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Dear Dr. Roach: Is it true that someone who takes antacids every day is more likely to get cancer of the esophagus?

D.R.

Dear D.R.: Yes, people who take antacids frequently are more likely to be diagnosed with esophageal and stomach cancer.

However, people who take more antacids usually do so because they have reflux. Reflux predisposes one to Barrett’s esophagus, which predisposes one to cancer; this is a more reasonable explanation than that taking antacids causes cancer.

Although some authorities have postulated that antacids may allow bile to reflux into the lower esophagus, increasing cancer risk, I believe the primary issue is that people take antacids too long before they seek medical attention when there might be something seriously wrong.

With either possibility, the message is clear: Don’t take antacids for prolonged periods without seeing your doctor. Those symptoms might be more serious than you think.

Dear Dr. Roach: I was diagnosed with stage 4 pancreatic cancer in January. It had already spread to my lungs. It is inoperable. I have had five chemo treatments, after which lung spots have shrunk, the tumor has shrunk by 50 percent and blood markers are 3. I am 80 to 90 percent active, except for a few days after chemo, and I have not taken any pain medication for 37 days because I have no pain.

What are your thoughts on my longevity? I am 67 years old.

E.N.E.

Dear E.N.E.: There are some tools to help make a prediction, such as those at mdanderson.org/pancreascalculator.

When I put in your information — without knowing additional information, such as the exact pathology and location of your tumor — the tool estimated that half of people similar to you would live more than three to six months.

However, these tools do not take into account your good activity level, nor even the effectiveness of the chemotherapy you have received, so your results are likely to be significantly better than the results you will find on the tool.

Dear Dr. Roach: I am trying to quit smoking, and was recommended a tobacco-free herbal snuff. I have used it once.

What are your thoughts on this?

S.B.

Dear S.B.: The long-term health risks of tobacco-free herbal snuff are not known.

However, it is my opinion that they are likely much less risky than tobacco snuff. I don’t think it is unreasonable to try tobacco-free herbal snuff as an aid to quitting only — not as a long-term solution.

Email questions to ToYourGoodHealth@med.cornell.edu.

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