Cancer de l’œsophage

Esophagus Cancer

Esophagus Cancer is the cancer that occurs in the Esophagus – the long, hollow tube that runs from our throat to the stomach. The esophagus carries the food items from the throat to the stomach for digestion.

Generally, esophagus cancer (also called esophageal cancer) occurs in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. It is seen that males are more prone to esophagus cancer than females.

Causes of Esophagus Cancer

The exact cause of esophagus cancer is still not known. The disease happens due to mutations in the DNA of cells which causes the cells to multiply abnormally. The excess cells form a tumor that grows and eventually spreads to other organs (metastates) if not treated. 

However, the following are considered to be the risk factors of Esophagus cancer:

  • GERD– Gastro-Intestinal Reflux Disease or GERD is a digestive disorder where the acids that help your stomach break down and process the food starts to push up the esophagus. Frequent acid reflux or chronic GERD can result in esophagus damage or cause cancer.
  • Poor Lifestyle. Lifestyle choices like poor dietary routine, tobacco and alcohol consumption, choosing fast food over nutritious food, etc can directly or indirectly (chronic indigestion) lead to this condition.
  • Barrett’s Esophagus. This is a medical condition that causes precancerous changes in the cell and can be one of the leading causes for esophagus cancer.

Other reasons may include:

  • Obesity
  • Achalasia (medical condition)
  • Drinking very hot beverages frequently/ persistently
  • Lack of nutrition
  • Previous radiation / chemo
  • Other types of chronic digestive disorder

Prevention of Esophagus Cancer

Following are some of the recommended steps for reducing risk of esophagus cancer (as well as, other types of cancers):

  • Quit smoking
  • Drink alcohol in moderation, if you have to. 
  • Eat more fruits & green vegetables
  • Maintain a healthy wait
  • Maintain an active lifestyle.

Types of Esophagus Cancer

There are broadly two types of esophagus cancers:

Squamous Cell Carcinoma– This type of cancer develops in the thin, flat cells that form the inner lining of the esophagus. Even though the most common places are the top and the middle, Squamous cell carcinoma can appear anywhere in the esophagus lining.

Adenocarcinoma- The esophagus contains certain glandular cells that are primarily responsible for fluid production in the esophagus. Cancer developing in these cells is medically termed as adenocarcinoma. This type of cancer most often occurs in the lower end of the esophagus (close to the stomach)

Others- While the above two are the most common type, there are other types such as small cell carcinoma, melanoma, lymphoma and more that can be accounted for.

Symptoms of Esophagus Cancer

In Esophageal cancer, early stages usually come with zero or no symptoms. It is not until the cancer progresses to the advanced stage, do the symptoms start showing.

Common symptoms for Esophagus cancer would include:

  • Discomfort, difficulty, and pain in swallowing
  • Hoarseness in voice
  • Severe coughing (chronic)
  • Sudden loss of weight (unintentional)
  • Frequent indigestion or acid reflux
  • Dry throat (and even mouth)
  • Chest pain or burning sensation in chest
  • Severe tiredness
  • Nausea (may be accompanied by vomiting)

Esophagus Cancer Stages

  • Stage 1: Cancer is detected in the inner esophagus lining.
  • Stage 2: Cancer has spread to the outer layer of the esophagus
  • Stage 3: Cancer may have spread deeper into the inner layers or the surrounding tissues and cells around the esophagus
  • Stage 4: Cancer is progressive and is spreading to other parts of the body.

Diagnosis of Esophagus Cancer

If the symptoms mentioned above start showing up, your healthcare professional will recommend one or more than one clinical tests to determine or identify the cancerous cells. Diagnostic tests may include:

Biopsy

Normal biopsy where a tissue is extracted from the suspected region and tested for presence of cancer.

Endoscopy

An endoscopy where the doctor uses a tube and image-guidance to view the esophagus lining and determine signs of abnormality

Scans

A MRI, CT or PET scan to determine the exact position of the cancer and whether it is spreading or not.

X-Ray

A X-Ray test known as barium swallow where the barium chemical helps highlight the images inside your body in an X-Ray allowing doctors a detailed vision of the esophagus and the tissues or organs around it.

If you have Esophagus cancer, on diagnosis, the doctor will determine your condition based on the 4 stages of the cancer.

Treatment options for Esophageal Cancer

The treatment method will heavily depend on the cell type, but the most common treatment methods recommended by doctors would be: 

Surgery

Surgical intervention too will depend upon the severity of the condition. While some surgeries may aim to remove the cancerous tumor, other forms of surgery may remove parts of the esophagus or upper portion of the stomach, based on the origin and spread of the cancer. Most surgeries are open procedures, but surgical treatment for esophageal cancer may come with certain complications like internal bleeding or infection.

Chemo

Chemo is one of the most popular treatment methods for cancer that aims to eliminate the cancerous cells within the body and can stop active cancer cells from spreading further. Chemo is often used alongside radiation treatment but even though it’s effective, this form of treatment may come with some side effects of its own, for instance, hair loss, nause, tiredness, and pain could be some of the side effects of chemo.

Radiation Treatment

Radiation treatment uses high beams of radiation (X-Rays or Protons) to eliminate the cancer cells from the body. This form of treatment can also relieve symptoms. However, radiation treatment too comes with its own side effects which may include pain, swallowing-difficulty, sunburn-like conditions in skin.

Immuno Treatment

Immuno treatment (also called biological treatment) is a new type of cancer treatment where the body’s immune system is boosted to help the body fight cancer by itself. Immuno treatment uses substances made by the body or in a laboratory to improve or restore immune system function.

What should my long-term expectations be?

Esophagus cancer, in the earlier stages can be cured completely. However, if you’ve already moved to the advanced stage, chances of complete cure can be difficult. However, it can always be treated to keep the symptoms in check. Chances of survival or cure are more if the cancer is not proactively progressive in nature.

FAQs

Are there any alternate treatment methods?

You can try other natural treatment methods like acupuncture, massage, aroma treatment, etc at home to keep the symptoms in check but the primary form of treatment would either include chemo, radiation, both or surgery.

What is the survival rate for esophagus cancer?

If the cancer is diagnosed at the right time, the survival rate would be something around 47-50%. However, if the cancer is progressive in nature, the survival rate drops down to around 25%. 

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