What is esophageal cancer?
Esophageal cancer is a disease in which malignant (cancer) cells
form in the tissues of the esophagus. The esophagus is a muscular tube that moves the food from the back of throat to stomach. The two most common forms of esophageal cancer are:
- Squamous cell carcinoma: Cancer that forms in squamous cells, also called epidermoid carcinoma. It is most often found in the upper and middle part of the esophagus.
- Adenocarcinoma: Cancer that begins in glandular cells.
Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.
What are the signs and symptoms of esophageal cancer?
Signs and symptoms of esophageal cancer include:
- Difficulty swallowing (dysphagia)
- Weight loss without trying
- Chest pain, pressure or burning
- Worsening indigestion or heartburn
- Coughing or hoarseness
- Early esophageal cancer typically causes no signs or symptoms.
What causes esophageal cancer?
The causes of most esophageal cancers are still unkown
. However, certain risk factors
make getting esophageal cancer more likely:
The chance of getting esophageal cancer increases with age.
Men are more likely than women to get esophageal cancer.
- Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a severe form of acid relux. It is very common, and most of the people who have it do not develop esophageal cancer. However, GERD can also cause Barrett' s esophagus, which may leads to higher risk.
- Barrett's esophagus
Barrett esophagus is a disorder in which the lining of the esophagus is damaged by stomach acid. Still, most people with Barrett's esophagus do not get esophageal cancer. But over time, Barrett's esophagus can result in dysplasia, a pre-cancerous condition. High-grade dysplasia is linked to the highest risk of cancer.
- Tobacco and heavy alcohol use
The use of tobacco products is a major risk factor for esophageal cancer and drinking alcohol also increases the risk.
People who are overweight or obese have a higher possibility of getting adenocarcinoma of the esophagus.
How to diagnose esophageal cancer?
You can take the following tests and procedures to diagnose:
- Medical history and physical exam
If you seem to have symptoms of esophageal cancer, your doctor will ask about your medical history to check for possible risk factors. The doctor will also examine you to look for unusual signs of your body, especially thos on your neck and chest areas.
- Image tests
Image tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body.
Your doctor will pass a flexible tube with a tiny video camera and light on the end down your throat and into your esophagus. So the doctor can examine your esophagus for cancer or areas of irritation.
During the endoscopy, your doctor will remove cells or tissues of your esophagus. Then a pathologist will check the tissues under a microscope for signs of cancer.
to determine the extent of the cancer
You may need to take extra tests if a diagnosis of esophageal cancer is confirmed. So, your doctor can determine whether your cancer has spread to other areas of your body.
- Tests may include:
- Endoscopic ultrasound (EUS)
- Computerized tomography (CT)
- Positron emission tomography (PET)
According to the test results, your docor will decide at which stage your cancer is. The stages of esophageal cancer
can range from 0 to IV, from the lightest to the severest. Your doctor uses your cancer stage to select suitable treatments for you.
What are the treatments for esophageal cancer?
Factors that influence the treatments you receive include:
- the type of cells involved in your cancer
- cancer's stage
- your overall health
- preferences for treatment
Here are the treatments you may receive:
You can have only surgery to remove the cancer or combine with other treatments. Operations used to treat esophageal cancer include:
- Surgery to remove very small tumors.
If your cancer is small and has not spread, your surgeon may recommend removing the cancer and margin of unhealthy tissue that surrounds it.
- Surgery to remove a portion of the esophagus (esophagectomy).
Your surgeon will remove the portion of your esophagus that contains the tumor, along with a portion of the upper part of your stomach, and nearby lymph nodes.
- Surgery to remove part of your esophagus and the upper portion of your stomach (esophagogastrectomy).
Your surgeon will remove part of your esophagus, nearby lymph nodes and a larger part of your stomach.
Esophageal cancer surgery carries a risk of serious complications
- leakage from the area where the remaining esophagus is reattached to the stomach.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It is typically used before or after surgery as neoadjuvant or adjuvant. It may be used alone to help relieve signs and symptoms caused by the cancer. Chemotherapy can also be combined with radiation therapy.
Radiation therapy uses high-powered X-ray beams to kill cancer cells. It can relieve complications of advanced esophageal cancer.
Keywords: esophageal cancer