Esophageal Cancer

The long muscular tube that connects the throat and the stomach in the human body is called esophagus. There are several layers of muscle that are in the esophagus. Those muscles help in moving the food from the mouth through the tube to reach the stomach. There is a special muscle called the esophageal sphincter which functions as a valve and facilitates the movement of food particles and liquids to the stomach through the esophagus.

When there is a growth of abnormal tissues in the esophagus, the condition is called esophageal cancer by the doctors. The esophageal cancer may start at the inner level of the esophagus, gradually affecting the entire esophagus. Eventually, it may spread to the other parts of the body when the cancer reaches a metastatic stage.

This is not a very common form of cancer. 19.2% of people having esophageal cancer have a surviving rate of 5 years from the date of diagnosis of the ailment.

Types of Esophageal Cancer:

There are mainly 2 types of esophageal cancer. They are as under:

• Squamous Cell Carcinoma – this form of esophageal cancer starts from the squamous cells. These cells line the esophagus. This form of esophageal cancer usually affects the upper and middle portion of the esophagus.
• Adenocarcinoma – this form of esophageal cancer develops in the tissues that produce mucus. The function of mucus is that of helping in swallowing food particles and liquids. This form of esophageal cancer affects the lower part of the esophagus.

Causes:

While no set of reasons may be pointed out as the most proximate cause for esophageal cancer, following are the commonly believed causes:

• Age – age of more than 60 is considered to be more prone to esophageal cancer.
• Sex – men are three times more susceptible to esophageal cancer than women.
• Race – the Asian and the African population more commonly contact the squamous cell carcinoma. Adenocarcinoma is more common among the whites.
• Tobacco – use of tobacco, both in the form of smoking or chewing is a common cause for esophageal cancer.
• Consumption of Alcohol – heavy and regular doses of alcohol increases the chances of esophageal cancer.
• Human Papillomavirus (HPV) – this virus is commonly found in Asian and African sub-continents which affect the esophageal tissues eventually resulting in cancer of the esophagus.
• Occupational hazards – people who are exposed to solvents used for dry cleaning for an extended period of time have a higher chance of contracting esophageal cancer.
• History of cancer – people with a history of neck or head cancer have a greater chance of contracting esophageal cancer.

Signs and Symptoms:

In the early stages of esophageal cancer, there is no obvious symptom. The first symptom may be difficulty in swallowing. As the size of the tumor keeps getting bigger the difficulty and pain of swallowing food particles and liquids increase. The other symptoms of esophageal cancer are as under:

• Sensation of pain in the back, throat, shoulder blades.
• Cough or vomit – often accompanied by blood.
• Heartburns
• Indigestion
• Chronic cough
• Hoarseness of voice
• Rapid loss of weight

Risk Factors:

• Tobacco - Use of tobacco in any form, either by smoking or otherwise is a potential risk factor for esophageal cancer.
• Alcohol - Heavy and regular consumption of alcohol works as a catalyst for esophageal cancer.
• Gastro esophageal Reflux Disease (GERD) – in this situation the acid and contents of the stomach goes back into the esophagus.
• Barrett’s esophagus – this condition affects the lower part of esophagus and may result in esophageal cancer.
• Obesity – this is also one of the conditions which is considered to be a risk factor for esophageal cancer.

Diagnosis and Tests:

• Barium Swallow Test – a patient is made to drink barium, after which X-Ray is taken. This shows esophageal cancer more vividly.
• Esophagoscopy - This is a procedure where the doctor uses an endoscope to have a look at the esophagus. The endoscope is passed through the mouth to the esophagus in order to take pictures. In case the esophagus is obstructed, the doctor may choose to use a balloon to dilate the esophagus.
• Biopsy – a small portion of the tissue is taken out and tested under a microscope.
• Esophageal endoscopic ultrasound – in this form of test, images are created by the use of sound. The machine used for this test is called an esophagoscope.
• Computed Tomography – commonly called CT scan.
• Chest X-Ray - a traditional way to take images of esophagus with the use of X-Rays.
• Thoracoscopy - here the doctor does a visual examination of the internal condition using a thoracoscope.
• Laparoscopy - commonly called key-hole surgery. Here the doctor makes small holes to put the visual instrument to get images of the internal condition.

Stages of Esophageal Cancer:

• Stage 0 – abnormal cells detected in esophagus
• Stage 1 – trace of cancerous cells found
• Stage 2 – at this stage, the cancer has reached the outer muscle layer of the esophagus.
• Stage 3 - When the cancer has reached the inner muscle layer of the esophagus. At this stage, the cancer may have also gone beyond the esophagus and have started getting into organs in the vicinity of the esophagus.
• Stage 4 – this is the final stage when the cancer has started spreading to other parts of the body.

Treatment and Care:

Esophageal cancer may be treated if the disease is detected at an early stage. However, the treatment depends on the stage at which the cancer is detected and the overall health of the patient. The common lines of treatment for esophageal cancer are as under:

Surgery – removal of the affected portion of the esophagus.

Radiation therapy - in this form of treatment, high resolution rays like gamma ray, electron beams are used in an effort to kill cancer cells.

Chemotherapy -powerful drugs are inferred upon the patient to kill cancer cells.

Targeted therapy – treatment of the specific portion of the esophagus that has been affected.

Immunotherapy- helps improve the immunity system to thwart the cancer cells.

Photodynamic therapy – treatment through special laser light.

Electrocoagulation – use of electricity to dissolve cancer cells.

Cryotherapy – the cancer cells are frozen to reduce the size of the tumor.

Apart from the tests mentioned above, your doctor might also recommend lifestyle modifications such as following an exercise regime and diet plan to regain strength and quick recovery.