Esophageal cancer is among the top cancer killing disease in the world. Esophagus is the tube linking the throat to the stomach, thus providing the passage for travelling of food from the mouth to the stomach. The tissues and cells lining the esophagus starts mutating rapidly leading to abnormal growth in cell which in turn leads to the formation of a tumor. Symptoms can range from difficulty in swallowing to rapid weight loss.
The treatment for esophageal cancer depends on the type of cells that are involved. As such esophageal cancer is of two types-
Adenocarcinoma (EAC) - This type of esophageal cancer generally involves the glandular cells lining the lower part of the esophagus. Some of the causes of EAC are smoking, obesity and acid reflux often termed as GERD and heartburn.
Squamous-cell carnimona (ESCC) - This type of esophageal cancer generally involve the epithelial cells present in the upper and middle portions of the esophagus. Some of the causes for ESCC are tobacco, alcohol, poor diet, coughing or hoarseness and chewing betel nut.
Early stages of esophageal cancer do not show any symptoms for which treatment usually begins at a much later stage. Moreover, people having Barrett’s Syndrome, a precancerous condition that increases the risk of developing esophageal cancer should immediately consult a doctor. The diagnosis of esophageal cancer is done by endoscopy and biopsy through which the presence of cancer cells is confirmed by a pathologist. However, treatments of the cancer depend upon the patients’ health, cancer stage and location of the cancerous cells.
Treatments for esophageal cancer depends on the type of cancer, health conditions and the stage of cancer. After the diagnosis that includes an endoscopy where the esophagus is examined with the help of a tube having video lens down your throat and biopsy where an endoscope is used to collect a sample of tissue for examination. The pathologist may include additional tests like-Endoscopic Ultrasound (EUS), Computerized Tomography (CT) and Positron Emission Tomography (PET).
If you are between stage I to III or the malignant tumor has not spread to other parts, then a surgery may be advised by your doctor. Surgery is the surgical removal of the tumor. A surgical oncologist is a doctor who specializes in cancer surgery. In a surgery, the tumor may be removed or a part of the esophagus may be removed or removing the esophagus along with the lymph nodes and stomach where the stomach is pulled up and reattached to the esophagus. This type of surgery is termed as esophagactomy. Along with this a combination of chemotherapy and radiation therapy might be used. In chemotherapy, drugs are used to destroy cancer cells and in radiation therapy, high-energy rays are used to kill the cancer cells. Both of them might be used individually or in combination for patients having a surgery or not having a surgery.
Moreover, there are certain treatments for the side effects occurring in a patient after or before a surgery or radiation and chemotherapy that includes- Endoscopy and dilation, endoscopy with stent placement, photodynamic therapy, electrocoagulation and cyrotherapy.
People who are eligible for the treatment of esophageal cancer shows various symptoms and signs including- difficulty in swallowing (also known as dysphagia), rapid weight loss, chest pain assisted with sensations of burning and coughing or hoarseness. People diagnosed with Barrett’s syndrome which is a precancerous condition are also eligible for the treatment.
Individuals who do not show any symptoms of esophageal cancer,either the squamous cell carcinoma or adenocarcinoma, should not undergo chemootherapy or radiation therapy.
There are various side effects of esophageal cancer and its associated treatment including pain, infections such as pneumonia, dysphagia( difficulty in swallowing), nausea, vomiting ,rapid weight loss and malnutrition. Moreover, patients may suffer from depression and become emotionally unstable to continue treatment and the post-surgery medications.
Cancer and its various treatments often have various side effects that need monitoring and relieving the person of the side effects. This type of support is termed as palliative care where patient’s emotional, social and physical needs are taken care of. It includes betterment of life and providing support to patients and their families. It may be started as early as the cancerous cells are detected or after the surgical removal of the tumor. The palliative care includes medication, nutritional changes, relaxation methods and other therapies. Therefore, palliative care is a very important part of the overall recovery of a cancer patient.
Recovery time depends upon various factors including- type of esophageal cancer, a person's health conditions, the stage at which cancer is at and the type of treatment the paerson is undergoing. The treatment may last upto four to six weeks but the palliative care may extend for many years.
Cancer is a costly affair. People suffering from esophageal cancer can incur costs between Rs. 305,922 to Rs.5 or 6,00,000. The treatment cost can go on increasing depending upon the hospital you are admitted to and the type of treatment you are going for.
The treatment of cancer does not have a permanent solution. If the cancer is detected early,then there are chances of it not returning. However, the cancer might recur even after the surgery and the associated chemotherapy and radiation therapy.
Cancer is one of the most widespread and incurable diseases that mankind has been combating with till date. We still have to go long for treating this deadly disease, regardless the progress man has made in medicine and medical sciences. Cancer continues to take the life of millions of people every year. In this article, we are going to talk about Esophageal Cancer, what it is, its symptoms and causes. Let us have a look.
What is Esophageal Cancer?
Esophagus is the long hollow tube that starts from your throat and ends up in the stomach. The esophagus helps us to move the food down when we swallow it. So, cancer which affects the esophagus tract is known as Esophageal cancer. It generally affects the cells that line the inner walls of the esophagus. It is the 6th most common form of cancer that takes thousands of lives every year. Let us have a look at the symptoms of esophageal cancer.
Symptoms: Esophageal cancer can be easily identified when it attacks a patient. There are some important symptoms that are prominent and clearly points towards the type of cancer.The patient faces difficulty in swallowing (dysphagia) because the esophageal tract starts to get narrow because of the excessive growth of abnormal cells inside its walls. Therefore food cannot be swallowed easily by the victim. Weight loss without the will of trying is also a symptom. This is because the patient cannot eat and drink properly anymore because of the unhealthy inflammation of the tract. The patient can suffer from abnormal chest pain, high pressure or burning sensations. These are followed by pukish feelings as well. Failure to digest properly or heartburn is very common and usually makes the patient weak and mentally irritated because of the problems in the digestive system.
How to prevent Esophageal cancer?
Actually, no one can definitely say that a set of the solution will keep someone away from cancer. It is not possible as cancer can affect anyone. But we can surely follow some steps at least to prevent it from happening in the first place. One needs to quit smoking and drinking alcohol. Tobacco is very harmful to each and every part of your body, therefore, it is absolutely not recommended to smoke and quit it completely. Same goes for alcohol intake. Even if you drink alcohol, drink it in moderation and not always. Eating more fruits and vegetables is one of the most important elements that can help your metabolism grow much stronger and help them to fight with any kind of foreign cells. Maintain a healthy weight and keep exercising daily for better body structure and functions.
Achalasia is a serious disorder of the esophagus in which your nerves and muscles fail to work properly. This disorder causes problems in your body such as chest pain, difficulty to swallow food and excessive coughing.
You will also face problems in breathing in case the food enters in to the lungs. There is a valve in your lower esophageal splinter, which closes the esophagus from your stomach. If you have problems like achalasia then perhaps your lower esophageal splinter fails to open while swallowing food it can lead to accumulation of food in esophagus. In this condition the nerves in your body gets damaged and hence cause health complications.
You are at risk of achalasia when you are middle aged, but it can also occur during childhood. Auto immune disorder often places you at risk for achalasia.
Symptoms of achalasia:
The major symptom of achalasia is dysphagia in which you face problems while swallowing food. You may feel that the food is struck in your esophagus which causes choking and problems when you breathe. There may be other symptoms of achalasia which includes:
1. Loss of weight
2. Heart burn
3. Discomfort or pain while you eat food
4. Chest pain
5. Risk of esophagus cancer
Treatment for achalasia:
Esophageal manometry is a technique your doctor may use, if he suspects achalasia when the symptoms include difficulty while you eat and swallow foods. A tube measures the muscular activity in your stomach and reports about the functioning of your esophagus. Another way to diagnose is through X- ray of the esophagus or endoscopy.
The treatment for achalasia generally starts with oral medications. Sphincter nitrates and calcium blockers often help to relax the muscles. Botox can also help to relax your sphincter and help you swallow food.
Esophagomyotomy also helps to treat achalasia in which your doctor can use an incision to access the sphincter and also alter it to enable better flow into the stomach. It’s a generally successful procedure, but sometimes can cause Gastroesophageal reflux disease (GERD) which causes heart burn and would require intensive care. Sometimes surgery can also help to give relief but it can also cause acid reflux, respiratory problems, tearing of esophagus along with other serious complications.
Laparoscopic surgery is a simple and effective way of treating this problem .The tight lower esophageal sphincter is released to make way for easy passage of food.The patient recovers in one day and is discharged home following this operation. If you wish to discuss any specific problem, you can consult a gastroenterologist.
Heatburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heatburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.
How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett’s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett’s esophagus doesn’t necessarily lead to esophageal cancer.
Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.
Key risk factors:
Some of the key risk factors for this type of cancer are as follows:
How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an x-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.
How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Esophagectomy is a procedure of removing a part of the esophagus and reconstructing the same using another organ of the body. The oesophagus is the tube that connects the stomach and the mouth. This procedure is often performed in an advanced stage of esophageal cancer and Barrett’s esophagus. This procedure removes the cancer cells from the esophagus and gives relief from the symptoms. The organs from where the reconstructing tissues are taken are generally large intestine and stomach.
Many esophagectomy surgeries are performed with minimally invasive techniques. The latter is commonly known as laparoscopic surgery. This is a procedure where numerous small incisions are made in order to perform the surgery. This procedure results in faster recovery and reduced pain as compared to the conventional surgery.
Newer methods such as Robotic surgery are being adopted by many doctors these days. Procedures like these can access the oesophagus through places such as the throat, collarbone and abdomen. They make a minute incision to get to the exact location of the cancer and treat them with an improved precision, unlike the conventional surgical methods.
An important aspect of treating this condition is to determine the procedure that is going to be implemented. To determine this, doctors uses imaging techniques such as PET scan, CT scan and an MRI scan. A doctor might also prescribe other tests such as FNAC and endoscopic ultrasound. Heart evaluations are also conducted before the surgery to ensure that there are no complications involved while performing the surgery.
Unless the cancer is detected at a very early stage, most doctors recommend radiation or chemotherapy or both. These treatments help to shrink the size of the cancer and make for an effective oesophagectomy. Both chemotherapy and radiation have their set of side effects, which include loss of appetite, fatigue, hair loss, vomiting and skin discolouration.
Post the procedure, a patient cannot directly consume food. He is required to consume food through a pipe for a duration of four-six weeks. Adequate nutrition is required during this phase to recover quickly. Once the patient is able to resume a normal diet, it should be ensured that he takes food in reduced quantities to make up for the reduced stomach size.
Almost 90% of patients who have gone through this procedure report an improved life quality. While lifestyle related adjustments have to be made, there could be regular follow-ups to ensure the below mentioned complications do not arise:
In case you have a concern or query you can always consult an expert & get answers to your questions!
Esophageal cancer is one of the fastest-growing cancers in incidence. Rates of esophageal cancer have surged due to a lack of awareness about what causes the disease and how it can be prevented. Heartburn is actually a symptom of GERD (gastroesophageal reflux disease) and is caused by acid refluxing back in the esophagus. Acid reflux is an uncomfortable burning sensation or pain behind the sternum. It happens when the content in your stomach flow upwards in the esophagus because the valve between the two organs does not close properly.
Scientists have known several factors which affect the risk of esophageal cancer. But having a risk factor does not mean you have the disease. Some risk factors of Esophageal Cancer are -
A case of acid reflux or heartburn is nothing to worry about. But if you experience it on a regular basis, it’s time to get professional help. Many people don't know that gastroesophageal reflux disease (GERD) is a potentially serious condition that if left untreated can ultimately lead to esophageal cancer.
The condition occurs when the GERD signs are not treated effectively, it lead to a serious state in which the cell lining of the lower part of the esophagus change or are replaced by the abnormal cells. These cells ultimately become deadly and cancerous. The real problem of GERD signs can lead to esophageal cancer. Other than heartburn, risk factors for the disease are smoking, obesity and excessive consumption of alcohol.
Esophageal Cancer is diagnosed at later stages because of absence of early sign and symptoms leading to delayed cancer treatment. If signs occur, they can include difficulty in swallowing, weight loss and indigestion. Most of the GERD signs can be managed by lifestyle changes such as avoiding large meals, weight loss and eating healthy.
The esophageal cancer treatment is based on cancer size, extent of disease and present condition. The treatment for oesophageal cancer must include a follow up plan for side effects and symptoms, which are an important part of the care.