ESOPHAGEAL CANCER
The Esophagus is a muscular tube connecting the throat (pharynx) with the stomach. The esophagus is about 8 inches long and is lined by moist pink tissue called Mucosa. The esophagus runs behind the windpipe (trachea) and heart and in front of the spine. They keep food and secretions from going down the windpipe. While cancers like breast and lung cancers are decreasing, esophageal cancer is on the increase. Endoscopic ultrasound-guided biopsy, laparoscopic/thoracoscopic biopsy diagnosis can identify esophageal cancer. Esophageal cancer is common in the US, Northern China, India and Northern Africa. These days the treatment has improved, and the survival rate has also increased, unlike earlier times where people used to die when affected by this disease.
Causes for Esophageal Cancer:
Actually, the exact reason that causes esophageal cancer is not apparent. But, when changes occur in the DNA of the esophagus cells, cancer occurs. At this stage, the cells grow and divide out of control. Then these abnormal cells form a tumor in the esophagus, and when they grow, they spread to the nearby structures and the other parts of the body.
Common Esophageal Cancers: Esophageal cancers are more common in men than in women. Adenocarcinoma cancer is the most common in many countries around the world, followed by squamous cell carcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. The Adenocarcinoma occurs in the lower part of the esophagus. This generally occurs among white men.
Squamous cell carcinoma: These cells are flat, and thin and surround the esophagus. It generally occurs in the upper and middle portions of the esophagus. It is the most common cancer in the world. The other esophagus cancers are small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.
Risk factors: 1. 2. 3.
4. 5. 6.
Chronic irritation in the esophagus Gastroesophageal reflux disease Smoking Obesity Drinking of alcohol, difficulty in swallowing. Not eating sufficient fruits and vegetables.
Prevention: Stop smoking. Consult your doctor to quit smoking. Reduce the consumption of alcohol, one drink for women and two for men, is permitted. Eat colourful fruits and vegetables. Healthy weight maintenance.
ESOPHAGEAL CANCER AND ACID REFLUX: Heartburn is a symptom of gastroesophageal reflux disease (GERD). It can finally lead to esophageal cancer. Though it is rare, people have GERD for a long time and live with it. Generally, people who overeat or lie down immediately after eating, GERD develops when the acid that digests the food in the stomach goes into the esophagus. It may also develop if there is a defect in the valve that connects esophagus and the stomach. DR. Molena says,” when the esophagus is bathed in acid, it wants to protect itself and so the cells in the lining begin to change. These changes can advance to become cancer.” The other symptoms are: 1. Cough, chest pain, 2. A sore throat or a hoarse voice, 3. Frequent sinus infections.
Treatment for Esophageal Cancer: Surgery: laparoscopy or robotic surgery. This results in fast recovery, and side effects are very few. Radiation Therapy: this shrinks the tumors, and it’s easy to remove and also reduce the risk that the cancer spreads to the other parts of the body. Targeted Therapies: Oncologists use genetic testing to see if the patient can benefit through clinical trials. Chemotherapy: can also shrink a cancer before surgery. Endoscopic therapies is also a way to treat. In the last few years, esophageal cancer is being diagnosed and cured. 1. 2. 3. 4. 5. 6.
The final stage of esophageal cancer: Sore throat and a bad cough Heavy breathing Difficulty in speaking, hiccups, Nausea and vomiting Bone and joint pain Bleeding in the esophagus, blood in the digestive tract and stool. After the treatment for esophageal cancer, the patient is kept in the hospital for seven days. Recovery time is six to eight weeks; during these days the patient needs to eat small quantity of food at frequent intervals. Patients have lived for nearly 19 years after treatment. The patient needs to sleep for eight hours. The head of the bed should be slightly elevated.
Diet after treatment: 1. 2. 3. 4. 5. 6. 7.
Liquid diet Soft food for eight weeks that does not need much chewing Soft food includes cooked fruits and vegetables Roasted and stewed meat, pastries, cereals While eating solid food sip liquids Avoid banana and bread that sticks to the throat. Avoid dried or dehydrated foods, processed foods, cheese, dairy products, red meat and sweets.
Questions often asked:
At what stage is esophageal cancer usually diagnosed? Ans. Esophageal cancer does not show any symptoms in the early stages. It mostly develops in men above 50 years of age. The doctor generally does a few tests like physical exam, chest x-ray, endoscopic ultrasound and so on. It is recommended to visit a cancer specialist in Hyderabad , one of the best places for medical treatments in India, for a good diagnosis.
Where does all the disease spread? Ans) It can spread through the esophageal wall to lymph nodes, blood cells in the chest, nearby organs, lungs, liver, stomach and the other parts of the body.
How does a patient find out that he has esophageal cancer? Ans) Symptoms are difficulty and pain in swallowing, burn in the chest, indigestion, vomiting, choking of food, weight loss, cough and pain behind the breastbone or in the throat.
How quickly should one need to start the treatment? Ans) As esophageal cancer is the eight most common cancer and sixth leading cause of death, it needs to be treated as early as possible after diagnosing it. Long delay can impact the stage of the cancer and can delay in the recovery.
What are side effects after the treatment? Ans) After radiation the skin turns red, blisters form and the skin can peel off. Painful sores in the mouth and throat, dry mouth or thick saliva, pain while swallowing, tiredness, diarrhea.
What happens if the esophagus is removed? Ans) A part of the esophagus is removed, along with the top part of the stomach, but it’s surprising to note that a person can live without a stomach. In the absence of the stomach, food eaten in small quantities goes directly from the esophagus to the small intestine. Awareness of esophageal cancer is a must. People have less knowledge that smoking, drinking, having a low diet of fruits, vegetables, obesity, poor oral hygiene, canned food; cooking food at high temperatures can cause esophageal cancer. Campaigns or awareness programmes need to be conducted to diagnose esophageal cancer at an early stage, so that it can be cured.