What is esophagus and facts about esophageal cancer?
The esophagus is a long hollow muscular tube located in the chest. Any food that you consume would be sent to the stomach through this tube only. Esophagus has several layers like mucosa, sub-mucosa, muscle layer and outer layer. Any cancerous growth that develops on the esophagus is called as esophageal cancer. The cancer can occur anywhere on the inner layer or outer layer of the esophagus. And it can develop on any portion of the esophagus. Men are more prone to develop esophageal cancer than women.
There are two major types of cancer occurring in esophagus namely squamous cell carcinoma and adenocarcinomas. People affected with esophageal cancer will have symptoms like difficulty in swallowing, vomiting, chest pain, heartburn and change in voice. Endoscopy test would determine this cancer. Esophageal cancer is treated based on its stage and patient’s health condition and age. Surgery, chemotherapy, radiation therapy and laser therapy are some of the methods of treatment available. Side effects are common after treatment. The patient should make follow-up visits to the clinic for monitoring the condition.
Cancer Cells :
Cells are the fundamental unit of our body and they grow and divide forming new cells. After some time old cells will die eventually giving way to new cells. Sometimes, more and more new cells are formed when there is no death of old cells. This would give rise to accumulation of extra cells in the tissue forming a tumor. Not all the tumors are cancerous. Some are benign and harmless and they do not attack other tissues. But if the tumor is malignant it can cause threat to life. They often grow big in size invading neighboring tissues and even organs. Thus cancer in any form can spread to other parts of the body.
Who are at risk?
No one can explain why certain people develop cancer while others do not. There are certain common risk factors that make one prone to develop esophageal cancer. Being old (people who are 65 years and above), being male, smoking frequently, alcohol abuse, having poor diet, being overweight and having acid reflux disorder are some of the general factors that increases the chance of getting esophageal cancer. A person undergoing radiation therapy for chest or abdominal cancer is more likely to develop esophageal cancer than others.
An individual who is developing esophageal cancer may have difficulty in swallowing, chest pain, heartburn, indigestion problems, hoarseness in voice and loss of weight. Often there will not be any symptoms in early stage and these symptoms will appear only when the disease has progressed. A person having Barrett’s esophagus is predisposed to develop esophageal cancer due to persistent acid reflux reaction.
Exact factor causing esophageal cancer is not known. It is believed to develop due to mutated genes in the DNA which give rise to more and more new cells. Eventually it develops into tumor causing cancer.
Types of Esophageal Cancer :
Adenocarcinoma cancer begins in the mucus cell layer of the esophagus and often it occurs in the lower part. Squamous cell carcinoma is the cancer that affects the surface lining of the esophagus and often it develops in the middle portion. This is the most common type of esophageal cancer occurring in many countries. If not treated within time, esophageal cancer can spread to other organs and tissues causing intense pain and in due course it will become impossible to swallow anything.
Your doctor will do a biopsy using special endoscopy method to cut a small tissue sample from the esophagus region to check it on the lab for cancerous growth. He would pass a thin long tube into your throat and observe the condition of esophagus through the connected lens. Sometime he would also use CT or PET scan for diagnosing the right staging of cancer.
Stages of Cancer :
Staging in any form of cancer is necessary to detect how deep the cancer cells have invaded and how far it has spread to nearby tissues. In the first stage, the esophageal cancer develops in the outer layer alone. In the second stage, the cancer cells would have spread to the inner layers also and even invaded the lymph nodes. In the stage III, the tumor would have grown deep into the walls of esophagus. In the final stage the cancerous cells would start affecting the neighboring tissues and organs of your body.
Surgery, chemotherapy, and radiation therapy are the types of treatment given for esophageal cancer. Often one or two form of treatments is combined to get the best outcome. Surgery is done for removing small tumor growth, or to remove part of esophagus or to remove esophagus completely. Endoscopic surgery can be performed to remove tiny tumors present in the esophagus. Esophagectomy is the process of removing a small (affected) portion of the esophagus. The remaining portion of the esophagus will be connected to the stomach.
In severe cases esophago-gastrectomy is done for removing part of esophagus along with upper portion of the stomach. Surgery always carries some risk and it can cause complications like infection and internal bleeding. It is an open surgery done with general anesthesia. For some small cases laparoscopic surgery will be done making small incisions on the skin.
If there is any obstruction in the esophagus your surgeon would place a stent (metal tubing) to keep the esophagus wide open. This may improve your eating ability and for some people the doctor would suggest keeping a feeding tube directly into the stomach so that esophagus area is left undisturbed.
- Chemotherapy :
Medications are used for killing cancer causing cells. It is given before the surgery and after the completion of surgery. Often chemotherapy will be given along with radiation therapy.
- Radiation Therapy :
High beams of radiation are sent directly into the esophagus to destroy the cancerous cells inside. Radiation will be given externally from the machine or sometimes it will be kept inside the body. Like chemo this therapy will also be supplemented after surgery. It can cause side effects like heartburn, pain during swallowing and slight damage to the lungs. Alternative therapies like acupuncture, massage and relaxation can give relief from intense pain before/after surgery.
It would be challenging to face cancer and its treatment methods along with side effects. You need to stay connected with your family and friends, and join any support group to share your feelings.