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Esophageal Cancer

The esophagus is a 10-inch long, hollow, muscular tube that connects the throat to the stomach. It is part of a personís gastrointestinal (GI) tract. When a person swallows, the walls of the esophagus contract to push food down into the stomach. Cancer begins when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body).

Esophageal cancer, also called esophagus cancer, begins when cells in the lining of the esophagus grow uncontrollably and eventually form a tumor.

Specifically, cancer of the esophagus begins in the inner layer of the esophageal wall and grows outward. If it spreads through the esophageal wall, it can invade lymph nodes, blood vessels in the chest, and other nearby organs. Esophageal cancer can also spread to the lungs, liver, stomach, and other parts of the body. There are two major types of esophageal cancer:

  • Squamous cell carcinoma. This type of esophageal cancer arises in squamous cells that line the esophagus. It usually develops in the upper and middle part of the esophagus.
  • Adenocarcinoma. This type begins in the glandular tissue in the lower part of the esophagus at the junction between the esophagus and the stomach.
Treatment is similar for both of these types. Other, very rare tumors of the esophagus (less than 1% of esophageal cancers) include small cell neuroendocrine cancers, lymphomas, and sarcoma.
Esophageal cancer is a tumor that begins to grow in the lining of the esophagus, and then can grow through the wall of the esophagus. If the tumor grows through the esophageal wall, it can then spread to other parts of the body through the lymphatic system. Most of the length of the esophagus is lined with squamous cells. If a malignant tumor grows here, it's called squamous cell cancer. The areas at the bottom of the esophagus, and where the esophagus joins the stomach, are lined with columnar cells. If a malignant tumor grows here, it's called adenocarcinomas. Studies have shown a relationship between frequency of reflux symptoms and risk of adenocarcinoma. The constant acid reflux will irritate the lining of the esophagus, and complications can occur, such as Barrett's esophagus. Individuals who develop Barrett's esophagus are about 40 times more likely to develop esophageal cancer than individuals in the general population
Symptoms of esophageal cancer
  • Heartburn
  • Difficulty swallowing
  • Inability to swallow solid foods (eventually liquids also)
  • Pain with swallowing
  • Food sticking in esophagus
  • Weight loss
  • Regurgitation of undigested food
  • Vomiting blood or passing old blood with bowel movements
Procedures used to diagnose esophageal cancer
  • Endoscopy
  • Barium x-rays
  • Computed tomography
Treatment of Esophageal Cancer: Treatment of esophageal cancer will depend on the stage the cancer is in at the time of diagnosis, the overall condition of the patient, and whether the cancer has spread to other organs. If the cancer has not spread to other organs, surgery may be performed to remove the a portion of the esophagus. In some cases, the surgery will also involve removing the stomach, spleen, and lymph nodes inside the chest. Then another part of the lower bowel is pulled up and attached to the remaining section of esophagus. Patients may receive chemotherapy and radiotherapy treatments after the surgery. If the cancer has spread to other organs, combined chemotherapy and radiotherapy is the most common treatment. This form of treatment is also used in the cases where the patient can't have surgery.
Prognosis for those with esophageal cancer: If the cancer is diagnosed in it's earliest stages, the patient's chances of living and be cancer free five years after treatment is greatly improved. Unfortunately, most cases of esophageal cancer is only discovered when the patient comes to their doctor because of swallowing difficulty, which doesn't happen until later stages of the cancer growth. The prognosis then is very poor.
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