If abnormal cells start to grow in an uncontrolled way in the oesophagus, it means a person has oesophageal cancer, which is very common among elderly people. Oesophageal cancer symptoms develop as the disease progresses and include pain with swallowing, heartburn, etc. Oesophageal cancer treatment depends on the stage of the disease and overall health of the patient. Below we are going to discuss this condition, as well as its symptoms, types, diagnostic services and oesophageal cancer treatment options in more details.
The oesophagus is a tube like structure that runs from your throat to your stomach. Food passes through your mouth to your stomach through your oesophagus. Oesophageal cancer develops when cancers cells become active in the oesophagus.
This normally starts in the inner layer and can spread to other layers of the oesophagus and other parts of the body. This is known as metastasis.
HOW MANY TYPES OF OESOPHAGEAL CANCER ARE THERE?
The two main types of oesophageal cancer are known as:
- Squamous cell carcinoma: When cancer cells appear in the flat thin cells that makeup the oesophageal lining. This type normally appears in the top or middle part of the oesophagus but can appear anywhere. As squamous cells line the inner oesophagus, cancer can affect the entire lining.
- Adenocarcinoma: When cancer cells occur in the glandular cells. These are the cells that are responsible for the fluids’ production such as mucus. This is the most common cancer in the lower half of the oesophagus. Squamous cells are replaced by gland cells when adenocarcinoma develops. This is believed to be related to acid exposure of the lower half of the oesophagus as it typically occurs at the area near the stomach.
OESOPHAGEAL CANCER SYMPTOMS
At the early stages of oesophageal cancer, you will most likely not experience any symptoms. However, as the cancer progresses, you may notice these symptoms:
- Unintended weight loss
- Trouble or painful swallowing
- Frequent choking while eating
- Unintentional regurgitation
- Pain in chest
OESOPHAGEAL CANCER TREATMENT OPTIONS
If the cancer has not spread to the other parts of your body, your doctor may recommend surgery. Alternatively, your doctor may also recommend chemotherapy or radiation therapy as the best treatment method. Sometimes, these treatments may also be used to shrink the tumours in the oesophagus so that they can be removed easily with surgery.
Your doctor may remove the tumour with an endoscope if the cancer is still contained within the superficial layers of your oesophagus. More serious cases involve removing a portion of your oesophagus and lymph nodes around it. In severe cases, a portion of the top of your stomach may be removed. Tissue from your stomach or large intestines will be used to reconstruct the tube.
The risks of surgery involve:
- Leaking in the area where the rebuilt tube was attached to the stomach
Drugs are used in chemotherapy to kill cancer cells and also to shrink the size of the tumour. Chemotherapy can be a solo treatment or combined with radiotherapy before or after surgery.
There are side effects to this treatment option and they are mostly related to the fact that the drugs affect your whole body; destroying healthy cells as well are also killed by the drugs. The side effect may vary depending on what drugs are used by your doctor.
What are the side effects of chemotherapy?
- Hair loss
- Pain in one or more parts of your body
- Dysfunctional peripheral nerves (Neuropathy)
Radiation beams are used to kill cancer cells. They may be administered externally using a machine or internally with a device placed near the tumour that is called brachytherapy. Radiotherapy is normally used with chemotherapy. Side effects are usually more severe when combined treatment is used.
What are the side effects of radiotherapy?
- Sun-burnt looking skin
- Pain or trouble swallowing
- Painful ulcers appear in the oesophagus lining.
It is possible for some side effects to be experienced long after treatment is completed. One of them is called oesophageal stricture where the tissue becomes less flexible. This can cause the oesophagus to become narrow and make it hard or painful to swallow.
DIAGNOSING OESOPHAGEAL CANCER
- History taking and physical exam: Your doctor will ask you questions about your symptoms, lifestyle and eating habits, as well as about your family history of medical conditions. Then he will perform a physical examination, which includes palpating your tummy area. All these is going to provide him a clearer picture of your condition.
- Gastroscopy (Upper endoscopy): The inside of your oesophagus and stomach are visually examined through endoscopy. A thin flexible tube with light and camera is inserted through your throat. A sample of tissue may be collected for further testing.
- Barium Swallow: The lining of your oesophagus can be seen when you swallow a substance called barium during X-ray imaging tests. This substance will be swallowed during the images are being obtained.
- Biopsy: A biopsy is performed where your doctor will take a sample of tissue from the abnormal looking area of your stomach which will then be sent for testing to determine if the tissue is cancerous.
CAN OESOPHAGEAL CANCER BE PREVENTED?
Even though there are no sure ways to prevent oesophageal cancer, there are steps that can be taken to lower the risks of developing this cancer:
- Avoid smoking cigarettes
- Avoid chewing tobacco
- Limit alcohol consumption
- Maintain a healthy weight
- Eat a healthy diet