Esophageal Cancer

What is Esophageal Cancer ?

Esophageal cancer is a malignant tumor of the esophagus, the muscular tube that transports food from the mouth to the stomach. It is most common in men over age 60 and is nearly always fatal.

Esophageal tumors are usually fungating and infiltrating. In most cases, the tumor partially constricts the lumen of the esophagus. Regional metastasis occurs early by way of submucosal lymphatics, often fatally invading adjacent vital intrathoracic organs. If the patient survives primary extension, the liver and lungs are the usual sites of distant metastases. Unusual metastasis sites include the bone, kidneys, and adrenal glands.

Causes of Esophageal Cancer

Although the cause of esophageal cancer is unknown. But sometime is might related to exposure of the esophageal mucosa to noxious or toxic stimuli, resulting in a sequence of dysplasia to carcinoma in situ to carcinoma.

Signs & Symptoms of Esophageal Cancer

Early cancer of the esophagus is usually asymptomatic (i.e., does not cause symptoms). Symptoms of the disease include the following:

• Difficulty swallowing solids or liquids
• Regurgitation of food
• Heartburn
• Severe weight loss
• Hoarseness
• Nausea and Vomiting
• Chest pain unrelated to eating

If the disease has spread to elsewhere, this may lead to symptoms related to this: liver metastasis could cause jaundice and ascites, lung metastasis could cause shortness of breath, pleural effusions, etc.

Diagnostic Tests

X-rays of the esophagus, with barium swallow and motility studies, delineate structural and filling defects and reduced peristalsis.

Bronchoscopy (usually performed after an esophagoscopy) may reveal tumor growth in the tracheobronchial tree. Endoscopic ultrasonography of the esophagus combines endoscopy and ultrasound technology to measure the depth of tumor penetration.

Treatment

Esophageal cancer is usually treated with surgery, radiation therapy (also called radiotherapy), or chemotherapy. The doctor may use just one treatment method or combine them, depending on the patient's needs.

When esophageal cancer is only in the esophagus and has not spread elsewhere, surgery is the treatment of choice. The goal of surgery, in most cases, is to cure the patient.

Prevention Tips

Avoiding heavy alcohol consumption and tobacco use may help prevent squamous cell carcinoma of the esophagus. In developed countries, these factors contribute to as many as 90% of cases.

Patients with frequent heartburn should undergo regular endoscopic screening to detect precancerous changes in the lining of the esophagus, which are the primary risk factor for adenocarcinoma of the esophagus. Dietary and lifestyle changes and medication may help prevent progression of Barrett's esophagus.