Esophageal Cancer - Causes, Symptoms, Diagnosis, Prevention & Treatment

Esophageal Cancer

Dr.Meenu Walia profile Authored by Dr.Meenu Walia on 29 Apr 2015 - 16:43.

Cancer of the esophagus is called esophageal cancer. Esophagus is the long tube which starts from the throat and ends at the stomach. It is responsible for the movement of food from the mouth to the stomach.

Esophageal cancer usually starts from the cells present in the inner lining of the esophagus. Although it can occur anywhere along the length of esophagus, it is usually seen in the lower regions. It is also observed that more men are affected than women.

Esophageal cancer is common in Asia and parts of Africa, but is less common in the United States.

Types of esophageal cancer:

Based on the types of cells affected, esophageal cancer is classified into different types. The treatment is given based on the type of esophageal cancer.

Adenocarcinoma: In adenocarcinoma, the mucous secreting cells present in the esophagus are affected. This type of cancer usually occurs in the lower part of the esophagus. It is the most common type of esophageal cancer in the United States, primarily affecting the white people.

Squamous cell carcinoma: This is the most common type of esophageal cancer seen worldwide. In this cancer, the squamous cells which are thin, flat cells lining the surface of the esophagus are affected. This type of cancer mostly occurs in the upper and middle of the esophagus.

Other types: The other types of esophageal cancer which are seen rarely include lymphoma, choriocarcinoma, sarcoma, melanoma and small cell cancer.

 

The exact cause of esophageal cancer in not known. Occurrence of mutations (changes) in the DNA of the esophageal cells cause esophageal cancer. These mutations trigger abnormal growth and multiplication of the cells, which eventually form a tumor in the esophagus. These cancerous cells can also affect the cells of nearby tissues and can also spread to the other parts of the body.

 

 

The signs and symptoms of esophageal cancer include the following:

  • Dysphagia (difficulty in swallowing)
  • Loss of body weight
  • Pain, burning or pressure in the chest
  • Indigestion or heartburn
  • Coughing
  • Hoarseness

The signs and symptoms are not seen in the early stages of esophageal cancer.

Complications:

The following complications can occur if the esophageal cancer advances into later stages:

  • Esophageal obstruction: Obstruction of the esophagus may occur due to the formation of tumor which leads to difficulty in passage of food and liquids to the stomach.
  • Esophageal bleeding: Bleeding can be caused in the esophagus due to cancer. Usually it is slow, but sometimes it can be severe and sudden.

Pain: Pain is experienced after the cancer reaches advanced stages.

 

 

The following tests are used in the diagnosis of esophageal cancer:

  • Endoscopy: Endoscopy involves the insertion of a hollow tube with a lens which helps to view the inner lining of the esophagus. It helps the physicians to examine the esophageal cells for cancerous growth.
  • Biopsy: In biopsy of esophagus, a special device is inserted inside the esophagus to collect a sample of cells. These cells are sent to a laboratory to check for cancerous cells.

When esophageal cancer is confirmed, the stage of cancer is determined using computerized tomography (CT) scan and positron emission tomography (PET).

The stages of esophageal cancer are:

  • Stage I: In this stage only the superficial layer of cells are affected.
  • Stage II: By this stage the cancer would have spread to deeper layers of the esophagus and also to the lymph nodes nearby.
  • Stage III: The deepest layers of cells and the nearby tissues are affected in this stage.
  • Stage IV: Distant parts of the body are affected in this stage.

 

 

Factors which increase the risk of esophageal cancer include the following:

 

 

The treatment for esophageal cancer is based on the type of cells affected in the esophagus, stage of cancer and personal preference.

Esophageal cancer is treated by the following therapies:

Surgery:

Surgery can be used alone or in combination with other therapies to treat esophageal cancer. The various surgeries used for the removal of cancer cells include:

  • Surgery to remove small tumors: When the cancer is in the early stage and hasn’t spread to deeper layers of the esophagus, the surgeon may remove the small tumor along with a small portion of healthy cells surrounding it using an endoscope.
  • Surgery to remove a portion of esophagus (esophagectomy): When the cancer has spread to deeper layers and the surrounding lymph nodes, the portion of esophagus affected is removed by surgery. In this procedure the stomach is pulled up to be joined to the upper part of the esophagus.
  • Surgery to remove a portion of esophagus and the upper region of the stomach (esophagogastrectomy): In this procedure, a part of the esophagus and the upper part of the stomach are surgically removed and then the remaining portion the stomach is joined to the esophagus directly or by using a portion of colon, if necessary.

Chemotherapy:

Anticancer drugs are used in chemotherapy to kill the cancerous cells. These drugs are usually used before and after the surgery. Chemotherapy is also used in combination with radiation therapy. It is used alone in patients with advanced stage of esophageal cancer to help relieve the symptoms.

Radiation therapy:

Radiation therapy involves the use of high powered energy beams. These beams kill the cancer cells. Radiation therapy can be external (external beam radiation) or can be internal (brachytherapy) where a radiation emitting substance is placed in the body near the cancer cells.

Radiation therapy is used to help relieve the complications of esophageal cancer in advanced stages. The side effects of this therapy include difficulty or painful swallowing and accidental damage to organs nearby, such as heart and lungs, with the use of newer radiation techniques & machines, these side effects can be minimized to a large extent.

 

 

The following tips can help reduce the risk of esophageal cancer:

  • Quit smoking
  • Eat more vegetables and fruits
  • Limit the intake of alcohol
  • Maintain a healthy weight

 

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.