Esophagus Cancer

Esophagus cancer Illustration

Esophagus, also called as food pipe is a hollow muscular tube that connect throat to the stomach. It is around 20-25 cm long and 2-3 cm wide. Foods goes from mouth to stomach in abdomen through esophagus/ food pipe. When cells in esophagus lining begin to grow out of control, they form esophagus cancer

  • 8th most common cancer and 6th most common cause of cancer related deaths worldwide.
  • There is regional variation in incidence of esophagus cancer in India.
  • More common in males compared to females
  • Esophagus cancer is among highly aggressive cancers, although cure rate is improving compared to previous.
Types

 

  • Squamous Cell Carcinoma – more common in upper and middle third part of esophagus.
  • Adenocarcinoma- more common in lower third part of esophagus
Risk Factors
  • Age >50 years
  • Tobacco
  • Alcohol
  • Gastroesophageal Reflux disease
  • Dietary Factors: red meat, very hot liquids, dietary deficiency of selenium/ zinc/ folate
  • Prior corrosive injury
  • Radiation exposure
  • Underlying esophageal diseases: achalasia, Barret’s esophagus, Tylosis
  • Prior history of head and neck cancer
  • Obesity
  • Genetic causes- very small no of cases
  • Diet rich in fruits and vegetables containing antioxidants, mineral and vitamins, dietary cereal fibers and regular physical activity are considered as protective factors.
Screening for Esophagus Cancer:

There is no standard or routine screening test for esophageal cancer. However, people with Barrett’s esophagus may be advised to have regular endoscopic examinations. An endoscopic examination is a procedure that uses a flexible, lighted tube to look inside the esophagus.

 

Alarmimg Signs of Esophagus Cancer

Esophagus is among few of very aggressive cancers. It is usually diagnosed in late stages and has high mortality rate. There are no routine guidelines for screening esophageal cancer. People who have a high risk for esophageal cancer like Barret’s esophagus, genetic predisposition or precancerous conditions should be followed closely. Disease diagnosed in early stage has better cure rates. Although symptoms appear in advance stage, following symptoms should be looked with high index of suspicion and doctor should be consulted regarding endoscopy or other investigation requirements.

  • Difficulty in swallowing which is gradually worsening starting with solid food.
  • Pain or burning feeling in chest
  • Weight Loss
  • Vomiting
  • Blood loss presenting either as blood staining in vomiting or anaemia
  • Cough or hoarseness of voice
  • Fistula with airways : Tracheoesophageal or brochoesophageal fistula leading to pulmonary complications
Investigations
  • Upper GI Endoscopy and Endoscopic Ultrasound with Biopsy – most common procedure for initial evaluation and confirmation of diagnosis. Female concentrated doctor gastroenterologist, operating endoscope during gastroscopic procedure of young afro-american man patient, lying on the couch  
  • CECT/ PET CECT- for pretreatment disease extent evaluation both at primary site and distant site.
  • Bronchoscopy – in case of suspected airway involvement.
  • Diagnostic laparoscopy/ thoracoscopy
Treatment
 
 

Best doctors for carcinoma esophagus suggest surgery as most effective treatment.

Surgery Esophagectomy: Most of the esophagus along with a small upper part of stomach and regional lymph nodes are excised. Remaining stomach is formed as a tube and reconnected to upper esophagus to that food can be swallowed normally. Esophagectomy is the mainstay of treatment for middle and lower esophagus cancer. It is a major surgery and it can be performed either by open or minimal invasive technique. Proper assessment and optimization by surgical oncologist is very important aspect of treatment, so patient must show to a surgical oncologist since the start of treatment.

Nutritional rehabilitation is also an important aspect of whole treatment. In severe dysphagia nasogastric tube feeding or esophageal stenting or feeding jejunostomy are most commonly methods to establish proper enteral feeding of patients.

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Integration of Multimodality Treatment
  • Radiation therapy – Mainstay of treatment for upper esophagus cancer. May be given before surgery as neoadjuvant therapy in advance stages.
  • Chemotherapy often combined with radiation therapy in curative settings. May be given before surgery as neoadjuvant therapy in advance stages. In metastatic patients it the treatment mostly used.
  • In metastatic patients often palliative intervention is also required like esophageal stenting for absolute dysphagia and tracheoesophageal fistula.
  • Immunotherapy and targeted therapy are also options in selected advance metastatic cases.

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Got some questions

Colon cancer can start anywhere in the colon, which is about 5 feet long and absorbs water from the stool. Rectal cancer begins in the rectum, which is the last 12 cm (about 5 inches) of the large intestine. This is where the body defecates until you have a bowel movement. Contact Cancer Surgery clinic Arogyam Care at Gurugram, Delhi NCR or book online appointment for colon and rectal cancer treatment in Gurgaon.
  • If all relavant examination and investigations has been done than plan of treatment is finalized with colon cancer surgeon
  • After deciding surgical procedure cost estimate can be taken from billing department or hospital. Clinic or hospital department coordinator will assist in case any help required. +918750587489,
Best Doctor for Rectal Cancer in Gurgaon says for rectal cancer, the overall 5-year survival rate for people is 67%. If the cancer is diagnosed locally, the survival rate is 89%. If the cancer has spread to surrounding tissues or organs and / or regional lymph nodes, the 5-year survival rate is 72%
It is 10 times more likely to cause stomach cancer than rectal cancer, where it returns after treatment has begun. Stomach cancer has about a 20 percent risk of local recurrence, versus about 2 percent with colon cancer. Contact Dr Kaushal Yadav for Cancer Surgery & for colon and rectal cancer treatment in Gurgaon, Delhi-NCR, India

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