Esophageal cancer is the growth of malignant cells in the esophagus, the passageway from the throat to the stomach. An esophageal tumor blocks the passage of food to the stomach, erodes the esophageal lining, causes bleeding, and contributes to the development of fistulas (abnormal channels between normally separate organs) between the esophagus and the trachea (the major airway to the lungs). Although uncommon, esophageal tumors worsen rapidly: by the time symptoms develop, the outlook is poor. Esophageal cancer affects men more frequently than women. It occurs most often in those over age 50. Although a cure may be attempted when the cancer is detected at an early stage, treatment is generally aimed at relieving symptoms and making the patient as comfortable as possible.
Symptoms of Esophageal Cancer
Progressive swallowing difficulty, first with
solid foods, then liquids; painful swallowing.
Chest pain.
Weight loss.
Regurgitation of blood or bloody mucus.
Vomiting or regurgitation of swallowed food.
Repeated respiratory infections. Material may
spill into the airway and lungs from frequent
regurgitation or from an esophagotracheal
fistula.
What Causes Esophageal Cancer
The cause of esophageal cancer is unknown.
Smoking and excess consumption of alcohol are believed to be the greatest risk factors for squamous cell cancers.
Swallowing lye or other corrosive chemicals may lead to esophageal cancer.
The habit of drinking extremely hot beverages may, over time, damage the esophagus and predispose it to cancer.
Persistent gastric reflux is associated with a higher risk of esophageal cancer (see Gastroesophageal Reflux Disease for more information).
Chronic, severe gastroesophageal reflux disease and Barrett esophagus are predisposing factors for adenocarcinoma of the esophagus.
Prevention of Esophageal Cancer
Do not smoke.
Have no more than two alcoholic beverages a day.
Diagnosis of Esophageal Cancer
X-ray after swallowing barium to create a clear image of the esophagus.
Endoscopy (a small, lighted viewing tube inserted into the esophagus through the mouth under local anesthesia).
A biopsy is performed during the endoscopy to remove a sample of esophageal tissue for examination under a microscope.
How To Treat Esophageal Cancer
Surgery may be performed in an attempt to remove the tumor.
If the tumor cannot be completely removed, laser surgery may be used to reduce its size and open a passageway into the stomach.
Radiation therapy may be used after or in conjunction with surgery to decrease tumor size and prevent its spread.
Chemotherapy may be used to destroy remaining cancer cells instead of, or in addition to, surgery and radiation therapy.
An esophageal dilator may be used to widen the stricture. Dilation is usually repeated periodically to maintain the opening.
Patients who are unsuited for surgery may have a metal, expandable tube inserted through the esophagus (a stent) to bypass the site of the tumor.
An artificial opening in the stomach (percutaneous gastrectomy) or small intestine (ileostomy) may be created endoscopically or surgically, so that food may bypass the entire esophagus.
Painkillers and tranquilizers are prescribed to relieve pain and anxiety.
When To Call A Doctor
Call a doctor if you experience difficulty in swallowing or any other symptoms that signal esophageal cancer.
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Medical Disclaimer: The information on this page is not intended to substitute for the advice of a physician.
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