I know – not the nicest of subjects to discuss while heading for the week-end, but there’s a reason why I’m writing about this.
A recent meta analysis shows that patients with Pernicious Anaemia have a near sevenfold increased chance of developing gastric cancer and an eleven-fold chance of developing Neuroendocrine Tumours (or NETs for short). And that’s why Prof. Mark Pritchard, a Gastroenterologist from Liverpool University wanted to find out just how many of the members of the Pernicious Anaemia Society had undergone an endoscopy at diagnosis and how many were receiving regular endoscopy investigations to identify anything nasty developing at an early stage. An Endoscopy is the process whereby the patient has a flexible camera inserted through their throat and/or anus. Survival rates and successful treatment is dependant to a certain degree on early identification of any problems.
And so, thanks to all those who participated in the survey which was analysed and written up into a letter by Professor Pritchard and submitted to the highly respected journal Alimentary Pharmacology and Therapeutics. The letter was published earlier this week. Here’s the link to it:
You’ll see that I am the co-author though my role was simply as a facilitator. The letter suggests that all patients diagnosed with Pernicious Anaemia should undergo an endoscopy at diagnosis and receive regular inspections following diagnosis – perhaps once every three years. This shows just how useful the Pernicious Anaemia Society is at playing a part in supplying doctors with information about this unique group of patients. And the letter has already led to responses from other medical professionals (see the letter at the bottom of Dr. Pritchard’s letter.
Remember, Gastric Cancer remains relatively rare in the UK and can be successfully treated if detected early. So don’t go worrying – and enjoy the week-end. But only after you have completed the current survey on Frequency of Injections where the information will be used to provide evidence for our next campaign.
I had a gastroscopy when I was first diagnosed with PA and it showed that I had many small NETs (aka a Type 1 gastric carcinoids).
One thing that the doctors keep telling me is that these things are almost always innocuous. Indeed, for people of my age, the 5-year survival rate is very slightly higher for those with NETs than for those without, presumably because we have more thorough health monitoring that picks up other problems.
The indolent nature of these tumours is reflected in my treatment – one gastroscopy per year just to keep an eye on them.
One thing I’m keen on is getting my gastroenterologist to investigate if treatment of achlorhydria by taking acidic supplements with meals might Help prevent the development of such tumours.
It is thought they are caused by hypergastrinaemia, which is caused by low stomach acid. I take lime juice with each meal, which should mimic the natural production of acid. We’re currently waiting to see if my, previously high, serum gastric levels have dropped.
I did not have an endoscopy when diagnosed with PA but had one later when being investigated for coeliac disease. I wonder if there is any connection or increased risk for people who also have coeliac disease?
I had a endoscopy 6 years ago and was told I had chronic stomach acid and was put on omeprazole. I was diagnosed with pernicious anemia 5 years ago but haven’t had one since then. I still have constant stomach ache and bowel problems.
Just for a bit of perspective…
The normal rate of Neuroendocrine Tumours is around 2 in a million – http://www.ncbi.nlm.nih.gov/pubmed/24628514 – so an elevenfold increase may sound scary, but the chances are still only 2 in a hundred thousand.