Cancer is a word that strikes fear into the hearts of many people, and for good reason. It is a complex and often devastating disease that can strike anyone, at any time, regardless of age, gender, or lifestyle. Although medical science has made significant advances, cancer is still one of the major causes of death globally. The disease is especially insidious since it frequently has no early signs, making it possible for it to go unnoticed and untreated until it has already evolved to an advanced state.

1. What is Esophageal Cancer?

The esophagus is a long, hollow tube that connects your throat to your stomach and aids in the movement of food. Generally, the inner lining (mucosa) of the esophagus is where esophageal cancer first manifests itself.

Esophageal cancer develops when mutations in DNA disrupt the control of cell division, allowing cells to multiply and expand uncontrollably until they merge into a tumor.

Esophageal cancer is the tenth most prevalent cancer in the world and ranks sixth when it comes to being a fatal disease. It is more common among men than in women.

Use of tobacco and alcohol, certain dietary habits, and obesity may all contribute to greater risks of esophageal cancer.

2. Causes of Esophageal Cancer

The exact cause of esophageal cancer still remains unknown; nevertheless medical professionals have recognized some risk factors that raise the possibility of acquiring esophageal cancer.

2.1. General Cause of Esophageal Cancer

• Use of tobacco and alcohol
• Obesity
• Chronic acid reflux and Barrett’s esophagus
• People with long-term heartburn sufferers are more likely to get esophageal cancer even if they don’t have Barrett’s esophagus.
• Human papillomavirus (HPV)
• People who have a history with cancer
• People who are exposed to chemicals for a long time
• Individuals with other disorders such as achalasia and tylosis.

2.2. Causes of Squamous Cell Carcinoma

Squamous cell esophageal cancer or squamous cell carcinoma can be brought on by:

• extremely hot beverage consumption
• drinking and smoking
• intake of burned-smoked food

Gastroesophageal reflux disease (GERD) typically causes esophageal adenocarcinoma cancer.

3. Symptoms of Esophageal Cancer

We will divide esophageal cancer symptoms into two part; first symptoms of esophageal cancer and other symptoms that gradually follow.

3.1. What is the First Sign of Esophageal Cancer?

Esophageal cancer generally doesn’t show signs until the tumor has gotten big enough to obstruct swallowing, eating, or digestion. However, having trouble swallowing (dysphagia) is typically the first symptom of esophageal cancer.

Early-stage esophageal cancer patients might experience a feeling of food being stuck in their throat or chest that could cause choking.

Although the signs of esophageal cancer are often mild at first, it typically gets worse as the tumor grows and can ultimately result in choking or an inability to swallow even liquids.

In some cases, there are no noticeable symptoms of the malignancy even when the cancer has occupied almost fifty percent of the esophagus.

The early signs of esophageal cancer in the elderly can include frequent drooling on the pillow and difficulty swallowing.

3.2. Other Signs of Esophageal Cancer

Other factors that contribute to the symptoms of esophageal cancer are as follows:

3.2.1. Chest Pain or Discomfort When Swallowing

People who suffer from gastroesophageal reflux disease (GERD) or chronic heartburn are very familiar with the accompanying pain, which feels like pressure or a burning sensation in the center of the chest. Similar sensation of chest pain can also be brought on by patients developing esophageal cancer, which often manifests itself within a few minutes after swallowing when food enters the esophageal tumor site.

3.2.2. Unintended Weight Loss or Change in Appetite

Many patients who have contracted esophageal cancer lose weight. This could be an outcome of insufficient eating because of swallowing issues. Moreover, every type of cancer, including esophageal cancer, can result in an increase in metabolism or a decrease of appetite.

3.2.3. Voice Hoarseness

Esophageal cancer patients experience an alteration of voice. The vocal cords may be squashed by an esophageal tumor, altering the patient’s voice. As an esophageal tumor advances, it may harm laryngeal nerves and interfere with neuronal impulses that travel to the voice box, paralyzing the vocal cords. Laryngeal nerve palsy is a disorder that can occasionally cause the vocal cord nerves to entirely stop functioning.

3.2.4. Chronic Cough

Excess mucus or blood from an esophageal tumor may result in a chronic cough. On rare occasions, a tumor may cause the trachea—the tube that transports air to the lungs—and the esophagus to connect. This erratic airway, known as a tracheoesophageal fistula (TEF), may also cause a cough.

3.2.5. Vomiting Blood

An obstruction in the throat caused by a tumor may result in blood loss which may reach the stomach. In such scenarios patients are likely to notice a spat of blood while vomiting. Stools may turn black as a result of the blood. Anemia, or decreased red blood cell counts, and weariness from blood loss can result from severe bleeding.

3.2.6. Indigestion and Heartburn

Another way individuals might define their chest pain is as heartburn. The sensation of discomfort in the upper abdomen could result from an esophageal tumor.

4. Diagnosis of Esophageal Cancer

The first step of devising a strategy for treating esophageal cancer is a comprehensive and precise cancer diagnosis. A doctor will inquire about your complaints and health background. The professionals treating you will employ a range of exams and instruments created for esophageal cancer diagnosis, assessing the condition, and creating your specific treatment plan.

For diagnosis, the doctor might do the following tests:

4.1. Imaging tests

Imaging test techniques used to identify esophageal cancer include barium swallow (esophagram), CT scans, PET scans and MRI. Imaging tests help in detecting the tumor in the esophagus as well as help in determining whether cancer has spread to distant organs like the liver.

4.2. Endoscopy of the Esophagus

Endoscopy is done to detect any abnormalities in the inner lining of the esophagus. Three ways of performing endoscopy are upper endoscopy, endoscopic ultrasound (EUS) and bronchoscopy.

4.3. Biopsy and lab test

Biopsy helps distinguish between two kinds of esophageal cancer; squamous cell carcinoma (that affects the squamous cells of the esophagus) and adenocarcinoma that have different prognoses and therapies. Biopsy is done to make an accurate diagnosis.

4.4. Advanced Genomic Testing

Another test called advanced genomic testing analyzes a tumor for DNA mutations that might be causing the growth and multiplication of the tumor. The doctors treating you may be able to change your cancer treatment by determining the changes that take place in a cancer cell’s genome.

4.5. Blood tests

Although a blood test alone cannot diagnose esophageal cancer but it surely helps provide further details about what’s going on inside your body. This blood test includes complete blood count (CBC) and liver panel.

5. Treatment of Esophageal Cancer

Treatment for esophageal cancer will depend on the sort of cells that are causing it, its stage, your general health, and your treatment preferences.

Several different types of treatment for esophageal cancer include:

• Surgery: The most typical course of treatment for early-stage esophageal cancer is an esophagectomy.  It entails removing part or all of the esophagus and the tissue around it and creating a new esophagus.
• Immunotherapy: Immune checkpoint inhibitors are used for this treatment. These medicines help in improving how well your immune system reacts to esophageal cancer cells.
• Chemotherapy: Chemotherapy either eliminates cancer cells or prevents their growth.
• Radiation Therapy: A radiation beam directed at the tumor causes the death or destruction of cancer cells.
• Targeted Therapy: The quantity of the HER2 protein in some esophageal cancer cells is unusually high. This protein promotes the growth of cancer cells. In targeted therapy, HER2 protein-targeting medications are used to treat esophageal cancer.
• Photodynamic Therapy (PDT): Drugs known as photosensitizers are used in photodynamic treatment to eradicate cancers.
• Endoscopic laser therapy: This treatment eases the blockage of esophagus.

6. Preventive measures

One can avoid the risk of esophageal cancer by maintaining healthy eating habits and a healthy weight.

Avoiding the consumption of alcohol and smoking also helps with the prevention of esophageal cancer.

Managing gastroesophageal reflux disease and achalasia is another way of preventing this disease.

Preventing Human Papillomavirus Infection (HPV) or even if you have been infected, vaccinating against this infection could help prevent the risk of esophageal cancer.

7. Conclusion

Signs of esophageal cancer might not initially be evident to patients, nevertheless, the first sign of esophageal cancer includes swallowing problems where the patients might have trouble swallowing food or liquid.

It is important to remember that esophageal cancer is difficult to detect at its initial stages, hence one can be wary about this cancer following certain simple symptoms that one may not even bat an eye to. If you are experiencing any of the above-mentioned symptoms then it is wise to go visit a doctor, do a thorough check, and get medical assistance because we all know that “precaution is better than cure”.

Last Updated on December 26, 2023 by soubhik92@gmail.com