Esophageal Cancer
Esophageal cancer is cancer of the esophagus, the tube that connects the mouth to the stomach. It is the sixth most common cause of cancer-related deaths in the world.
In this article, we take a closer look at the causes, symptoms, treatment, and how to prevent it.
What Is Esophageal Cancer?
Esophageal cancer occurs when the cells in the lining of the esophagus begin to change and grow abnormally. Over time, this abnormal cell growth becomes a tumor which may press on the esophagus or stomach, causing various symptoms.
The two most widespread types of esophageal cancer are:
- Squamous cell carcinoma
- Adenocarcinoma
Squamous cell carcinoma affects the flat cells that line the esophagus and can occur anywhere along the length of this organ. Adenocarcinoma affects the glandular cells of the esophagus and tends to occur closer to the stomach.
What Causes Esophageal Cancer?
The most well-known common cause of esophageal cancer is gastroesophageal reflux disease or GERD.
GERD causes acid from the stomach flows up into the esophagus, causing symptoms such as heartburn and indigestion. Over time, this excess acid causes changes in the cells which line the throat, leading to a condition known as Barrett's esophagus. Approximately one in every 10–20 people with Barrett's esophagus will go on to develop esophageal cancer.
This type of cancer can also be caused by numerous different lifestyle factors which can lead to irritation of the esophagus. These factors include:
- Smoking
- Excessive alcohol consumption
- Regularly drinking scorching hot drinks
- Eating an unhealthy diet
- Being overweight or obese
Another possible cause of esophageal cancer may be related to another medical condition. Achalasia, or bile reflux, is a disorder which impairs the swallowing of food, and it is more common in males than females and generally develops in the 60s or 70s.
Symptoms of Esophageal Cancer
In its early stages, esophageal cancer does not usually cause any symptoms. However, once a tumor begins to grow and press on the surrounding organs, several issues can occur.
The symptoms of esophageal cancer include:
- Difficulty swallowing (dysphagia)
- Frequently choking on food
- Heartburn or indigestion
- Regurgitation of food soon after eating
- Loss of appetite
- Weight loss
- Pain in the throat, chest, abdomen, or back
- Coughing
- Hoarse voice
- Tiredness
- Shortness of breath
- Pale skin
- Coughing or vomiting blood
Not all of these symptoms will affect everyone with esophageal cancer, and many of them can be confused with the symptoms of other conditions. However, early diagnosis is key to survival, so be sure to see your physician if you experience any of the above symptoms for three weeks or more.
Treatment for Esophageal Cancer
There are several possible treatments for esophageal cancer. The options vary depending on how advanced the disease is, at the time of diagnosis.
Surgery
Endoscopic mucosal resection is a procedure that involves passing a long tube with a camera (an endoscope) through the throat and removing cancerous tissue using a loop of wire. If esophageal cancer is caught in the very early stages, typically this surgery will be done to remove any cancerous tissue.
More advanced tumors can be removed in a procedure known as an esophagectomy. Esophagectomy involves removing the affected section of the esophagus and surgically reattaching the remainder to the stomach. If part of the stomach also needs to be removed, this is known as an esophagogastrectomy.
In most cases, the lymph nodes in the surrounding area will also be removed to reduce the chances of esophageal cancer spreading to other organs. Surgery is usually combined with chemotherapy or radiotherapy to prevent the spread of the disease.
Chemotherapy and Radiotherapy
For patients whose cancer is more advanced and has already begun to spread to other organs, surgery may not be an option. In these cases, chemotherapy or radiotherapy may help to slow the spread of the disease and relieve some symptoms.
Chemotherapy involves injecting one or more drugs into a vein to stop the spread of cancerous cells. Radiotherapy has the same intended outcomes but is performed using powerful x-rays rather than drugs.
Some of the most common side effects of chemotherapy and radiotherapy include:
- Nausea and vomiting
- Reduced appetite
- Weight loss
- Diarrhea
- Fatigue
- Increased risk of infections
- Sore or red skin (radiotherapy)
Other Treatments for Esophageal Cancer
Newer treatments for esophageal cancer include electrocoagulation, immunotherapy, and laser treatment. All of these treatments aim to prevent the growth and spread of cancerous cells.
In the final stages of esophageal cancer, patients can be made more comfortable using treatments such as a stent to open up the esophagus and aid swallowing. For patients who are unable to swallow, nutrition may be provided by using a feeding tube or injecting nutrients directly into a vein.
Preventing Esophageal Cancer
There are several steps you can take to reduce your chances of developing esophageal cancer. These include the following healthy lifestyle changes:
- Do not smoke
- Drink alcohol in moderation only
- Maintain a healthy weight
- Eat a balanced diet including plenty of fruit and vegetables
- Allow hot drinks to cool slightly before drinking
Following these guidelines should help you to prevent esophageal cancer as well as a range of other serious medical conditions. It is important to be aware of the symptoms of esophageal cancer and have them investigated by your physician should they occur.