What You Need to Know About Esophageal Cancer

Cancer is a serious illness wherein abnormal cells multiply uncontrollably and may spread to other areas of the body. There are more than 200 types of cancer and esophageal cancer is one of them.

What is Esophageal Cancer?

Esophageal cancer is a type of cancer that attacks the esophagus. The esophagus is a tubular, elongated organ that connects the pharynx and stomach. The primary function of the esophagus is to transport food and liquid from the throat to the stomach.

Cancer of the esophagus can affect any area along this organ. Initially, the cancer develops in the inner layer of the esophagus wall and spreads outward through the other layers.

On a global level, esophageal cancer is the 8^th most common type of cancer. Additionally, it is the 7^th most prevalent cancer in men and the 13^th most common in women.

Types of Esophageal Cancer

There are different types of esophageal cancer, but adenocarcinoma and squamous cell carcinoma are the most common.

Adenocarcinoma

Adenocarcinoma originates in glandular cells, which aren’t usually present in the lining of the esophagus. Condition Barrett’s esophagus can lead to the formation of these cells. This type of esophageal cancer primarily affects the lower part of the esophagus and the upper part of the stomach.

As the most common type of esophageal cancer, adenocarcinoma primarily affects middle-aged, overweight, Caucasian men. The increased prevalence of adenocarcinoma, compared to the 1970s, could be due to the high incidence of gastroesophageal reflux disease (GERD), which causes chronic inflammation.

Squamous cell carcinoma

Squamous cells are located in the epithelium that makes the surface of the skin. They are present in different parts of the body, including the esophagus. The cancer begins when these cells start dividing abnormally. Squamous cell carcinoma affects the upper and middle areas of the esophagus primarily.

Symptoms of Esophageal Cancer

Esophageal cancer manifests itself through the following signs and symptoms:

• Dysphagia (difficulty swallowing)
• Chronic cough
• Hoarse voice
• Indigestion or heartburn
• Unintentional weight loss
• Loss of appetite
• Pressure, burning, or pain in the chest
• Feeling sick
• Vomiting
• Black stool (due to bleeding into the esophagus, uncommon)

Causes of Esophageal Cancer

The exact cause of esophageal cancer is unclear. The cancer itself results from DNA mutations in cells of the esophagus. Due to mutations, cells start multiplying rapidly. Abnormal cells keep building up, which may lead to cancer. However, it’s not known why these changes occur. Some DNA mutations can run in families, but most of them are acquired. That means a person may develop mutations in their DNA, but they don’t pass them on to their children.

Risk Factors for Esophageal Cancer

Factors that increase the risk for esophageal cancer include:

• Advancing age
• Being a male
• Smoking cigarettes and cigars or chewing tobacco
• Drinking alcohol
• Having GERD
• Bile reflux
• Overweight and obesity
• A diet high in processed meat
• A sedentary lifestyle and lack of physical activity
• Achalasia (difficulty swallowing due to esophageal sphincter’s inability to relax)
• Drinking very hot liquids
• Radiation treatment to the chest or upper abdomen areas
• Barrett’s esophagus, a condition wherein the lining of the esophagus is damaged by stomach acid. Barrett’s esophagus causes precancerous changes in the cells.

When to See a Doctor?

Make sure to see a doctor if you’re experiencing the following problems:

• Difficulty swallowing
• Unintentional weight loss
• Persistent heartburn
• Symptoms of esophageal cancer that keep worsening

Schedule an appointment to see a doctor if you have a health problem that induces digestive symptoms, but current treatments cannot alleviate them successfully.

Most importantly, you should see a doctor if you experience any symptom that worries you. Doing so allows doctors to carry out necessary diagnostic tests identify the cause of the symptoms early and propose treatment promptly.

How is Esophageal Cancer Diagnosed?

If a doctor suspects you have an esophageal cancer, they may order tests such as:

• Endoscopy: the main goal of this test is to look into your esophagus. The doctor uses an endoscope (long, thin, flexible tube with a smaller camera inside) and passes it down the throat into the esophagus to look for areas of irritation or signs of cancer. The duration of gastroscopy is 10 to 15 minutes.
• Barium swallow study: for this test, it’s necessary to swallow a barium-containing drink prior to undergoing an X-ray. Since the barium covers the inside of the esophagus, tissue changes will be visible on X-ray.
• Computed tomography (CT) scan: takes multiple images so that a computer can combine them to show the specific part of the body studied. A CT scan may show whether esophageal cancer reached nearby or distant tissues and organs.
• Magnetic resonance imaging (MRI) scan: shows detailed images of soft tissues in the body. This test is useful for detecting esophageal tumors and metastases.
• Blood tests: a complete blood count test measures the concentration of different types of cells in blood. Low levels of red blood cells may indicate anemia. Some patients with esophageal cancer have low red blood cell count. Blood tests may also analyze liver enzymes to evaluate whether the liver is functioning normally. Sometimes esophageal cancer can spread to the liver and affect its function.
• Biopsy: involves collecting a sample of a suspicious tissue using an endoscope. Once collected, the sample is sent to a laboratory where it is observed for the presence of cancer cells.

Treatment Options for Esophageal Cancer

Treatment approach for esophageal cancer depends on factors such as:

• Size of the cancer
• Type of esophageal cancer
• Location of cancer
• Stage of cancer
• Your overall health and treatment preferences

The treatment may involve:

• Chemotherapy
• Surgery
• Radiation therapy
• Targeted drug therapy
• Immunotherapy

Chemotherapy

Chemotherapy relies on medications to destroy cancer cells. In treatment of esophageal cancer, chemotherapy is often used before or after surgery. Sometimes chemotherapy is used in combination with radiation therapy. Chemotherapy is used on its own in patients with advanced cancer.

Surgery

The doctor may recommend surgery alone or in combination with other treatment approaches. Surgery is recommended usually in cases when the cancer has been identified early and hasn’t spread to other organs and tissues. There are several approaches to surgery. The doctor chooses the best surgery for the specific needs of each patient. These may include:

• Removing small tumors: the surgeon may remove the cancer and the margin of healthy surrounding tissue if the cancer is very small.
• Esophagectomy: the removal of the part of the esophagus, portion of the upper part of the stomach, and neighboring lymph nodes. The remainder of the esophagus is connected to the stomach.
• Esophagogastrectomy: removal of a portion of the esophagus, nearby lymph nodes, and a bigger portion of the stomach.

The doctor may choose to perform an open procedure or minimally invasive surgery. The exact approach depends on each patient’s situation.

Radiation therapy

Radiation therapy relies on high-energy beams to destroy cancer cells. In treatment for esophageal cancer, radiation therapy is often used to treat early stages of cancer or to help manage symptoms of an advanced disease.

Targeted drug therapy

Targeted drug therapy focuses on specific issues in cancer cells, blocks them, and destroys cancer cells. This treatment approach is often combined with chemotherapy, especially when cancer doesn’t respond to other treatment strategies.

Immunotherapy

Immunotherapy is a type of treatment that strengthens the immune system so it can fight cancer. Doctors may recommend it when your cancer:

• Is advanced
• Has come back
• Reached other tissues in the body.

How King’s College Hospital London in Dubai Can Help?

While esophageal cancer is a complex disease, it is treatable with a well-structured treatment approach and expertise. King’s College Hospital London in Dubai is home to an excellent team of specialists, surgeons, and oncologists who provide the best possible care to each patient.

The hospital’s Cancer Care Centre offers advanced therapies in state-of-the-art facilities so that patients can feel confident their health is in good hands. In addition to the marvelous multidisciplinary doctor team, King’s College Hospital London in Dubai has a comforting and calming environment that provides emotional support to patients and their family members.

If you or your loved one is in a high-risk group for esophageal cancer or the disease itself, don’t wait – schedule an appointment at King’s College Hospital London in Dubai.