For William, Paul, and all other 2+ year survivors

paul61 said:

I am on Omeprazole
Melinda,

I am on Omeprazole. I take 20 MG twice daily. In the morning and before bed. The last time I had an endoscopy my gastroenterologist saw some minor irritation and recommended I continue to take it. I am not sure about danger of recurrence from reflux but taking it works for me and does not seem to cause any side effects.

Best Regards,

Paul Adams
McCormick, South Carolina

DX 10/22/2009 T2N1M0 Stage IIB
12/03/2009 Ivor Lewis
2/8 through 6/14/2010 Adjuvant Chemo Cisplatin, Epirubicin, 5 FU
Two year survivor

Life may not be the party we hoped for, but while we are here we might as well dance!

Mazj said:

Nexium first then Pantoprazole Sandoz
Hi Melinda,
My husband was diagnosed in 2005 and is 6 years post IL. Has generally suffered reflux since then. His endoscopy report of 2007 found 'moderate to severe reflux esophagitis' and had his Nexium increased from 20mg to 40mg. I am unsure of the reason why he now takes a different tablet(with a name you may or may not be familiar with as we are in Australia), but it is one each morning with breakfast. He too sleeps with his head elevated on a wedge pillow which appears to offer more relief. Appetite was remarkably good for the first few years following surgery but has decreased in the last few. This year he was diagnosed with metastases to the peritoneal cavity.
Hope this helps
Marilyn

bingbing2009 said:

Thanks to all
I really appreciate everyone's responses.

@Paul--As always, you are a wealth of info and always willing to share. I truly appreciate that.

@Teresa--Of course I don't mind you responding. The more I hear, the better. Thanks for sharing!

@Kenem--Thank you so much for responding. I'll have to look up your drug.

@Marilyn--So sorry to hear of the recurrence, but thanks so much for sharing the info. Sending you lots of hugs and all the support possible!

@ Ann(2)--I really appreciate you sharing the info.

@Eric--You are such an inspiration. I love hearing from an 11 year survivor! Strange you mentioned bile, because that's mostly what I vomited for weeks following my surgery.

@Daniele--What an interesting take on the polyps. Hadn't thought about that. Thanks!

@BMGky--I won't try to tackle that study, but I will say it is somewhat confusing because it seems that those with severe GERD symptoms are not developing cancer to the degree that others are. Thanks for sharing.

My plan? I'm going to have a heart to heart with my oncologist when I see him next February. I will question about polyps and all the other long-term possible problems of staying on Omeprazole. When I do find out something, I'll share the info.

BMGky said:

I'm glad you posted this
I'm glad you posted this question. i've been wondering about PPI's. Some of my friends are for them. Some of my friends are against them. We're for our friends..... Doctors will say to take them, it won't hurt. But some doctors say that if have no reflux symptoms, then stop them. It would be great if your doctor would tell you why he is suggesting this decrease in PPI usage.

I'm putting a copy of an article on EC completed in July of this year. It mentions PPIs. The article is really over my head. Maybe you all can tell me what it means.

It is from Medscape Medical News
Severe GERD Symptoms Inversely Linked to Esophageal Cancer
Laurie Barclay, MD
Authors and Disclosures
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July 21, 2011 — The risk for esophageal adenocarcinogenesis is significantly higher in medically treated patients with mild or absent symptoms of gastroesophageal reflux disease (GERD) vs those with severe symptoms, according to the results of a cross-sectional study reported in the July issue of the Archives of Surgery.

"Screening for esophageal adenocarcinoma has focused on identifying Barrett esophagus (BE) in patients with severe, longstanding symptoms of ...GERD," write Katie S. Nason, MD, MPH, from the Division of Thoracic and Foregut Surgery, University of Pittsburgh in Pittsburgh, Pennsylvania, and colleagues. "Unfortunately, 95% of patients who develop esophageal adenocarcinoma are unaware of the presence of BE before their cancer diagnosis, which means they never had been selected for screening. One possible explanation is that no correlation exists between the severity of GERD symptoms and cancer risk."

The hypothesis tested by this study was that severe GERD symptoms are not associated with an increased prevalence of BE, dysplasia, or cancer among patients undergoing primary endoscopic screening. At a university hospital, 769 patients with GERD underwent primary screening endoscopy from November 1, 2004, through June 7, 2007. The primary study endpoint was esophageal adenocarcinogenesis, defined as BE, dysplasia, or cancer, as a function of symptom severity and proton pump inhibitor (PPI) therapy.

Esophageal adenocarcinogenesis was detected in 122 patients. Endoscopic findings of esophagitis correlated positively with an increasing number of severe GERD symptoms (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 - 1.09). In contrast, the odds of adenocarcinogenesis were lower with increasing number of severe GERD symptoms (OR, 0.94; 95% CI, 0.89 - 0.98).

Among patients taking PPIs, those with no severe typical or atypical GERD symptoms were 61.3% and 81.5% more likely to have adenocarcinogenesis, respectively, than patients who reported that all symptoms were severe.

"Medically treated patients with mild or absent GERD symptoms have significantly higher odds of adenocarcinogenesis compared with medically treated patients with severe GERD symptoms," the study authors write. "This finding may explain the failure of the current screening paradigm in which the threshold for primary endoscopic examination is based on symptom severity."

Limitations of this study include cross-sectional design, inability to determine causality, failure to control for all known risk factors for BE and esophageal adenocarcinoma, and lack of validation of the symptom severity scale developed for this study.

"These findings ... suggest that, rather than recommending BE screening only in patients with long-standing, poorly controlled GERD, patients with long-standing but well-controlled symptoms of typical or atypical GERD may be a better population to target," the study authors conclude. "In addition, patients who present initially to the otolaryngology clinic with severe atypical-predominate symptoms should be strongly considered for primary screening endoscopy. Larger-scale prospective studies, ideally having a validated measure of symptom severity, will enable us to determine the prevalence of BE stratified by symptom duration, antisecretory medication use, and current symptoms severity and lead to stronger guidance in recommendations for screening endoscopy."

The Robert Anthony McHugh Research Fund for the Prevention and Early Detection of Esophageal Cancer, American Surgical Association Foundation Fellowship Award, and the National Institutes of Health supported this study. The study authors have disclosed no relevant financial relationships.

Arch Surg. 2011;146:851-858.

Kenem said:

Protonix
My gastro doctor (not oncologist) has me on one Protonix daily forever.