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Cough, hoarseness and cancer

February 9, 2009 3:40:09 PM PST
A hoarse throat or a cough can be a sign of something more serious than just a cold. And a new device is helping doctors make the diagnosis. If you had heartburn, you might think it's coming from the stomach and esophagus. But what about symptoms of cough or hoarseness? One study shows those symptoms are linked to the esophagus, too, ominously, to cancer there. Now, one doctor is using a quick and safe method to find the problem.

Through the nose? Why put a tiny scope through the nose when it sounds like Nick Tsaclas' symptoms are coming from his stomach and esophagus?

"About 12 years ago," he said, "I was starting to develop recurrent symptoms of heartburn along with cough.

For these symptoms, it turns out that a nasal approach to the esophagus is faster and safer than using a large stomach scope through the mouth, where, to prevent gagging, patients are anesthetized.

"The most common complications are with breathing," said Dr. Jonathan Aviv, of the Columbia University Medical Center. "One can stop breathing, and problems with the heart, one can actually have a heart attack after the procedure."

Dr. Aviv admits the complications are rare, but says the nasal scope can avoid them completely. He says it's best for patients like Nick with an unexplained cough.

Even though people tend to associate heartburn with esophageal illness, it turns out that cough and hoarseness better predict one of the most serious illnesses of the esophagus, esophageal cancer.

But despite that, Nick appears comfortable. For him, all the way down the esophagus near the stomach, a bright salmon-colored area of abnormal cells is what was causing the problems. It is a precancerous area called Barrett's Esophagus, which is related to Nick's coughing symptoms. Because the nasal scope can't get all the way into the stomach, it doesn't replace the standard procedure. But if the standard method finds esophagus problems, Dr. Aviv thinks the tiny scope could replace the bigger one in follow-up visits.

And that is safer for the patient. Patients with stomach issues need the standard scope procedure. Nick's treatment is a daily antacid pill and regular checkups with Dr. Aviv. The nasal scope can also clearly see the vocal cords, as well as the esophagus.

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WEB PRODUCED BY: Bill King


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