By Adriana Ermter
In our monthly column, senior writer and editor Adriana Ermter shares her personal experiences with breast cancer
Gulping back a big glass of water. I have heartburn. Waking up in the middle of the night. I have heartburn. Swimming laps in the pool. I have heartburn. Feeling anxiety over what to wear, being stuck in traffic, thoughts of a recurrence. I have heartburn.
Only after being diagnosed with breast cancer and undergoing surgery and treatment did the burning in my throat and chest—the uncomfortable, dry and always-on-fire feeling of heartburn—become a constant in my life. Single-digit years now, cancer-free, I'm still carting a container of Tums in my black Lululemon Everywhere Belt Bag.
While my doctors acknowledged this symptom could happen, and the American Cancer Society notes on its website that cancer and its treatments can cause heartburn, there are no definite answers to my questions: how long, how often and when will it go away?
Just like its name suggests, heartburn is the slow burn that sneaks up on you, an unwelcome visitor that overstays its welcome. Technically, it’s caused by stomach acid backing up into the esophagus, that slim tube running from your mouth to your stomach. When the lower esophageal sphincter—basically a ring of muscle that acts like a lid—is weakened or relaxes when it shouldn’t, acid travels up. That’s when the heat, pain, and pressure set in. Mine always feels like a fist pushing on my chest directly between both of my breasts before it’s fire creeps upwards, but other women dealing with a diagnosis have described it to me as a lump in the throat or as a low burning that climbs into their mouth. Because I’ve been living with it for six years now, I know the odds are stacked against me when I eat a too-late dinner, have a glass or two of wine (white is worse than red for me), or stress about paying the bills or packing for a trip away.
According to the Canadian Digestive Health Foundation—as well as my trusty safeguard, Tums—more than five million Canadians experience heartburn at least once a week and around 20 per cent have chronic symptoms. They also note that diet and lifestyle choices, like overeating, lying down too soon after meals, alcohol consumption, smoking and being overweight can make it worse. Health Canada recommends eating smaller meals, avoiding known triggers like spicy foods and coffee, and elevating your head while sleeping. But it all still frustrates me.
I only drink one big cup of coffee in the morning and the beans are organic so cut down on the acidity that triggers heartburn. I don’t smoke, and while I’m still 40 Tamoxifen pounds away from my goal weight, I work hard to be healthy. I go to bed early, eat well, forego sugar, walk with my neighbour and swim laps at the community pool two to three times a week. I’ve even started a weekly one-hour Britney Spears dance class with a friend. And no, I can’t bear to make eye contact with myself in the mirror, but yes, I do lip sync “Work Bitch” as I gyrate—and love it. Still, nothing about cancer is straightforward and that includes heartburn.
I never had acid reflux before my breast cancer diagnosis and yet, here I am years later, still living with it. That’s because heartburn is more than just what I’m eating or how I’m sleeping—it’s about the impact of cancer treatments on the body. Chemotherapy can damage the lining of the gastrointestinal tract, increasing sensitivity and reducing the ability to keep stomach acid where it belongs. Radiation, particularly when it’s focused on the chest area, as it often is with breast cancer, can cause inflammation in the esophagus. Surgeries like mine that impact the chest and lymph nodes can also lead to lingering nerve pain or anatomical changes that impact digestion. In an article published on BreastCancer.org, medications such as painkillers or anti-nausea drugs (which I could’ve popped like Smarties during treatment), and even hormone therapies like Tamoxifen (the worst drug I have ever experienced), are said to potentially contribute to digestive issues, slowing down digestion or affecting the way your body handles certain foods, making heartburn more likely.
There’s a physical gut-brain connection that living with cancer, including surviving it, can put into play too. Anxiety, depression and post traumatic syndrome disorder (commonly referred to as PTSD) can intensify gastrointestinal symptoms. Cortisol and adrenaline mess with digestion, and when I’m stressed—especially around scans, appointments or unexpected body changes—my heartburn flares up. A 2020 study from the University of Alberta published by Education & Research Archive makes me feel slightly more normal about this, explaining how cancer-related fatigue and psychological stress can influence the severity of digestive symptoms, including acid reflux, in breast cancer survivors.
Support can help. My general practitioner continues to work with me to find longer-lasting solutions than the chalky mint-flavoured tablets I chew. Recently, another breastie talked to me about resources accessible through the Canadian Cancer Society, as well as Wellspring’s tailored workshops and support programs for people living with cancer-related side effects. I’m also considering using a low-dose proton pump inhibitor to provide me with extra relief and control. If it's a solid solution, I’ll let you know. Afterall, someone’s got to talk about the little-known or barely shared idiosyncrasies like this. Reach out if you experience heartburn and what you do to combat it. We all deserve the knowledge and power that comes from shared transparency.
Adriana Ermter is a multi award-winning writer and editor. Her work can be read in IN Magazine, Living Luxe, 29Secrets.com, RethinkBreastCancer.ca and AmongMen.com. The former Beauty Director for FASHION and Editor-in-Chief for Salon and Childview magazines lives in Toronto with her two very spoiled rescue cats, Murphy and Olive. You can follow Adriana on Instagram @AdrianaErmter
Receive updates by email 
