Oesophagus cancer is not necessarily a rare disease, but it is not that common too. In UK, it is estimated to be the ninth most frequently occurring cancer that affects in excess of 8,500 people per year. Cancer of the oesophagus affects men more than women with most of the patients having their ages in the 60s. The average age at which the diagnosis of this cancer is usually made is around 72.
What Is Oesophagus Cancer?
Oesophageal cancer or oesophagus cancertargets the gullet or the esophagus. Although it is not that common, it is among the most dangerous types of cancers.
The gullet which is an important part that constitutes the digestive system is medically known as oesophagus. It is the tube that connects the throat with the stomach and is responsible for the carrying of the food down. The oesophagus has two parts; the first one is present at the back of the trachea or the windpipe while the second one is present in the chest in between the heart and the spine.
Types of Oesophagus Cancer
Oesophagus cancer is of two different types.
- Squamous cell carcinoma usually develops in the front portion of the oesophagus. It happens when the cells lining the inside part of the oesophagus starts multiplying in an abnormal manner.
- Adenocarcinoma of the oesophagus develops in the bottom portion of the oesophagus. It happens when the cells of the mucous glands lining the oesophagus starts multiplying in an abnormal manner. The mucous glands are responsible for producing a substance that is slimy in nature, making it easier for the food to slide down the oesophagus into the stomach.
What Causes Oesophagus Cancer?
A single abnormal cell becomes the reason for the development of a cancerous tumor. The specific reason for the conversion of a cell into a cancerous tumor is unknown. An alteration in the genes of the cell is considered to be the reason behind the abnormal multiplication of the cells in an uncontrollable manner. The following are the risk factors:
Smoking any kind of tobacco whether in the form of cigarettes, cigars or pipes can increase your chances of getting oesophagus cancer.
Excessive drinking of alcohol is one of the major risk factors for oesophageal cancer. People who smoke regularly and drink excessively have a much higher chances of developing oesophageal cancer.
Obese people have a much higher risk of getting oesophageal cancer.
Barrett’s Oesophagus and Acid Reflux
Barrett’s Oesophagus and Acid Reflux can irritate the oesophagus and end up making changes to the cells there. If you suffer from this condition then you have a higher chance of developing oesophagus cancer.
Achalasia is a condition in which the muscles of the oesophagus are unable to relax and expand easily. Patients suffering from Achalasia are prime suspects for developing oesophageal cancer.
Prevention of Oesophagus Cancer
- Limiting tobacco and alcohol use
- Keeping the weight under control
- Patients suffering from GORD must undergo an endoscopy for screening purposes
- Patients suffering from Barrett’s oesophagus must undergo endoscopic tests on a regular basis to check whether precancerous changes are taking place in their oesophageal lining
Such patients also have to keep the Gastro-Oesophageal Reflux symptoms in check as well. This includes making changes in your lifestyle and dietary habits and also use of drugs and even surgery as well to ensure that Barrett’s oesophagus does not progress further.
What Are the Symptoms of Oesophagus Cancer?
In the early stages when the cancer is smaller in size, oesophageal cancer does not show any kind of symptoms. In fact, symptoms of this cancer do not appear until it has reached an advanced level.
- Dysphagia or narrowing of the oesophagus is among the first symptoms of oesophagus cancer. The food starts getting stuck in the oesophagus and in severe cases even drinks become hard to swallow
- Vomiting the food you have eaten that had been become stuck in the oesophagus
- Odynophagia which is characterized by a chest pain when you are swallowing
- Loss of weight
- Bloody vomit
- Formation of lump in oesophagus
- Coughing fits when you are swallowing
- Hoarseness of voice
- The symptoms of acid reflux might start to appear or worsen if the tumor develops in the lower portion of the oesophagus, close to the stomach. Heartburn or chest pain is the most common symptom of acid reflux.
Acid reflux is a common problem but it does not mean that everyone having acid reflux will suffer from oesophageal cancer too.
Oesophagus Cancer Diagnosis and Staging
An endoscopic examination is performed for diagnosing oesophagus cancer. The process involves the insertion of an endoscope, which is essentially a long luminous tube containing a small camera, into the oesophagus. The camera provides pictures of the inside of the oesophagus to the doctors so that they can have a look at the area that might have become cancerous.
The location and size of the oesophageal tumors determines the cancer stage the patient is in.
- If the cancer is present in the top layer of the cells that are lining the oesophagus, then it is classified as stage 1.
- If the cancer has spread to the surrounding lymph nodes or has penetrated into the muscle layer of the oesophagus then it is classified as stage 2.
- In stage 3, the cancer has metastasized to the tissues that are present outside the oesophageal wall while in stage 4; the cancer has spread to the other organs of the body respectively.
Doctors can make use of biopsies, CT scan, nuclear bone scans and chest x-rays to confirm the diagnosis of oesophageal cancer and determine the stage it is in.
Oesophagus Cancer Treatment
The health of the patient and the stage of the oesophageal cancer he is suffering from are the factors that determine which type of oesophagus cancer treatment can be given to him. Patients who have advanced lung or heart issues are not candidates for receiving aggressive treatment options like chemotherapy and radiotherapy. In most of the cases the cancer has developed so much that usual treatment options do not even work. For such cases, the doctors recommend the following treatment methods.
- Placement of a stent in the oesophagus
- Photodynamic therapy
- Destruction of the tumor through use of laser
For healthy patients, the following treatment methods are indicated:
- Post-operative radiotherapy and chemotherapy
Prognosis of Oesophagus Cancer
If the doctor is able to diagnose oesophageal cancer at an earlier stage then there is a 30% chance that the patient might survive and live a long life. However, if the cancer has metastasized to other parts of the body then long-term survival becomes highly unlikely. If the cancer has reached the muscle layer of the oesophagus then there is a strong chance that it is going to come back following surgery. Continuous follow-up is required by patients who have recovered from oesophagus cancer.