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Understanding Esophageal Cancer: Symptoms, Diagnosis, and Treatment

icon-blog By -Dr. Aaksha Shukla
icon-blog By -March 11, 2024
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Esophageal Cancer: Symptoms, Diagnosis, and Treatment

The esophagus is a long, hollow tube that connects your throat to your stomach. Esophageal cancer is defined as cancer that develops in this tube. When you swallow, your esophagus assists in moving the food from the back of your throat to your stomach, where it is broken down. The cells lining the inside of the esophagus are typically where esophageal cancer starts. Cancer of the esophagus can develop at any point in its course. Cancer of the esophagus strikes more men than women. The sixth most common cause of cancer-related fatalities globally is esophageal cancer. Different geographic regions have varying incidence rates. Some areas may have greater risks of esophageal cancer because of tobacco and alcohol use, certain dietary practices, and obesity. A gastroenterologist (a physician who specializes in disorders of the digestive system) may identify symptoms of esophageal cancer before any other medical professional.

Symptoms Of Esophageal Cancer

Early esophageal cancer typically causes no signs or symptoms. Early esophageal cancer typically causes no signs or symptoms. Most esophageal cancer symptoms aren’t noticeable until the cancer is in an advanced stage, when it may be hard to treat. Esophageal cancer symptoms can also result from other, more common diseases. If you think you could be at risk, it's critical to have a physician accurately diagnose you.

Dysphagia, Or Trouble Swallowing

Trouble swallowing, particularly the sensation of food stuck in the chest, is the most common sign of esophageal cancer. Choking on meals also happens to certain patients. As the cancer grows, your esophagus narrows, causing these symptoms to gradually develop over time, including increased pain when swallowing.

Your best doctor should perform a screening evaluation if you have recently altered your eating habits in an attempt to prevent swallowing difficulties. Some examples of these changes include eating soft food, taking smaller pieces, or abstaining entirely from solid food.

Chronic Chest Pain

If you have gastroesophageal reflux disease (GERD) or persistent heartburn, you are already aware of the sensation of burning in the middle of your chest. When esophageal cancer progresses, that unpleasant feeling could become worse. When food or liquid reaches the site of the tumor in the esophagus, it can also produce chest pain right after swallowing, which is another symptom of esophageal cancer.

Losing Weight Without Trying

About half of patients with esophageal cancer lose weight for no known reason. This may occur due to a decreased appetite caused by the common cancer or eating less due to swallowing issues.

Persistent Coughing Or Hoarseness

The development of a scratchy, hoarse voice or a persistent cough may potentially be signs of esophageal cancer.

Worsening Of Indigestion Or Dyspepsia

Pain and difficulty swallowing, especially after consuming raw veggies, bread, or meat. The tumor may obstruct the stomach's entrance as it expands. Swallowing fluids can cause pain.

Other symptoms may include pain in the throat or behind the breastbone, frequent choking episodes, and vomiting.

When Should You Visit A Doctor?

If you experience any persistent symptoms that alarm you, schedule a visit with your physician. Chronic acid reflux causes Barrett's esophagus, a precancerous condition that increases the risk of esophageal cancer. 

Indicate your illness is worsening. Consult your best doctor about the symptoms and indicators that could indicate that your illness is getting worse. For those who have Barrett's esophagus, screening for esophageal cancer may be a possibility. If you have Barrett's esophagus, discuss the advantages and disadvantages of screening. 

Causes Of Esophageal Cancer

Although the precise etiology of esophageal cancer is unknown, medical professionals have identified risk factors that raise the likelihood of the disease occurring, such as:

  • Tobacco Consumption: This covers both smokeless and traditional tobacco products.
  • Alcohol Consumption: Drinking alcohol excessively or chronically raises the risk of esophageal cancer.
  • Obesity: Being obese or overweight increases the risk of esophageal cancer by inflaming the esophagus.
  • Barrett's Esophagus: The alterations in the cells at the base of the esophagus that result from long-term, untreated acid reflux are known as Barrett's esophagus. People who suffer persistent heartburn are more likely to develop esophageal cancer, even in the absence of Barrett's esophagus.
  • Human Papillomavirus (HPV): This widespread virus can alter the tissue in your mouth, vocal cords, hands, feet, and genitalia.
  • Cancer History: Individuals with a history of head or neck cancer are more at risk of developing esophageal cancer.
  • Other Disorders: There are several uncommon and/or hereditary disorders associated with esophageal cancer. One rare illness that makes swallowing difficult is achalasia. Tylosis is an uncommon hereditary illness that causes extra skin to grow on the palms of your hands and the soles of your feet.
  • Chemical Exposure At Work: Individuals who work with dry cleaning solvents for an extended period have a higher chance of developing esophageal cancer.

Types Of Esophageal Cancer

The classification of esophageal cancer is based on the type of cells that are involved in the development of the cancer. The type of esophageal cancer will determine how it is managed. These kinds of esophageal cancer can be classified as: 

  • Adenocarcinoma: It starts in the cells of the mucus-secreting glands in the esophagus. The lower part of the esophagus is where adenocarcinomas commonly occur. It is the most prevalent type of esophageal cancer in the US, and it affects primarily white men.
  • Squamous Cell Carcinoma: The thin, flat cells that border the esophageal surface are called squamous cells. Most cases of squamous cell carcinoma are found in the middle and upper regions of the esophagus. Globally, squamous cell carcinoma is the most common type of esophageal cancer.
  • Other Rare Types: Some atypical forms of esophageal cancer consist of sarcoma, small cell carcinoma, melanoma, lymphoma, and choriocarcinoma.

Risk Factors

Chronic esophageal irritation is thought to be a contributor to the changes that lead to esophageal cancer. The following are some of the factors that irritate the esophageal cells and raise the possibility of esophageal cancer:

  • Gastroesophageal reflux disease (GERD)
  • Smoking & Drinking
  • Barrett's esophagus
  • Being obese
  • Alcohol intake
  • Bile Reflux
  • Achalasia
  • The habit of drinking very hot liquids
  • Not eating enough fruits and vegetables
  • Undergoing radiation treatment to the chest or upper abdomen 

Diagnosis Of Esophageal Cancer

Accurate diagnosis and staging are especially important for the best possible result because esophageal cancer is often not detected until it has progressed to an advanced stage. A gastroenterologist (a physician who specializes in disorders of the digestive system) may identify symptoms of esophageal cancer before any other medical professional. It’s critical to get treatment as soon as possible while the cancer is still treatable if you have any signs of esophageal cancer. To diagnose esophageal cancer, various kinds of tests are available. Typically, tests like these are administered:

  • Endoscopy With Biopsy: Also referred to as an esophagogastroduodenoscopy or EGD, this is the most commonly used diagnostic procedure physicians use to check for esophageal cancer. A biopsy is the process by which a physician removes tissue samples from abnormal parts of your body using an endoscope, which is a flexible tube with an attached camera that lets the doctor view your body.
  • Endoscopic Ultrasonography (EUS): Your doctor may prescribe an EUS if the results of your biopsy indicate that you have cancer. This is among the most precise imaging techniques available for identifying esophageal cancer. To examine your esophagus, EUS combines two procedures:
  • Endoscopy: Your doctor will put a tiny, illuminated tube into your body during this procedure.
  • Ultrasound: Using high-frequency sound waves, ultrasound creates detailed images.
  • PET Scan: It is used to find out whether the cancer has spread to organs other than the esophagus. To help a doctor treat possibly malignant areas of your body, a PET scan uses radioactive dye to highlight those areas.

Other, less common forms of testing include:

  • Barium Swallow: Also known as an esophagram, a barium swallow is an X-ray procedure in which you ingest a solution containing barium while a medical professional observes the passage of the solution down your esophagus.A barium swallow is comparable to the video fluoroscopic swallowing exam, or VFSE. While you swallow, a doctor records a digital video of your esophagus. Study up on fluoroscopy.
  • Endoscopic Confocal Microscopy: This method eliminates the need for a biopsy or pathology and yields rapid findings using laser technology.
  • Computed Tomography Scans (CT scans): These are imaging tests that are frequently performed following a cancer diagnosis. Doctors can use it to determine whether the tumor has progressed outside of the local area or how far along it is.

Treatment Of Esophageal Cancer

The course of treatment for esophageal cancer varies according to the specific requirements of each patient. Approaches for treatment include:

  • Radiation Therapy: X-rays, gamma rays, and charged particles are used in radiation treatment to treat cancer.
  • Chemotherapy: The treatment of malignant cells with anticancer medications
  • Surgery: the process of removing malignant tissue from the body through an operation
  • Combination Therapy for Cancer of the Esophagus: The majority of esophageal cancer treatment programs use a combination approach, which combines chemotherapy, radiation, and/or surgery with other forms of treatment.
  • Neoadjuvant therapy:  is a combination of treatments (typically chemotherapy and radiation) used before surgery to shrink tumors and prevent them from growing again.Combining chemotherapy and radiation therapy stops tiny cancers from spreading outside of the initial tumor site.Additionally, studies reveal that when radiation and chemotherapy are administered before surgery rather than afterward, individuals recover more quickly.

Your medical professional will take many things into account while creating the best treatment plan for your particular case, including:

  • The stage at which your cancer is detected Your general state of health and dietary habits
  • Where is the tumor located?
  • Your individual preferences for various forms of care

Complications

As esophageal cancer spreads, it may result in complications such as: 

  • Esophageal obstruction: Food and liquids may become more difficult for them to pass through your esophagus if you have cancer.
  • Pain: Pain can arise from advanced esophageal cancer.
  • Bleeding In The Esophagus: The bleeding may result from esophageal cancer.Bleeding often occurs gradually, but occasionally it can happen suddenly and severely.

Prevention

Esophageal cancer is a risk that can be reduced. Some examples to reduce risk are::

  • Quit Smoking: If you smoke, talk to your doctor about ways to stop. To help with quitting, there are options for both medication and treatment. If you don't already smoke, don't start.
  • Alcohol Intake: If you do drink, try to limit it. If you choose to drink, make sure you only do it occasionally. This means a maximum of one drink for women and two for men per day for those in good health.
  • Consume More Fruits And Vegetables:. Eat a diet you health richer in colorful fruits and vegetables.
  • Keep Your Weight In Check: If you are overweight or obese, talk to your doctor about weight-loss options. Aim for a slow, steady weight loss.

Conclusion

Although it can be difficult to identify esophageal cancer, early identification can greatly enhance treatment outcomes. Even though the majority of people may not exhibit symptoms in the early stages, being aware of the possible warning signs helps you get help as soon as possible. Make an appointment with your doctor as soon as possible if you encounter any of the above-mentioned symptoms, including heartburn, trouble swallowing, or unexplained weight loss. An early diagnosis increases the chance of success and provides additional options for treatment.

FAQ's

Is esophageal cancer ever cured?

When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed. At later stages, esophageal cancer can be treated but rarely can be cured.

What is the cause of esophageal cancer?

The exact cause of esophageal cancer is unknown, but the following things can increase your risk: persistent gastro-oesophageal reflux disease (GORD) smoking. drinking too much alcohol over a long period of time.

Does esophageal cancer spread fast?

After entering the lymphatic system, esophageal cancer can potentially travel throughout the body and spread to distant organs and tissues. This type of cancer typically grows slowly, and it may be many years before the symptoms become noticeable. However, once the symptoms begin, the cancer progresses rapidly.

Is esophageal cancer curable at stage 4?

Stage IV esophageal cancer has spread to distant lymph nodes or to other distant organs. In general, these cancers are very hard to get rid of completely, so surgery to try to cure the cancer is usually not a good option.

How fast does esophageal cancer grow?

Esophageal cancer grows slowly and may grow for many years before the symptoms are felt. However, once the symptoms develop, esophageal cancer progresses rapidly. As the tumor grows, it can seep into the deep tissues and organs near the esophagus.
 

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