Long-standing daily heartburn increases the risk of adenocarcinoma (cancer) of the esophagus.  Barrett's esophagus is another significant risk factor.  Patients with heartburn or Barrett's esophagus who develop the alarm symptoms of difficulty with swallowing, unexplained weight loss, and/or blood-loss anemia should consult their physicians immediately for further evaluation.  White males over the age of 40 with Barrett's esophagus are especially at risk of developing cancer of the esophagus.  In this group of patients, frequent monitoring by gastroenterologist is highly recommended.