EndoSign®
Heartburn Health Check
Heartburn is a common (and usually an innocuous) health ailment that the majority of people have experienced at some point in their life. However persistent heartburn – sometimes referred to as chronic heartburn or acid reflux – can be an early warning sign of oesophageal cancer (cancer of the food pipe).
People with Gastro-oesophageal reflux disease (GORD) should not be alarmed; not everyone who has chronic heartburn develops cancer. About 1 in 10 may develop a condition called Barrett’s oesophagus, which means the cells in the food pipe change somewhat (although it’s worth noting these changes are not harmful in themselves). 1 in 1000 Barrett’s patients will progress to oesophageal cancer.
Heartburn symptoms should not be ignored though. Everyone who has oesophageal cancer would have had Barrett’s first (whether they knew it or not) and chronic heartburn before that. A Heartburn Health Check offers peace of mind for anyone experiencing persistent heartburn.
What is EndoSign® ?
EndoSign® is an incredibly simple and affordable test for people with ongoing acid reflux or chronic heartburn. It can detect if a person has any cancerous (early stage adenocarcinoma or AOC) or pre-cancerous cells (Barrett’s oesophagus).
EndoSign® is a newer and less invasive way to investigate the health of the oesophagus without the need for a ‘camera down the throat’ test (known as a gastroscopy).
Previously the only way to detect the presence of cancerous or pre-cancerous cells in the food pipe was with a gastroscopy. This involves passing a catheter down the throat (with a light/camera and scope attached) to look at the appearance of the cells and usually requires sedation.
EndoSign® patients report finding the test quicker, more comfortable and convenient. As no sedation is needed – a person can drive themselves or take public transport home unaccompanied.
What happens during the Heartburn Health Check?
Foremost patients will be a consultation with one of the gastroenterology team at Cleveland Clinic, to take a brief medical history and check that the EndoSign® procedure is right for the individual (based on age, gender, symptoms and current medications).
Eligible patients will be invited to attend the clinic for a 20 minute EndoSign® appointment. Here the patient will swallow a pill sized capsule on a string with a glass of water. The capsule covering* dissolves in the stomach and a sponge emerges (this takes 7 minutes). The sponge is retrieved via the string (which remains outside the mouth). As it is pulled out it collect cells from entire length of the oesophagus – from where the food pipe connects to the stomach all the way to the back of the throat.
The sponge picks up a comprehensive samples of cells and is then sent to a state of the art laboratory where ‘biomarkers’ TFF3 and P53 are used to assess the presence of pre-cancerous Barrett’s cells and early stage cancer in the patient’s sample. This pioneering analysis process can take 1-2 weeks.
Dr Rehan Haidry will review your results and can discuss the most appropriate next steps:
- All clear – if there are no Barrett’s or AOC cells Dr Haidry may advise a repeat EndoSign® screen in 2-5 years (depending on your individual risk factors). The person’s three year risk of developing oesophageal cancer is less than 1%
- Positive for Barrett’s – Additional investigations will be required, likely a Gastroscopy. You can read more about Barrett’s Oesophagus
- Positive for AOC – Additional investigations will be required, likely a gastroscopy in the first instance, followed by treatment. You can read more about Oesophageal Cancer
- On rare occasions, a repeat EndoSign® may be required
Why EndoSign® ?
OAC is an aggressive type of cancer with poor levels of detection and low survival rates. Sadly 81% of patients are diagnosed with late stage disease (stage 3 or 4) where interventions are more intensive and patient outcomes are worse. The patients diagnosed at stage 4 have a one-year survival rate of 21%, and a five-year survival rate of 0% due to the aggressive nature of the disease.
EndoSign® has been developed to detect cancer and pre-cancer early when management of the disease is effective and in many cases curative.
- There is a much brighter outlook for those who detect oesophageal cancer early with cure rates of over 90% and excellent long term disease free survival. Dr Haidry is able to offer pioneering treatments (such as Endoscopic Mucosal Resection (EMR), Endoscopic Submucosal Dissection (ESD), Radiofrequency ablation (RFA) and Cryoballon ablation treatment at the Cleveland Clinic. These minimally invasive and innovative endoscopic procedures are in many cases completely curative.
- Further, for those whose Barrett’s Oesophagus is picked up ongoing surveillance can be organised and (by knowing disease status) a person can receive fast tracked and targeted treatment, such as radio frequency ablation and cryoballoon ablation.
A negative or ‘all clear’ result gives peace of mind for anyone with persistent heartburn anxious about their cancer risk or oesophageal health status. Dr Rehan Haidry can discuss ways to manage chronic reflux or even a procedure to prevent heartburn permanently (massively reducing the risk of ever developing OAC), called TIF.
* The capsule covering is derived from plant fibres. As such it is vegan, halal and kosher
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org