, cancer risk for a given patient with Barrett’s esophagus is lower than previously estimated. Current strategies for improved survival in patients with esophageal adenocarcinoma focus on cancer detection at an early and potentially curable stage. This can be accomplished either by screening more patients for Barrett's Esophagus or with endoscopic surveillance of patients with known Barrett’s esophagus.

The Cleveland Clinic has a multidisciplinary clinical care and translational research program dedicated to a comprehensive scientific approach to the management of GERD, Barrett's Esophagus and early esophageal adenocarcinoma.

The components of this program include the following core areas:

  • Cancer Biology
  • Anatomic Pathology
  • Molecular Pathology
  • Cytopathology
  • Thoracic Surgery
  • Gastroenterology
    ~ Endoscopy – Imaging and Intervention
    ~ Pharmacologic Treatment
  • Epidemiology and Biostatistics
    ~ Barrett’s Esophagus Registry
  • Ohio Familial Barrett's Esophagus Consortium
  • Medical Oncology

For patients with Barrett’s esophagus, the Cleveland Clinic offers the following:

  • expertise in diagnosis and treatment
  • expertise in pathologic diagnosis
  • entry into a Registry to remind patients of their next follow-up surveillance date
  • opportunities to participate in clinical research programs examining:
    ~ novel endoscopic imaging
    ~ new approaches to medical therapy and chemoprevention
  • entry iinto the Ohio Familial Barrett's Esophagus Consortium Research Program

For patients with Barrett’s esophagus and dysplasia or early cancer:

  • expertise in diagnosis and treatment
  • expertise in pathologic diagnosis
  • expertise in esophageal surgery
  • expertise in endoscopic intervention
  • a multidisciplinary approach involving gastroenterologists, pathologists, thoracic surgeons and oncologists
  • opportunities to participate in clinical research programs examining novel endoscopic imaging techniques and cancer risk
  • new approaches to medical therapy and chemoprevention
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