Esophageal Cancer 

Food moves from the throat to your stomach with the help of the esophagus. It is a long and hollow muscular tube where cancer may develop in the inner lining. It may be cured from surgery and other treatments when detected in the early stage but if cancer takes on advanced stages, it’s difficult to cure it even with the help of various treatments like chemotherapy, radiation therapy and immunotherapy.

Generally, there are two types of Esophageal cancers that are noticed in people, they are:

1. Adenocarcinoma - This type of esophageal cancer ismostly found in the lower part of the esophagus. It is the most common cancer and these cancerous cells are found in tissues that make mucus!
2. Squamous Cell Carcinoma - Squamous Cells are found in the lining of the esophagus. When cancer cells spread in squamous cells, the upper, middle or lower parts of the esophagus are affected.

The main concern with Esophageal Cancer is that it does not show noticeable symptoms in the early stages which makes it hard to detect.

Symptoms that you need to keep a check on

Although Esophageal Cancer does not show early symptoms, still stay aware if you notice any of these symptoms, it may be an alarming sign of canceresophagus:

- Unintentional Weight Loss

- Difficulty while swallowing

- Pressure, Pain or Burning Sensation in the Chest

- Coughing or Hoarseness

- Vomiting

- Poor Digestion

- Heartburn

- Pain in the Throat, Back or between your shoulder blades.

If you experience Chronic Acid Reflux, you might be suffering from Barrett’s Esophagus which is known as a Precancerous condition that increases the risk of Esophageal Cancer, so stay aware and see a doctor.

Causes of Esophageal Cancer

Although the exact cause of Esophageal Cancer is not known, it is known that chronic irritation in Esophagus increases the risk of Esophageal Cancer. Hence, there are few risk factors that cause this irritation and are known to be a probable cause of Esophageal Cancer. These are:

1. Smoking: Smoking is injurious to health and a prominent risk factor to cause Esophageal Cancer. Hence, people who smoke or consume tobacco are more likely to suffer from Esophageal Cancer.
2. Alcohol: Being addicted to alcohol and consuming it in high quantities often irritates the esophagus, hence increasing the risk of Esophageal Cancer.
3. Obesity: Maintaining a healthy weight can reduce your risk of diseases. One such disease that obesity causes is Esophageal Cancer. It causes inflammation in the Esophagus that turns into cancer. Hence, being overweight or obese can make your body prone to Esophageal Cancer.
4. Chronic Acid Reflux/ heartburn: If you are suffering from Chronic Acid Reflux which is not treated well, it can become a condition of Barrett’s Esophagus wherein the cells in the lower part of the esophagus change which may increase the risk of Esophageal Cancer.
5. History of Cancer: If you have a history of any kind of cancer in the neck or head, which was previously treated then you are more likely to develop cancerous cells in the esophagus.
6. Radiation Treatments: If you are undergoing any radiation treatments to the chest or upper abdomen, this will irritate your esophagus and increase the risk of esophageal cancer.
7. Difficulty in Swallowing: If you are suffering from Achalasia, you won’t be able to swallow easily. This is because Esophageal Sphincter won’t relax. This is a precancerous condition and makes you more vulnerable to Esophageal Cancer.
8. Diet deficient in fruits and vegetables: If you are not eating enough fruits and vegetables and do not maintain a healthy diet, your esophagus is more likely to develop the risk of esophageal cancer.
9. Drinking Extremely Hot Liquids: If you are drinking very hot liquids, then you are definitely irritating your esophagus, which in turn increases the risk of esophageal cancer.

As Esophageal Cancer occurs with the changes in the cells of the esophagus, it eventually grows rapidly and multiplies and spreads to other parts of the body.

The complications that can be noticed in the advanced stages of Esophageal Cancer are:

1. Blockage in the Esophagus: The cancerous cells in the Esophagus make it difficult to swallow food and liquids, hence restricting them from passing through the esophagus easily.
2. Pain: People suffering from Esophageal Cancer experience pain in Esophagus while swallowing food.
3. Bleeding: Esophagus cancer can cause bleeding in Esophagus at times.

Diagnosis of Esophageal Cancer

In order to diagnose Esophageal Cancer, there are following tests that should be done which help healthcare providers to diagnose it properly.

1. Esophagogastroduodenoscopy (EGD) / upper GI endoscopy: In EGD, a thin flexible tube which is called an endoscope is attached to a lighted camera which is passed down the throat to get a clear vision from the inside of the esophagus.
2. Biopsy: During EGD, a small tissue from the Esophagus is removed to be examined in the laboratory to know whether it has any cancer cells or not.
3. CT Scan: CT Scan also known as. Computed tomography helps to identify the tumours and the level to which it is spread to the chest and abdomen.
4. Esophageal Endoscopic Ultrasound: With High-Frequency Sound Waves, detailed pictures of the Esophagus are created with the help of Esophageal Endoscopic Ultrasound.

Once the tests are done, the reports define the further course of treatment. The treatment may vary depending on the cancer stages, the tumour location and depth and the level to which it has been spread to other parts of the body.

The following course of treatment may include the following treatment options depending on the stage of Esophageal Cancer:

For upper third of cancer esophagus treatment is with chemo and radiation therapy. There is no role of surgery here.

For middle and lower thirds of cancer esophagus in early stages surgery is the treatment of choice

For advanced stage cancers initial chemoradiation followed by surgery and then chemotherapy in the end, is the protocol.

1. Surgery: If Esophageal Cancer is detected in the early stage, it can be eliminated through surgery. The surgery is called Esophagectomy wherein the affected area in the Esophagus is removed and replaced by pulling up part of your stomach into your chest and neck. The latest in surgery is minimally access surgery with thoracoscopic and laparoscopic esophagectomy (key hole surgery).
2. Radiation Therapy: Cancer Cells are killed or damaged with the radiation beam pointed at the cancerous tumour. It can also be given after the surgery to reduce the chances of recurrence of Esophageal Cancer.
3. Chemotherapy: It is paired up with Radiation Therapy and Surgery and aims at destroying the cancerous cells through drugs. It is effective and given through veins. Chemotherapy is well known to have various side effects.
4. Endoscopic Submucosal Dissection (ESD)- This Treatment is used to treat early-stage cancers wherein the surgical tools are inserted through the endoscope to remove the irregular tissues. It is a minimally invasive procedure which is quicker and less painful.
5. Endoscopic Mucosal Reaction (EMR) - This minimally invasive procedure allows you to remove tumours in the mucous lining of the esophagus with surgical tools through the endoscope inserted from your mouth. It is ideal for small tumours or precancerous lesions.
6. Endoscopic Laser Therapy: Esophageal Cancer comes with a severe complication of difficulty in swallowing. Endoscopic Laser Therapy is used to ease out your symptoms and improve your condition to help you swallow food.
7. Targeted Therapy and immunotherapy- reserved mainly for the metastatic stage of cancer.

After Effects of Surgery

People who underwent surgery to treat Esophageal Cancer may experience certain side effects like nausea, vomiting or heartburn. People may also experience difficulty in eating and should opt for eating smaller meals or drinking nutritional supplements.

There can be a dumping syndrome where your stomach acts like an Esophagus and quickly dumps food into the intestines without digesting it properly. This leads to symptoms like nausea, vomiting, diarrhoea, stomach cramps, sweating or flushing of the skin. Hence, keep a close check on how your body is reacting after the surgery and get immediate help from healthcare providers to get control of the side effects. Also, avoid tobacco, smoking and alcohol as it may increase the risk of reoccurrence of Cancerous Cells.

Apart from quitting smoking, and alcohol and maintaining a healthy diet, keep your schedule intact for follow up checkups. You should see a doctor every three to six months for the first two years after treatment to keep a close check on your body and protect it from any further complications. After that, you can visit every six to 12 months for the next three years. The checkups may include the process of physical examinations, blood tests, imaging tests, endoscopy etc. to ensure that you are free from any developing risk of cancer.

Reduce the Risk of Esophageal Cancer with the Preventive Measures

It’s always a good idea to protect your body from diseases that hurt you to the core and shorten your lifespan. Hence, following some preventive measures can keep you away from Esophageal Cancer and allow you to live a quality of life. These are:

1. Say ‘No’ to Smoking - A Big No to smoking can save you from the risk of Esophageal Cancer. It’s high time that you should know smoking is injurious to health and is a major cause of Esophageal Cancer. So, quit smoking and tobacco for a healthy esophagus.
2. Goodbye to the Addiction of Alcohol - Consuming Alcohol in large amounts can increase your risk of Esophageal Cancer, hence stop consuming Alcohol if you wish to safeguard your Esophagus or at least limit the quantity with occasional sips rather than daily drinks.
3. Eat Healthy - Follow a healthy diet filled with Fruits and Vegetables to minimise the risk of Esophageal Cancer. A healthy body is always less prone to serious diseases.
4. Healthy Weight - Obesity is the major cause of certain deadly diseases. So, adopt practises to maintain a healthy weight, go to a gym, dance, walk, or attend a yoga session or 30-minute exercise routine that keeps you fit and healthy.

Hence, being aware of Esophageal Cancer, knowing its signs and symptoms and adopting preventive measures to reduce its risk can save you from Esophageal Cancer. Get in touch with the Cancer Specialist and go for a diagnosis as soon as you notice any symptom that gives you an alarming sign of Esophageal Cancer. Detecting cancer in the early stage can definitely help you to eliminate it and live a happy life.