A Family Doctor's Tale - ESOPHAGEAL CANCER

DOC I HAVE ESOPHAGEAL CANCER

Esophageal cancer is not very common in family practices because most patients are either warded in hospital or undergoing special treatment in the hospitals. I used to see some cases in the general surgery wards. However esophageal cancer is not a common cancer. Any one who smokes or drinks alcohol is a potential  victim of this form of cancer.

Esophageal cancer is the growth of abnormal cells in the lining and wall of the esophagus which mutates and proliferates giving rise to the esophageal cancer growth. Esophageal Cancer can spread to the surrounding organs like liver,pancreas and colon. Once in the blood stream it can spread to the brain, bones and kidneys.

There are 2 types of esophageal cancer:
1.Adenocarcinoma -lower one third of the gullet which is also more common
 
2.Squamous Cell Carcinoma - upper one third of gullet

Causes:
1 Age 65 or older:

2 male: men are three times more likely as women to develop esophageal cancer.

3.Smoking: smokers are more likely to develop esophageal cancer.

4. Heavy drinking: increases the risk of squamous cell carcinoma of the esophagus.

5. Diet: meat and carbonated drinks increases the risk of adenocarcinoma

6.Obesity: increases the risk of adenocarcinoma of the esophagus.

7.Acid reflux:  may lead to adenocarcinoma of the esophagus in some people.

In the early stages, esophageal cancer may have no symptoms. As it spread it can

cause the following symptoms:
1.pain on swallowing
2.pain in the chest
3.heartburn
4.hoarse voice
5.loss of weight

Diagnosis is by:
1.medical history and  complete physical exam.
2.Barium meal show obstruction in the gullet
3.Endoscopy:  a thin, lighted tube is put into your mouth and passed down to your esophagus.
4.Biopsy: During endoscopy, a small piece of your suspicious cancerous tissue is

taken to check for cancer cells. This is called a biopsy sample which is then examined under a microscope for cancer cells.

Treatment for esophageal cancer may include surgery, chemotherapy or radiation therapy, or a combination of these treatments.
The choice of treatment depends on whether the cancer is just in the esophagus or if it has spread to other places in the body.
A person’s age and overall health will also affect the choice of treatment.

Surgery
Surgery is still the best form of treatment for esophageal cancer.
For smaller cancers -partial removal of the esophagus is done. In early stages the cure rate is about 90%.
For later stages of cancer, the whole esophagus and surrounding tissues may be removed and a feeding tube is placed in the small intestine

Chemotherapy
Chemotherapy is used in conjunction with surgery in later stages of cancer and given though the veins 

Radiotherapy:
Radiation can help to kill the cancer cells surrounding the esophageal cancer as well as to relieve pain.External and internal radiation may be done before or after surgery

There is no way to prevent esophageal cancer.
However, you can help reduce your risk of getting stomach cancer by:
Living a healthy lifestyle
Not drinking a lot of alcohol or smoking.
Avoid preserved food
Eat a diet high in fresh fruits and vegetables, and vitamin C. Vitamin C is found in foods such as oranges, grapefruit and broccoli.