An esophageal cancer is the cancerous growth seen in the hollow tube, called the food pipe, which runs from the throat to the stomach. The food pipe transfers the food eaten to the stomach for digestion. The cancer of the esophagus usually begins in the tissue cells lining the insides of the food pipe.
Most of the times the esophageal cancer affects the lower part of the food pipe and studies have shown that men are more prone to esophageal cancer than women.
What are the causes of Esophageal Cancer?
Although the medical fraternity has not been able to pinpoint the exact cause of esophageal cancer studies have shown that esophageal cancer develops as a result of mutation in the patient’s DNA. This mutation causes the tissue cells lining the inner parts of the esophagus to grow at an uncontrolled rate and form a tumor. This is a malignant form of cancer and is known to spread and affect the various surrounding organs as well.
What are the types of Esophageal Cancer?
An esophageal cancer is classified into different categories depending on the type of cancerous cells that develop into the tumor.
These are the types of esophageal cancer:
This type of esophageal cancer develops in the mucosal glands of the food pipe. Adenocarcinoma mostly affects the lower portion of the esophagus and is the most common form of esophageal cancer.
Squamous cell carcinoma
The squamous cells compose the inner surface of the esophagus are thin and flat in shape. Squamous cell carcinoma occurs in the middle part of the esophagus and is the most prevalent form of esophageal cancer in the world.
There are certain more rare form of esophageal cancers such as choriocarcinoma, melanoma, lymphoma, small cell cancer and sarcoma.
What are the risk factors of Esophageal Cancer?
Research has shown that continuous irritation in the esophagus contributes to the mutation of the DNA which causes esophageal cancer. These are the factors that irritate the cells of the esophagus and increase the risk for development of the esophageal cancer:
- Alcohol consumption
- Bile reflux
- Achalasia (tightness of the esophageal sphincter) causing swallowing difficulty
- Hot liquid consumption
- Fewer vegetables and fruits in regular diet
- GERD – gastroesophageal reflux disease
- Prolonged radiation treatment to chest and upper abdomen
What is Esophagitis?
Esophagitis is the inflammation of the food pipe and may be chronic or acute in nature.
Symptoms of esophagitis include heartburn, nausea, abdominal pain and difficulty in swallowing.
There are several different factors that cause esophagitis, these are:
- Fungal infections such as esophageal candidiasis
- Viral infections such as herpes esophagitis and cytomegalovirus
- GERD – gastroesophageal reflux disease (also known as reflux esophagitis)
- Injury caused by chemicals such as an acid or an alkali
- Pill esophagitis
- Alcohol abuse
- Food allergies may cause eosinophilic esophagitis
How is an Esophageal Cancer diagnosed?
These are the common tests used to diagnose an esophageal cancer:
Endoscopy – This is performed using a thin and flexible surgical tube that has an attached lens. The doctor inserts the endoscope into your throat to the esophagus and examines it for abnormal cancerous growths in the tissue lining the inner walls of the food pipe.
Biopsy – An endoscope is again used for this diagnostic method. The doctor will insert an endoscope attached with a tiny incision instrument into the esophagus through your throat to cut a sample of the suspected cancerous growth. This sample is sent to a pathological laboratory for detailed analysis.
How the prognosis for an Esophageal Cancer done?
Most cases of esophageal cancer prove to be treatable but not curable. Pre-cancerous cases or patients with fewer cancer cells are usually successfully treated.
The 5-year survival rate is an average between 5%-30%. This low rate is usually the result of late diagnosis of the esophageal cancer.
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How is the staging for an Esophageal Cancer determined?
After the diagnosis of the presence of esophageal cancer is confirmed the doctors will determine the stage (progress) of the esophageal cancer which is helpful in deciding the type of treatment that will be best suited for you.
Positron Emission Tomography (PET) and Computerized Tomography (CT) scan are performed in determining the stage an esophageal cancer has reached.
These are the stages of esophageal cancer:
Stage I – The cancer affects only the outer layer of the cells lining the food pipe (esophagus)
Stage II – The cancer has penetrated to the deeper layers of the esophageal lining and may have affected to the lymph nodes.
Stage III – The cancer has penetrated to the deepest layers of the esophageal tissue lining and may have affected the lymph nodes and nearby tissues.
Stage IV – The cancer has spread extensively to the surrounding organs.
What are the symptoms of Esophageal Cancer?
These are the symptoms that indicate the presence of esophageal cancer:
- Dysphagia – Difficulty swallowing
- Unexplainable loss in weight
- Heart burn or chest pain
- Continuous indigestion
- Hoarseness in throat
- Excessive coughing
What are the treatment methods for Esophageal Cancer?
The method for treating esophageal cancer is determined by the stage of the cancer, the type of cancerous cells that form the tumor and the overall health of the patient as well as the preference.
These are the type of treatment methods for esophageal cancer:
Surgery for removing the cancerous growth of esophageal cancer is done singularly or in combination with other methods. The surgical treatment for esophageal cancer includes:
Removal of cancer – This surgery is preferred when the cancer is seen only in the upper layer of the tissue lining the esophagus and has not spread to other regions in the body. This surgery will involve the surgeon removing the cancerous growth as well as a portion of the surrounding tissues to prevent chances of further growth of the cancerous cells in the future. This surgery is usually performed using an endoscope.
Esophagectomy – This surgical method requires the surgeon to remove the cancer-affected of the esophagus and the lymph nodes. The remaining food pipe is reattached to the stomach.
Esophagogastrectomy – This surgery requires the removal of the cancer-affected esophagus portion, lymph nodes and the upper portion of the stomach. The remaining part of the stomach is stretched upwards and reconnected to the remaining healthy part of the esophagus.
These surgeries are either performed using the conventional open-type of surgery requiring larger incisions or it can be performed in a minimally-invasive way with the help of a laparoscope requiring smaller and fewer incisions. The method for surgery is dependent on the surgeon’s experience, your preference and mainly on the extent of the cancer.
Chemotherapy involves using special medicinal drugs to destroy the cancerous cells. These may either be used ‘neo-adjuvant’ (before surgery) or ‘adjuvant’ (after surgery). Chemotherapy is often performed in combination with radiation therapy as well as to relieve painful symptoms caused by the esophageal cancer.
The radiation therapy method involves using high-powered energy beams focused on the cancerous parts to kill the cancer-causing cells. This can be either external beam radiation (from outside the body) or brachytherapy (from inside the body using radiation pills).
This method is often used in combination with chemotherapy as well as after or before a surgical treatment for cancer including esophageal cancer. Radiation therapy is also helpful in relieving painful complications caused by esophageal cancer.