Esophageal cancer

Esophageal cancer is the world’s 6th leading cause of cancer death across the world.

It is more commonly seen in men than women. The oesophagus is the long, hollow tube connecting the back of the mouth to the stomach. After taking the food that becomes a soft pulp and other liquids pass through the esophagus. Thus, foods and drinks reach the stomach for further digestion and absorption of nutrients.

Generally, Esophageal cancer occurs within the inner lining of the esophagus where the cells grow with no control. When cancerous cells spread to other parts of the body, it is known as metastasis.

Smoking and tobacco use along with alcohol impose a great risk in the development of this cancer.

Types of esophageal cancer

1) Adenocarcinoma

2) Squamous cell carcinoma

Causes

Some factors increase the risk of esophageal cancer.

1) Barrett’s Esophagus

2) Tobacco

3) Alcohol

4) High fat, low protein diet

5) Esophgeal irritation

6) Exposure to nitrosamines

Signs and symptoms

Very few cases are diagnosed at early stages. Most patients present with later stages of this cancer, at which point they complain of difficulty in swallowing solid foods.

1) weight loss

2) loss of appetite

3) cough

4) bone pain

5) hoarseness

6) shortness of breath

Diagnosis

When there is suspicion of this condition, a physical examination followed by Endoscopy to visualise the esophagus. CT scan and MRI is a vital procedures in the workup of patients with esophageal cancer. If an abnormal area is seen in Endoscopy or detected in physical examination, then a biopsy is performed and the tissue sample is sent to the pathologist.

Treatment

Most patients are treated with a combination of surgery, chemotherapy and Radiation therapy.

Even for the most advanced disease, a combination of chemotherapy and radiation therapy may control disease in a high percentage of patients.

The majority of patients are treated with a combination of 5-FU and cisplatinum and radiation.

Radiation therapy

Radiation to the esophagus is a treatment offered over six to eight weeks.

Prognosis

The prognosis depends on the extent of the disease at diagnosis, as well as response to the treatment. Most patients with early-stage cancers can be cured.

Special situations

Patients with advanced esophagal cancer may develop any of the following complications.

1) Pleural effusion

2) Brain metastasis

3) Bone metastasis

4) Spinal cord compression

5) Superior vena cava obstruction

6) pain

7) High calcium levels

Follow up

After completion of treatment in any combination, patients need to remain under surveillance. The frequency of follow up will depend on the condition of the patient and his\her disease. A CT scan of the chest, bone scan and Endoscopy are performed once a year.

Prevention

preventions are the best precautionary measures that reduce the chances of getting esophageal cancer.

1) lifestyle

2) quit smoking

3) drinking moderately

4) diet

5) maintain a healthy weight

6) treat Gerd

Dr S.k.jha