Esophageal Cancer: Causes, Symptoms, and Test

Esophageal cancer is cancer that occurs in the esophagus a long and hollow tube that runs from your throat to your stomach. It is also the esophagus is the muscular passage that food and liquids use to reach the stomach.

To digest the food your esophagus helps move the food you swallow from the back of your throat to your stomach.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Moreover, esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. And also incidence rates vary within different geographic locations. In Addition, tobacco and alcohol may attribute to, higher rates of esophageal cancer in some regions.

Here are the two main types of esophageal cancer: Such as squamous cell carcinoma (which starts in the cells of the lining) and adenocarcinoma (which starts in the tissue that helps you swallow).

Symptoms of Esophageal Cancer

Signs and symptoms of esophageal cancer include:

  • Difficulty swallowing (dysphagia)
  • Weight loss without trying
  • Chest pain, pressure or burning
  • Worsening indigestion or heartburn
  • Coughing or hoarseness

Early esophageal cancer typically causes no signs or symptoms.

Therefore, make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

Most importantly, screening for esophageal cancer may be an option for people with Barrett’s esophagus. And, if you have Barrett’s esophagus, naturally, you should discuss the pros and cons of screening with your doctor.

Causes

In fact, it’s not exactly clear what causes esophageal cancer.

Esophageal cancer occurs when cells in the esophagus develop changes (mutations) in their DNA. The changes make cells grow and divide out of control. As a result, accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

Types of esophageal cancer

Classification is according to the type of cells. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

  • Adenocarcinoma. 
    • Adenocarcinoma begins in the cells, mucus-secreting glands in the esophagus. It occurs most often in the lower portion of the esophagus. It is the most common form of esophageal cancer, and it affects primarily white men.
  • Squamous cell carcinoma. 
    • The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
  • Other rare types. 
    • Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.

Esophageal cancer diagnosis

The doctor will ask you about your medical history, including your current symptoms. After a physical examination, the doctor might order certain tests that can help in diagnosing and assessing esophageal cancer.

  • Barium swallow
    • Uses a special series of X-rays to visualize the esophagus.
    • The patient drinks a liquid containing barium, which makes the esophagus easier to see on the X-ray.
  • Esophagoscopy
    • Is a procedure that allows the doctor to look at the inside of the esophagus using a thin, lighted tube called an endoscope. The endoscope is passed through the mouth and down the throat into the esophagus while you are asleep.
    • The doctor can insert a balloon to dilate an obstructed esophagus. Looking at the esophagus and the upper part of the stomach is called an upper endoscopy.
  • Biopsy.
    • During the esophagoscopy, the doctor may remove a small piece of tissue to examine under a microscope to see if there are any cancer cells.
  • Esophageal endoscopic ultrasound
    • Uses sound waves to create images of internal structures.
  • Computed tomography (CT) 
    • This often used in evaluating the extent of tumor that spread in chest and abdomen.

How is esophageal cancer classified?

Most cancers are grouped by stage, a description of cancer that aids in planning treatment.

The stage of a cancer is based on the location and depth of the tumor; the involvement, if any, of the lymph nodes; and the degree that cancer has spread, if at all, to other tissue and organs.

Grading is a way of rating a tumor based on how much its cells look and act like normal cells. Tumor grading can also tell the doctor how fast the tumor is growing.

Tumors with almost normal-looking cells that grow slowly are called low-grade tumors. In a similar fashion, high-grade tumors are more likely to spread than low-grade tumors.

Esophageal cancer treatment

The approach to treatment depends on the stage and grade of cancer. Esophageal cancer treatment includes this option:

  • Surgery is the most common treatment for esophageal cancer. Surgery may be done to remove some or most of the esophagus, as well as some tissue around it, in a procedure called esophagectomy. 
    • The doctor may also remove lymph nodes around the esophagus and look at them under a microscope to see if they contain cancer.
      Surgery can cure cancer in some patients who have no spread of the tumor beyond the esophagus.
  • Radiation therapy is a way of treating disease using radiation (high-energy rays) or radioactive substances.
    • It is used to kill or damage, cancer cells, often by aiming a beam of radiation at the tumor.
    • The radiation destroys the cancer cells by interfering with their growth and division.
    • During radiation treatments for esophageal cancer, a stent (small tube) is sometimes inserted into the esophagus to keep it open.
    • This is called intraluminal intubation and dilation.
  • Chemotherapy mostly, uses medicines to kill or stop the growth of cancer cells.
    • And also some chemotherapy drugs are taken as pills and some are placed directly into the bloodstream through a vein (intravenous). Chemotherapy drugs travel through the bloodstream and can kill cells throughout the body.

Additional Treatment for Esophageal Cancer

  • Endoscopic submucosal dissection (EDS) or endoscopic mucosal resection (EMR) are procedures to treat early tumors that are small.
    • The tumors may be removed endoscopically without having to remove the esophagus.
  • Endoscopic laser therapy may be used to treat more advanced tumors that may cause a blockage in the esophagus.
    • As part of palliative therapy, lasers can be used to cut a hole in the blockage to improve swallowing and allow the patient to eat.
  • Photodynamic therapy (PDT) uses photoactive drugs (drugs activated by non-thermal light) that are absorbed by cancer cells, thus destroying the cancer cells.
    • Using this treatment help ease difficulty in shallowing.

People with esophageal cancer may participate in clinical trials. 

Risk factors

Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

  • Having gastroesophageal reflux disease (GERD)
  • Smoking
  • Having precancerous changes in the cells of the esophagus (Barrett’s esophagus)
  • Being obese
  • Drinking alcohol
  • Having bile reflux
  • Difficulty swallowing because of an esophageal sphincter that won’t relax (achalasia)
  • A steady habit of drinking very hot liquids
  • Not eating enough fruits and vegetables
  • Undergoing radiation treatment to the chest or upper abdomen

Complications

As esophageal cancer advances, it can cause complications, such as:

  • Obstruction of the esophagus. 
    • Cancer may make it difficult for food and liquid to pass through your esophagus.
  • Pain. 
    • In the same way, advanced esophageal cancer can cause pain.
  • Bleeding in the esophagus. 
    • Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.

Prevention

You can take steps to reduce your risk of esophageal cancer. For instance:

  • First Quit smoking.
    •  If you smoke, talk to your doctor about strategies for quitting. Medications and counseling are available to help you quit. If you don’t use tobacco, don’t start.
  • Next is Drinking alcohol in moderation, if at all.
    •  If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
  • Another thing is Eat more fruits and vegetables. 
    • Add a variety of colorful fruits and vegetables to your diet.
  • Lastly Maintain a healthy weight.
    •  If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.

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