Esophageal cancer

Esophageal cancer is a malignant tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach. There are two major types of esophageal cancers: squamous cell carcinoma and adenocarcinoma.

Signs and Symptoms

The symptoms of esophageal cancer include:

  • Backward movement of food through the esophagus and possibly mouth
  • Chest pain not related to eating
  • Heartburn
  • Vomiting blood
  • Weight loss
  • Difficulty in swallowing solids or liquids

Causes

Its major causes are:

  • Age – people above 60 years of age are more likely to develop esophageal cancer
  • Sex – This problem is more common in men
  • Family history
  • Gastroesophageal reflux disease (GERD)
  • Tobacco smoking
  • Heavy alcohol
  • Obesity
  • Coeliac disease
  • Thermal injury as a result of drinking hot beverages

Treatment

The treatment is determined by the cellular type of cancer (adenocarcinoma or squamous cell carcinoma vs. other types), the stage of the disease, the general condition of the patient and other diseases present.

In case patient cannot swallow at all, an esophageal stent may be inserted to keep the esophagus patent. A nasogastric tube may be necessary to continue feeding while treatment for the tumor is given, and some patients require a gastrostomy (feeding hole in the skin that gives direct access to the stomach). The latter two are especially important if the patient tends to aspirate food or saliva into the airways, predisposing for aspiration pneumonia.

Esophagectomy is the removal of a segment of the esophagus; as this shortens the length of the remaining esophagus, some other segment of the digestive tract (typically the stomach or part of the colon or jejunum) is pulled up to the chest cavity and interposed. If the tumor is unresectable or the patient is not fit for surgery, palliative esophageal stenting can allow the patient to tolerate soft diet.

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