Esophageal Cancer
Esophageal cancer is the eighth most common cancer with a yearly prevalence of 456000 new cases. In India, it is fourth most common cause of cancer- related deaths. Esophageal cancer starts when cells in the lining of the esophagus begin to grow in form of ulceration, nodularity, infiltrative or proliferative growth. Men are more likely to get esophageal cancer compared to women.
Types of Skin Cancer
There are two major types of esophageal cancer.
- Squamous cell carcinoma: The inner layer of the esophagus is generally lined with squamous cells. Cancer beginning from these cells is called squamous cell carcinoma. This type of cancer can go on anywhere along the esophagus but is most often in the neck region and in the upper two-thirds of esophagus.
- Adenocarcinoma: Cancers that begins from gland cells (mucus secreting cells) are called adenocarcinomas.
Risk factors
- Increasing Age
- Men are more prone to get esophageal cancer compared to women.
- Use of tobacco and alcohol
- Gastroesophageal reflux disease
- Obesity
- No physical activity
- Regularly take hot beverages
We don’t yet know what exactly causes most esophageal cancers.
Symptoms
- Difficulty in swallowing or dysphagia
- Weight loss
- Pain in the chest
- Coughing
- Hoarseness
- Indigestion and heartburn
Diagnosis
To diagnose esophageal cancer, your health care professional will analyze your symptoms, medical history and physical examine. In addition, they may order some blood tests and X-ray.
Tests for esophageal cancer may include
- Barium swallow X-ray test: In this test you drink a liquid that coats your esophagus. This makes the esophagus clearer on X-ray so that your doctor can identify certain problems.
- Endoscopy: To examine esophagus, your doctor passes an endoscope, a thin, lighted tube, down your throat into the esophagus. Endoscopic ultrasound (EUS) uses sound waves to provide further data about the extent of tumor involvement.
- Biopsy: During an endoscopy, takes small tissue from esophagus for histopathological examination. The cells are checked under a microscope for the presence and type of cancer.
Other tests, including computed tomography (CT) scans, positron emission tomography (PET) scan, thoracoscopy and laparoscopy, may be carried out to determine if the cancer has spread, or metastasized, outside of the esophagus. This process is called “staging”. The doctor needs these data in order to plan treatment.
Treatment
As with numerous cancers, chances of survival increases if it is detected early. Unfortunately, by the time esophageal cancer is diagnosed for many people, it has spread throughout the esophagus and beyond.
Treatment depends on numerous factors, including the stage of the cancer and the overall health of the patient.
- Surgery: Part of the esophagus or possibly some nearby tissue may be removed (Open / thoracoscopic or Robotic surgery).
- Radiation therapy: It uses high-powered energy beams to kill cancer cells.
- Chemotherapy: Medicines that attack cancer cells throughout the body; generally used in combination with radiation therapy and/ or surgery.
- Targeted therapy: newer treatments that target specific aspects of a cancer to inhibit cancer growth and spread.
- Immunotherapy: Boost the immune system to attack cancer cells.
- Photodynamic therapy: kills cancer cells with a special laser light.
- Electrocoagulation: Uses electric current to kill cancer cells for very small lesion.
- Cryotherapy: Freezes cancer cells for very small lesion.
Endoscopic mucosal resection can be done to treat pre-cancers or veritably small early cancers by removing the inner lining of the esophagus. Radiofrequency ablation treatment using a device that targets cancer cells with radiofrequency energy is used for selected early cancers.