Esophageal cancer is a serious form of cancer that develops in the esophagus, the long tube that connects the back of your mouth with your stomach. The most common types of esophageal cancer are adenocarcinoma, which starts in the glandular cells producing fluids such as mucus, and squamous cell carcinoma, which starts in flat cells of the esophageal lining. Although the causes of esophageal cancer aren’t known, chronic irritation from gastroesophageal reflux disease (GERD), Barrett’s esophagus, smoking, obesity, and heavy alcohol use are leading risk factors for the disease.
- Difficulty in swallowing
- Unintentional weight loss
- Chest pain
- Hoarse voice
DIAGNOSING ESOPHAGEAL CANCER:
Tests and procedures used to diagnose esophageal cancer include:
Using a scope to examine your esophagus (endoscopy)
During endoscopy, your doctor passes a flexible tube equipped with a video lens (video endoscope) down your throat and into your esophagus. Using the endoscope, your doctor examines your esophagus, looking for cancer or areas of irritation. Samples of suspicious tissue can be collected (biopsy). The tissue sample is sent to a laboratory to look for cancer cells.
Determining the extent of the cancer
Once a diagnosis of esophageal cancer is confirmed, additional tests may be ordered to determine whether your cancer has spread to your lymph nodes or to other areas of your body. Endoscopic ultrasound (EUS), Computerized tomography (CT), Positron emission tomography (PET).
SURGICAL TREATMENT OPTIONS:
EARLY STAGE ESOPHAGEAL CANCER
Cancer occurs when the abnormal cells involved in Barrett’s esophagus have rapid and uncontrolled growth and invade the deeper layers of your esophagus. This is called cancer of the esophagus, or esophageal adenocarcinoma (EAC). The cancer can also spread beyond the esophagus. A majority of patients with esophageal cancer have Barrett’s esophagus, although unfortunately most of them don’t know they have it until cancer develops.
Until recently, all patients diagnosed with esophageal cancer were offered curative esophagectomy, surgery to remove the esophagus, to manage their disease. While this treatment is very effective for early-stage cancer, removing the esophagus significantly affects one’s ability to eat and live normally. A newer minimally invasive procedure has been developed to help patients with early-stage esophageal cancer. Good evidence has been published to show that patients can benefit from an Endoscopic Mucosal Resection. This procedure is done as an outpatient under sedation. A flexible tube is inserted into the esophagus via the mouth allowing the surgeon to remove a portion of the cancer from the lining of the esophagus. This lower risk procedure allows the patient to eat and live normally Follow up care after treatment is very important and patients should schedule regular checkups regularly to make sure the cancer does not return.
LOCALLY ADVANCED ESOPHAGEAL CANCER
For advanced esophageal cancer, a minimally invasive esophagectomy is the recommended course of treatment. During this surgical procedure, part of the esophagus, which is the tube between the mouth and stomach, is removed and then reconstructed using part of another organ usually the stomach. The minimally invasive surgical esophagectomy techniques have evolved since the early days when the entire esophagus was removed and replaced with the stomach. Today, the surgical treatment is based upon the size and location of the tumor. All esophagectomy procedures can be performed using minimally invasive surgical techniques, which result in less pain, shorter hospital stays, and faster recovery than traditional open surgery.