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Esophageal cancer affects men much more often than women. Can You Avoid It? Yes. However, you need to know what may be favorable to it.
Esophageal cancer – risk factors
The development of this cancer is fostered by excessive drinking of high-percentage alcohol and smoking (especially when started at an early age). These risk factors, as doctors call it, account for 80-90% of esophageal cancers. The disease is also favored by an improper diet, which should be understood as frequent use of spicy spices, drinking hot drinks, deficiencies of vitamins A, B2, C, E, trace elements, including zinc, magnesium, molybdenum and manganese.
People who have had mechanical injuries of the esophagus, have been subjected to chemical or thermal burns are also at risk of the disease.
But cancer can also develop in people who are infected with the Helicobacter pylori bacterium. In 5-12 percent of cases, esophageal cancer can occur together with other cancers, e.g. cancer of the mouth, larynx, throat, lung, kidney, bladder (this cancer is classified as tobacco-dependent cancer)
Squamous cell carcinoma is the most common cancer of the esophagus. It accounts for about 90 percent. all malignant neoplasms of this organ. 10 percent is an adenocarcinoma that usually occurs in the lower 1/3 of the esophagus.
Tumors of the esophagus – what is worth remembering?
The first symptoms of esophageal cancer (this concerns 90% of patients) are problems with swallowing, that is, using medical language – dysphagia. They appear when the tumor has spread to 2/3 of the esophagus. Most patients see a doctor for help when such ailments last 3 or even 6 months. Specialists distinguish four degrees of dysphagia:
I – possibility of swallowing solid food,
II – possibility of swallowing only comminuted food,
III – possibility of swallowing only liquids,
IV – aphagia, complete inability to swallow, even saliva
About 50 percent. the sick suffer because the pain when swallowing radiates to the back. Rarely, retrosternal pain, vomiting, regurgitation pneumonia, epigastric pain, or stench ex ore, or halitosis, are reported. When the disease develops, bloody vomiting, hemoptysis, oesophageal bronchial fistulas, hoarseness caused by the tumor infiltrating nerves in the larynx appear. Many patients lose weight quickly, which is related to difficulties in swallowing food.
Tumors of the esophagus – specialized examinations
Before starting treatment, the doctor must assess the patient’s general health, degree of malnutrition and dehydration, check for enlarged lymph nodes above the collarbones and in the neck, determine if the patient is coughing (coughing may indicate an oesophageal bronchial fistula) or hoarseness, enlarged liver.
Then, an X-ray of the esophagus is performed with contrast, which allows you to determine the type and size of the tumor. Lung X-rays are also done to make sure there are no metastases. Speculum examination (esophagoscopy) allows to determine the location of the tumor, the degree of esophageal stricture and to take specimens for histological examination. The next examination – ultrasound of the abdominal cavity and neck shows the picture of the liver, sub-diaphragmatic lymph nodes, supraclavicular and cervical area. If the tumor is in the upper and middle parts of the esophagus, bronchoscopy is performed. If the tumor picture is not clear, a CT scan should be performed. The efficiency of the respiratory system is assessed in a spirometric test. Basic tests also include blood and urine tests, assessment of the circulatory system.
More and more often, although not in all centers, endoscopic ultrasonography is used to diagnose esophageal neoplasms (it enables checking the condition of individual layers of the esophagus and lymph nodes), magnetic resonance imaging (MRI), and positron emission tomography (PET). Neoplastic markers characteristic of esophageal cancer are also assessed.
Tumors of the esophagus – treatment
The treatment that can be given to someone with esophageal cancer depends on the stage of the cancer. The treatment of choice is usually to remove the esophagus. Unfortunately, because most patients report to a specialist when the disease is very advanced, only 30 percent. patients can undergo surgery. The rest can be offered palliative or conservative treatment. Qualification for surgery is carried out according to special schemes that take into account the general condition of the patient, the absence of distant metastases, the proper functioning of the hematopoietic system, the proper functioning of the kidneys and liver. In addition, the patient must consciously consent to radical surgery.
Esophageal resection can be performed by several methods, e.g. by removing the thoracic esophagus, by dragging the stomach in the retrosternal tunnel, or by esophagus-gastric anastomosis on the neck.
The perioperative mortality is 5-30 percent. depending on the experience of the center. The most common complications are pneumonia, anastomotic leakage, and suppuration of the operating wound.
If the operation cannot be performed, radical radiotherapy or combination therapy is used, which consists in the use of radio- or radiochemotherapy before surgery. The most frequently used palliative procedures include laser therapy, enteral microplastics for feeding, bipolar coagulation, self-expanding esophageal prostheses. The most effective way to facilitate the patient’s swallowing is laser restoration of the esophagus and the use of radiotherapy (tele- or brachytherapy).
Esophageal cancer is a serious cancer. Only about 5 percent can count on a 8-year survival. sick. Among people who underwent combined treatment followed by surgery – 5-year survival is about 20-30%. With a very advanced cancer of the esophagus and the use of palliative treatment, the prognosis of the patient is poor. The survival time in such situations is estimated at 6-10 months.
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