Esophageal Cancer Treatment in Delhi, India
Overview
Esophageal cancer is a medical condition that develops when the abnormal cells in the esophagus continue to grow out of control, leaving very little space for normal cells to grow, making it hard for the body to function effectively.
Types of Esophageal Cancer
Esophageal cancer is mainly divided into two categories.
Squamous cell carcinoma
Squamous cell carcinoma is a type of cancer that develops in the cells lining the esophagus (squamous cells) and usually affects the upper and middle portions of the esophagus.
Adenocarcinoma
Adenocarcinoma develops in the lower portion of the esophagus in the cells of mucous-secreting glands.
Associated Anatomy of Esophageal Cancer
Esophageal cancer develops in the esophagus or the food pipe, which helps move food down from the throat to the stomach.
Esophageal Cancer Causes
Currently, the exact cause behind esophageal cancer is not fully understood. Research suggests that changes in the genetic structure allow the cells to grow out of control. It is the accumulation of these abnormal cells that result in the formation of a tumor in the esophagus, which may spread to other parts of the body.
Esophageal Cancer Symptoms
While initial stages of esophageal cancer show no symptoms, in the later stages, one may develop the following symptoms.
- Coughing or vomiting blood
- Trouble swallowing food
- Indigestion
- Heartburn
- Choking while eating
- Extreme weight loss
- Chronic cough
- Pain in the back of the throat
- Chest pain
- Fatigue
Esophageal Cancer Diagnosis
The first step of diagnosing esophageal cancer involves conducting a physical exam to check for any symptoms of cancer. If the doctor suspects esophageal cancer, they may suggest a battery of tests for further diagnosis, such as an endoscopy where a thin tube is inserted down the throat to examine the lining of the esophagus.
In all cases, the doctor conducts a biopsy which includes taking sample tissue from the esophagus and sending it for testing. Another way of diagnosing esophageal cancer is to have liquid barium contrast, which makes it easier to see the esophagus during x-rays. Complete work up includes CT Chest + abdomen / PET CT Whole body.
Stages of Esophageal Cancer
For better understanding and treatment of esophageal cancer, medical professionals have divided esophageal cancer into four stages.
- Stage 0 – (Precancerous Stage) The cancer is on the top cell lining of the esophagus
- Stage 1A - The cancer is in one of the top layers of the esophagus
- Stage 1B - The cancer is in the top or third layer of the esophagus without spreading to other parts of the body
- Stage 2A - Cancer has spread to either in the outer top, middle, or lower portion of the esophagus
- Stage 2B - The cancer is in the outer layer of the upper or middle portion of the esophagus and has spread to one or two lymph nodes near the cancer
- Stage 3A - The cancer is in any part of the esophagus or the third layer of the esophagus and has spread to three to six lymph nodes nearby.
- Stage 3B - The cancer is in any part of the esophagus and has grown into a third layer or surrounding structure of the esophagus.
- Stage 4A - The cancer is in any part of the esophagus and has spread to seven or more lymph nodes.
- Stage 4B - Cancer has spread to other parts of the body.
Esophageal Cancer Treatment
The treatment is dependent on factors such as the size and location of cancer and whether it has spread to other parts of the body or not. Once these factors are determined, the doctor may recommend either one or a combination of the following treatment options to treat cancer.
Surgery
A surgeon may conduct an esophagectomy where a portion of the esophagus along with the surrounding tissues and a few lymph nodes are removed. They may restructure the food pipe by taking tissue from the large intestine or stomach. Surgery may be performed by an open or minimally invasive method. The latest and best being Robotic Surgery.
Chemotherapy
Chemotherapy is an aggressive form of drug therapy where the patient is injected intravenously with medication to destroy the cancer cells.
Radiation therapy
In this procedure, a beam of radiation is used to destroy the cancer cells in the esophagus. Radiation therapy is conducted in conjunction with chemotherapy before or after surgery.
Risk Factors of Esophageal Cancer
Studies indicate that irritation in the esophageal cells may increase the risk of developing esophageal cancer. They are:
- Family history of neck or esophageal cancer
- Excess consumption of alcohol
- Excessive chewing or smoking of tobacco
- People diagnosed with HPV infection have a higher chance of developing esophageal cancer
- Individuals with a history of gastroesophageal reflux disease (GERD) or acid reflux
- Barrett’s esophagus is a condition where the pink lining of the esophagus is damaged by acid reflux which leads to a thicker and redder lining.
- Being overweight or obese
- Achalasia is a rare medical condition where the esophagus is unable to move liquid and food from the throat to the stomach
- Not eating adequate vegetables and fruits.
Complications of Esophageal Cancer
Esophageal cancer may result in possible complications such as low red blood cells (anemia), severe pain in the esophagus, bleeding, and difficulty swallowing liquids and fluids.
Esophageal Cancer Preventions
Primary Prevention of Esophageal Cancer
While esophageal cancer cannot be completely avoided, there are some ways to decrease the risk of developing esophageal cancer. These include:
- Limit or avoid the consumption of alcohol and tobacco
- Eating a healthy diet rich in fruits and vegetables and keeping physically active by exercising.
Secondary Prevention of Esophageal Cancer
- Radiation therapy or chemotherapy at the site of recurrence can kill cancerous cells after the surgery.
- Have regular follow-up exams and screening tests to look for signs of recurrence of cancer.
Epidemiology of Esophageal Cancer
Esophageal cancer is the sixth most common cancer in the world. Studies estimate that:
- People over the age of 60 years of age.
- Men are at a higher risk of developing esophageal cancer than women.
- Approx. 47,000 cases are diagnosed each year in India with a mortality of around 42,000 per year.
Expected Prognosis of Esophageal Cancer
Esophageal cancer has a poor prognosis due to the majority of the cases being diagnosed in the later stages. If the cancer is caught in the earlier stages then chances of recovering from it are better with surgery and a combination of radiation and chemotherapy. Studies estimate that the five-year survival rate of people with esophageal cancer is 19.2%.
Natural Progression of Esophageal Cancer
Like other cancer types, if left untreated, esophageal cancer spreads to surrounding organs such as the lymph nodes, blood vessels in the chest, and so on. This progression may cause life-threatening health conditions and can even lead to death.
Pathophysiology of Esophageal Cancer
Esophageal cancer is characterized by the abnormal growth of cells in the esophagus. It is majorly caused by changes in the genetic structures of the cells, and it remains one of the leading causes of cancer-related death worldwide.