Disease: Esophageal cancer

    Overview

    Esophageal cancer is cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.

    Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.

    Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.

    Esophageal cancer care at Mayo Clinic

    Source: http://www.mayoclinic.com

    Symptoms

    Signs and symptoms of esophageal cancer include:

    • Difficulty swallowing (dysphagia)
    • Weight loss without trying
    • Chest pain, pressure or burning
    • Worsening indigestion or heartburn
    • Coughing or hoarseness

    Early esophageal cancer typically causes no signs or symptoms.

    When to see a doctor

    Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

    If you've been diagnosed with Barrett's esophagus, a precancerous condition that increases your risk of esophageal cancer caused by chronic acid reflux, ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening.

    Screening for esophageal cancer isn't done routinely except for patients with Barrett's esophagus because of a lack of other easily identifiable high-risk groups. If you have Barrett's esophagus, discuss the pros and cons of screening with your doctor.

    Source: http://www.mayoclinic.com

    Causes

    It's not exactly clear what causes esophageal cancer.

    Esophageal cancer occurs when cells in your esophagus develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

    Types of esophageal cancer

    Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

    • Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.
    • Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
    • Other rare types. Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.

    Source: http://www.mayoclinic.com

    Diagnosis

    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 (videoendoscope) down your throat and into your esophagus. Using the endoscope, your doctor examines your esophagus, looking for cancer or areas of irritation.
    • Collecting a sample of tissue for testing (biopsy). Your doctor may use a special scope passed down your throat into your esophagus (endoscope) to collect a sample of suspicious tissue (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, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.

    Tests may include:

    • Endoscopic ultrasound (EUS)
    • Computerized tomography (CT)
    • Positron emission tomography (PET)

    Your doctor uses the information from these procedures to assign your cancer a stage. The stages of esophageal cancer are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating that the cancer is small and affects only the superficial layers of your esophagus. By stage IV, the cancer is considered advanced and has spread to other areas of the body.

    The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you.

    Source: http://www.mayoclinic.com

    Complications

    As esophageal cancer advances, it can cause complications, such as:

    • Obstruction of the esophagus. Cancer may make it difficult or impossible for food and liquid to pass through your esophagus.
    • Pain. Advanced esophageal cancer can cause pain.
    • Bleeding in the esophagus. Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.

    Source: http://www.mayoclinic.com

    Prevention

    You can take steps to reduce your risk of esophageal cancer. For instance:

    • Quit smoking. If you smoke, talk to your doctor about strategies for quitting. Medications and counseling are available to help you quit. If you don't use tobacco, don't start.
    • Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
    • Eat more fruits and vegetables. Add a variety of colorful fruits and vegetables to your diet.
    • Maintain a healthy weight. If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.

    Source: http://www.mayoclinic.com

    Alternative medicine

    Complementary and alternative therapies may help you cope with the side effects of cancer and cancer treatment. For instance, people with esophageal cancer may experience pain caused by cancer treatment or by a growing tumor. Your doctor can work to control your pain by treating the cause or with medications. Still, pain may persist, and complementary and alternative therapies may help you cope.

    Options include:

    • Acupuncture
    • Guided imagery
    • Massage
    • Relaxation techniques

    Ask your doctor whether these options are safe for you.

    Source: http://www.mayoclinic.com

    Coping and support

    Coping with the shock, fear and sadness that come with a cancer diagnosis can take time. You may feel overwhelmed just when you need to make crucial decisions. With time, each person finds a way of coping and coming to terms with the diagnosis.

    Until you find what brings you the most comfort, consider trying to:

    • Find out enough about esophageal cancer to make decisions about your care. Ask your doctor for the specifics about your cancer, such as its type and stage. And ask for recommended sources of information where you can learn more about your treatment options. The National Cancer Institute and the American Cancer Society are good places to start.
    • Stay connected to friends and family. Your friends and family can provide a crucial support network for you during your cancer treatment. As you begin telling people about your esophageal cancer diagnosis, you'll likely get offers for help. Think ahead about things you may like help with, whether it's having someone to talk to if you're feeling low or getting help preparing meals.
    • Find someone to talk to. You might have a close friend or family member who's a good listener. Or talk to a counselor, medical social worker, or pastoral or religious counselor.

      Consider joining a support group for people with cancer. You may find strength and encouragement in being with people who are facing the same challenges you are. Ask your doctor, nurse or social worker about groups in your area. Or try online message boards, such as those available through the American Cancer Society.

    Source: http://www.mayoclinic.com

    Risk factors

    It's thought that chronic irritation of your esophagus may contribute to the changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

    • Having gastroesophageal reflux disease (GERD)
    • Smoking
    • Having precancerous changes in the cells of the esophagus (Barrett's esophagus)
    • Being obese
    • Drinking alcohol
    • Having bile reflux
    • Having difficulty swallowing because of an esophageal sphincter that won't relax (achalasia)
    • Having a steady habit of drinking very hot liquids
    • Not eating enough fruits and vegetables
    • Undergoing radiation treatment to the chest or upper abdomen

    Source: http://www.mayoclinic.com

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