Esophageal Cancer: Causes, Symptoms, Types, Risk Factors, Diagnosis, Treatment, Prevention and Complications

The esophagus is the long hollow tube that passes the food into the stomach. Typically, esophageal cancer begins in the cells that line the interior of the esophagus. Anywhere along the esophagus is susceptible to esophageal cancer. Men experience esophageal cancer more commonly than women.

Esophageal cancer is the sixth most common cancer that kills people. Different geographic areas have different incidence rates. Alcohol consumption, tobacco use, specific dietary habits, and obesity may all increase the risk of esophageal cancer in different regions.

What Causes Esophageal Cancer?

What specifically causes esophageal cancer is unclear. When cells in the esophagus experience DNA changes (mutations), esophageal cancer results. The modifications cause uncontrolled cell growth and division. 

The esophagus develops a tumor from the accumulating aberrant cells, which has the potential to expand, infect neighboring structures, and metastasize to other regions of the body.

What Are The Symptoms Of Esophageal Cancer?

Esophageal cancer symptoms and signs include:

• Difficulties with swallowing (dysphagia)
• Loss of weight without effort
• Chest pressure, pain, or burning
• Worsening of heartburn or indigestion
• Hoarseness or coughing
• Early esophageal cancer typically has no signs or symptoms.

What Are The Types Of Esophageal Cancer?

The classification of esophageal cancer depends on the type of cells involved. The type of esophageal cancer you have affects the therapy options you have. Esophageal cancer can take many different forms.

• Adenocarcinoma. Adenocarcinoma grows in the cells of the mucus-secreting glands in the esophagus. Adenocarcinoma typically develops in the lower portion of the esophagus.
• Squamous cell carcinoma. The lining of the esophagus is made up of squamous cells, which are flat, thin cells. Squamous cell cancer typically appears in the upper and middle esophagus. Globally, squamous cell carcinoma is the most common esophageal cancer.
• Other Rare types. Some rare esophageal malignancies include small-cell carcinoma, sarcoma, lymphoma, melanoma, and choriocarcinoma.

What Are The Risk Factors Of Esophageal Cancer?

Esophageal irritation for an extended period of time is thought to cause changes that lead to esophageal cancer. The following items can aggravate esophageal cells and increase your risk of getting esophageal cancer:

• Having gastroesophageal reflux disease (GERD)
• Smoking causes Barrett's esophagus, which has cells with precancerous changes

• Getting fat
• Consuming alcohol
• Bile reflux
• Achalasia, a condition in which the esophageal sphincter refuses to relax, causes trouble swallowing
• A consistent practice of consuming hot beverages
• Inadequate consumption of fruits and vegetables
• Being treated with radiation to the chest or upper abdomen

How Is Esophageal Cancer Diagnosed?

To identify esophageal cancer, many tests and methods are used.

• Barium swallowing study. You'll be given a liquid containing barium to drink before the study, after which you'll go through X-rays. Your esophagus' inside is coated with barium, which makes any tissue changes visible on an X-ray.
• Endoscopy, which involves peering down a scope at your esophagus. A flexible tube with a camera attached to it called a video endoscope is passed down your throat and into your esophagus by your doctor during an endoscopy. Your physician checks your esophagus using an endoscope to look for inflammation or cancer.
• Tissue sample for analysis (a Biopsy). When performing a biopsy, your doctor may take a sample of worrisome tissue using an endoscope, a special scope that is sent down your neck and into your esophagus. It is sent the tissue sample.

How Can We Detect The Extent Of Cancer?

After esophageal cancer is identified, your doctor can advise more testing to find out if the disease has progressed to your lymph nodes or other parts of your body.

Tests might include:

• Bronchoscopy
• EUS, endoscopic ultrasound
• CT scans on a computer
• PET (positron emission tomography)

Your doctor stages your cancer based on the data from these procedures. The stages of esophageal cancer are denoted by Roman numbers that range from 0 to IV, with the lowest stages signifying tiny cancer that only affects the outermost layers of your esophagus. By stage IV, the cancer is regarded as advanced and has spread to other parts of the body.

What Is The Treatment Of Esophageal Cancer?

As medical professionals develop cancer diagnosis and therapy, the cancer staging system keeps changing and getting more complicated. Your doctor will choose the best treatments for you based on the stage of your cancer.

The stage and grade of the malignancy determine the course of treatment for esophageal cancer. Various forms of treatment are available, including:

• Surgery: The most common surgical treatment for esophageal cancer in its early stages is an esophagectomy. Your esophagus and surrounding tissue are removed partially or completely during the procedure. By raising a portion of your stomach into your chest and neck, surgeons can build a new esophagus.
• Radiation Therapy: By directing a radiation beam at the tumor, radiation kills or injures cancer cells. Before or after surgery, medical professionals may provide radiation as adjuvant therapy.
• Chemotherapy: Chemotherapy either kills cancer cells or inhibits their growth.
• Endoscopic submucosal dissection (ESD): Surgeons may employ ESD to treat esophageal cancer in its extremely early stages.
• Endoscopic mucosal resection (EMR): Surgeons utilize this technique to remove tumors from the mucous lining of your esophagus.
• Endoscopic laser therapy: When tumors may obstruct your esophagus, making it difficult for you to swallow, this treatment helps to relieve symptoms.
• Using medications referred to as photosensitizers, photodynamic treatment (PDT) eliminates tumors. These medications are activated by light, which causes a chemical reaction that kills cancer.
• Targeted therapy: The HER2 protein is abnormally abundant in some esophageal cancer cells. Drugs that target HER2 proteins are used by medical professionals in targeted treatment to treat esophageal cancer.
• Immunotherapy: Immune checkpoint inhibitors are used in this therapy. These medicines aid in improving how well your immune system reacts to esophageal cancer cells.

How Can We Prevent Esophageal Cancer?

Your chance of developing esophageal cancer can be decreased. Consider this:

• Stop smoking. Consult your doctor about quitting smoking if you do. You can quit smoking with the aid of medications and counseling. If you don't already smoke, refrain from doing so.
• If you decide to consume alcohol, do so moderately. For healthy individuals, that means no more than one drink for women and two for men per day.
• Boost your veggie and fruit intake. Include a range of fruit and vegetable colors in your diet.
• Maintain a healthy weight. Consult your doctor about weight-loss techniques if you are overweight or obese. Go slowly and steadily.

What Are The Complications Of Esophageal Cancer?

Complications from esophageal cancer's progression include:

• Esophageal obstruction. Food and liquid passage down your esophagus may become challenging if you have cancer.
• Pain. Advanced esophageal cancer may cause discomfort.
• An esophageal bleed. Esophageal cancer may result in bleeding. While bleeding typically occurs gradually, it can occasionally happen suddenly and be very severe.

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