About the disease
Esophageal cancer affects the esophagus, which is the tube that carries chewed food from the mouth to the stomach. Most commonly, esophageal cancer develops in the inner layer of the esophagus, also known as the mucosa. As it starts to progress, malignant cells spread to other layers of the esophagus located outside the inner lining of this organ.
According to the American Cancer Society, approximately 16,900 new cases of this type of cancer are diagnosed in the USA alone. This disease is 3 times more common in males than in females, although the reason for this has not yet been determined. Esophageal cancer accounts for 1% of all cancers, which makes it relatively rare.
Recent statistics shows that the survival rate for a localized tumor is 40%. A regional tumor has a 5-year survival rate of approximately 21% and a distant tumor that has spread to other organs has a 5-year survival rate of only 5%.
Although the exact cause of esophageal cancer has not yet been determined, smoking, obesity and alcoholism are believed to be risk factors. People with reflux disease, HPV infection and previous esophagus injuries are also in the risk group.
Symptoms
- Food gets stuck in the esophagus
- Trouble swallowing
- Constant vomiting and nausea
- Indigestion
- Vomiting with blood
- Long-term coughing
- Hoarse voice
- Chest pain
- Weight loss
Diagnosis
- During a physical examination, the doctor may inspect the patient’s trachea with a special device to find out if the difficulty in swallowing is caused by an obstruction or a pulmonary disease/ infection.
- The Barium swallow test is one of the most commonly used methods to diagnose problems with the esophagus. It can detect gastrointestinal problems and cancer even at its early stages.
- CT and MRI scans produce images of the esophagus that can be used to examine it more precisely. If cancer is discovered, the scans can determine its stage and the dynamics of its progression.
- An endoscopy can also detect cancer and determine its progression.
- A biopsy may be performed, whereby a sample of esophagus tissue is examined under the microscope.
Treatment
- Endoscopic bougienage and stent overlay is used if the esophagus has become too narrow due to the presence of cancer. If this is the case, a cylindrical bougie is used to widen the esophagus and to implant a special stent, which keeps the esophagus open. This procedure helps the patient to swallow food properly and to normalize digestion.
- Brachytherapy is a special radiotherapy technique that only irradiates the affected organ. This type of treatment is used to shrink tumor in the esophagus and to prevent it from growing any further.
- Conservative treatment with 1 course of chemotherapy is used if cancer has been diagnosed early on and can be destroyed completely with 1 course of chemotherapy.
- Radiotherapy for esophageal cancer can be either internal or external and is very effective in shrinking esophageal tumors.
- Resection with plasty is a surgical procedure, whereby the esophagus is partially resected or reshaped. At the late stages of cancer, the esophagus may be completely resected and replaced with a prosthetic one.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
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