Esophageal cancer is a malignant cancer in the tissue of esophagus which is a muscular tube connecting throat and stomach. It is the sixth most common cause of cancer deaths worldwide. Esophageal cancer starts in the inner mucosal layer of the esophagus and spreads through the other esophageal layers and parts of the body. There are 2 main types of esophageal cancer, adenocarcinoma which develop from the glands and squamous cell carcinoma that occur in the epithelium or flat cells lining the esophagus. Esophageal cancer commonly occurs in men than women; however, the reason is unknown.
Signs and symptoms
Early stages of esophageal cancer typically have no signs and symptoms. The symptoms develop as the condition gets severe. The signs and symptoms of esophageal cancer include:
- Difficulty swallowing
- Sudden weight loss
- Pain or burning in the chest
- Worsening indigestion and heartburn
- Persistent cough and hoarseness
With the increasing severity of esophageal cancer, the patient may develop certain complications like obstruction of the esophagus, pain, bleeding in the esophagus.
The exact cause of esophageal cancer is unclear. However, researchers believe that it occurs when esophageal cells develop errors or mutations in their DNA. These abnormal cells develop as tumor in the esophagus which may spread to the other parts of the body, if left untreated.
Various factors that increase a person’s risk of developing esophageal cancer include:
- Age - men and old people are at greater risk of esophageal cancer
- Gastro esophageal reflux disease
- Smoking and other tobacco use
- Heavy alcohol use or drinking very hot liquids
- Barrett’s esophagus, a condition that affects the lower part of the esophagus, leading to esophageal cancer
- Undergoing radiation treatment to the chest or upper abdomen
The doctor assesses the symptoms, medical history, and perform physical examination test. If esophageal cancer is suspected, the doctor would perform other tests to conform the disease. These tests include:
- Barium swallow test- X-ray images of the esophagus are taken after the patient is made to swallow barium containing solution
- Endoscopy-an endoscope which is a thin tube is passed down the throat into the esophagus to examine it.
- Biopsy-using the endoscope, the physician collects a sample of tissue from the esophagus to check for the presence of tumors.
- Other imaging studies include- computed tomography (CT) scans of the abdomen and chest, positron emission tomography (PET) scanning, thoracoscopy, and laparoscopy.
Stages of esophageal cancer
There are 5 stages of esophageal cancer, ranging from 0 to IV, highest number indicating advanced cancer stage. Based on the diagnostic reports, the physician stages the cancer and provides treatment accordingly
Stage 0- abnormal cells (still not cancerous) are found on the lining of the esophagus
Stage I- cancer cells or tumors occurs in the superficial layers of the esophagus
Stage II- the cancer has spread to muscle layer or other layers of the esophagus and also to the nearby lymph nodes
Stage III- the cancer has spread or reached to the inner muscle layer or to the connective tissue wall. It may also spread to the other body parts surrounding the esophagus
Stage IV- this is the most advanced stage in which the cancer spreads to the other body parts or lymph nodes far from esophagus
Similar to other types of cancers, esophageal cancer can also be treated well if diagnosed in early stages. Treatment of esophageal cancer depends on various factors like severity, patient condition, and age. The various treatment options of esophageal cancers include:
- Radiofrequency ablation- Radiofrequency energy is used to target cancer cells, especially during early stage of cancer
- Surgery- Based on the severity of the condition, a part or entire esophagus will be removed, either through open surgery or laparoscopically. Esophagectomy and esophagogastrectomy are the commonly used surgical techniques. In esophagectony, a portion of the esophagus containing tumor is removed, including part of upper part of the stomach and nearby lymph nodes. The remaining esophagus is then reattached to the stomach, usually by pulling the stomach up. In esophagogastrectomy, esophagus, nearby lymph nodes, and a larger part of the stomach are removed and the remaining stomach is reattached to the esopaphagus.
- Chemotherapy- In this treatment approach, powerful drugs are used to kill cancer cells. This may sometimes (when cancer has spread to other body parts) be combined with radiation therapy for best output.
- Radiation therapy- In this technique, high-power X-rays are used to kill cancer cells. Sometimes, this treatment option is considered to relieve the complications of advanced cancer stage or after giving chemotherapy, or in combination with chemotherapy.
- Electrocoagulation- Electric current is used to destroy early cancer cells
Making certain lifestyle changes can prevent the risk of esophageal cancer, these include:
- Quitting smoking and alcohol
- Eating more fruits and vegetables
- Maintaining a healthy weight