Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.
Signs & Symptoms:
Difficulty in swallowing
Weight loss
Pain when swallowing
A hoarse voice
Enlarged lymph nodes (glands) around the collarbone
Persistent dry cough
Possibly coughing up or vomiting blood
Risk Factors:
Drinking alcohol
Having bile reflux
Having difficulty swallowing because of an esophageal sphincter that won’t relax (achalasia)
Drinking very hot liquids
Eating few fruits and vegetables
Having gastroesophageal reflux disease (GERD)
Being obese
Having precancerous changes in the cells of the esophagus (Barrett’s esophagus)
Undergoing radiation treatment to the chest or upper abdomen
Smoking
Common Types:
Squamous cell carcinoma (often abbreviated to ESCC)
Esophageal adenocarcinoma (EAC)
Diagnosis:
Medical history and physical exam
Barium swallow
Computed Tomography (CT or CAT) Scan
Magnetic Resonance Imaging (MRI) Scan
Positron Emission Tomography (PET) Scan
Endoscopy
Upper Endoscopy
Endoscopic Ultrasound
Bronchoscopy
Thoracoscopy and Laparoscopy
Stages:
Stage 0
A stage 0 tumor is not true cancer. It contains abnormal cells called high-grade dysplasia and is really a type of pre-cancer
Stage 1 In this stage the cancer has grown into some of the deeper layers of the esophagus wall (past the innermost layer of cells) but has not reached the lymph nodes or other organs
Stage 2
Stage 2 includes cancers that have grown into the main muscle layer of the esophagus or into the connective tissue on the outside of the esophagus. This stage also includes some cancers that have spread to 1 or 2 nearby lymph nodes
Stage 3 Stage 3 includes some cancers that have grown through the wall of the esophagus to the outer layer, as well as cancers that have grown into nearby organs or tissues. It also includes most cancers that have spread to nearby lymph nodes
Stage 4
Stage 4 esophageal cancer has spread to distant lymph nodes or to other distant organs
Prevention:
Avoid alcohol
Avoid cigarette smoking
Maintain body weight
Eat right
Control / Treat Gastroesophageal Reflux Disease (GERD)
Management:
Treatment options depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Treatment plan may also include treatment for symptoms and side effects, an important part of cancer care
Surgery Surgery is the removal of the tumor and surrounding tissue during an operation. Surgery has traditionally been the most common treatment for esophageal cancer. However, currently, surgery is used as the main treatment only for patients with early-stage esophageal cancer.
In addition to surgery to treat the disease, surgery may be used to help patients eat and relieve symptoms caused by the cancer. This is called supportive or palliative surgery.
Radiation Therapy Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. When radiation treatment is given directly inside the body, it is called internal radiation therapy or brachytherapy. For esophageal cancer, this involves temporarily inserting a radioactive wire into the esophagus using an endoscope.
Chemotherapy Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide.
Targeted therapy Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.
Photodynamic therapy Photodynamic therapy is a palliative or supportive option used to make swallowing easier, especially for people who cannot or choose not to have surgery, radiation therapy, or chemotherapy. In photodynamic therapy, a light-sensitive substance is injected into the tumor and stays longer in cancer cells than in healthy cells. A light is then aimed at the tumor, destroying the cancer cells. Although photodynamic therapy may relieve swallowing problems for a short period of time, it does not cure esophageal cancer.
Electrocoagulation This type of palliative treatment helps kill cancer cells by heating them with an electric current. This is sometimes used to help relieve symptoms by removing a blockage caused by the tumor.
Cryotherapy This is a type of palliative treatment that uses an endoscope with a probe attached that can freeze and remove tumor tissue. It can be used to reduce the size of a tumor to help a patient swallow better.
Metastatic esophageal cancer If cancer has spread to another location in the body, it is called metastatic cancer. Metastatic cancer requires multi-disciplinary approach with treatment options being a combination of surgery +/- chemotherapy +/- radiation therapy.
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