Overview of Esophageal (Food Pipe)  Cancer

Many health problems like heart diseases, diabetes, cancers can occur due to unhealthy lifestyle. Poor lifestyle choices in today's times are considered one of the leading causes of many types of cancer. Habits that typically attract health issues are poor dietary practices, stress, lack of physical activity,  inadequate sleep, excessive alcohol consumption, and smoking. Smoking and alcohol consumption are the reason for the development of lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, colon, and rectum cancer.

Esophageal cancer is a tumour that develops in the esophagus (Food Pipe), the long hollow tube that  runs from the throat to the stomach. The esophagus functions to carry the food swallowed from the throat to the stomach for digestion. Esophageal cancer typically originates in the cells lining the esophagus and can develop  anywhere along the complete length of esophagus. It mainly affects elderly people and is more common in men than women. Esophageal considered the sixth most common cause of cancer mortality globally. A higher prevalence of esophageal cancer is attributed to unhealthy lifestyle habits  including tobacco, alcohol use, obesity, and poor eating practices.

 Symptoms

 Some of the common signs and symptoms of esophageal cancer include:

·       Difficulty swallowing (dysphagia)

·       Continuous  weight loss

·       Chest pain, or burning

·       Indigestion

·       Heartburn

·       Coughing

·       Hoarseness of voice

 Esophageal cancer in the early stage does not show any signs or symptoms.

Types of Esophageal Cancer

 Esophageal cancer is categorized according to the type of cells that are involved, which

 include:

 Adenocarcinoma: This type originates in the cells of mucus-secreting glands in the  esophagus, and usually develops in the lower part of the esophagus.

 Squamous cell carcinoma: The squamous cells are flat, thin cells lining the surface of the esophagus. This type mostly develops in the upper and middle parts of the esophagus.

 A few rare forms of esophageal cancer include small-cell carcinoma, sarcoma, lymphoma,  melanoma, and choriocarcinoma.

Risks Factors For Esophageal Cancer

 Chronic irritation of the esophagus may contribute to the changes in the lining of the esophagus that result in the development of esophageal cancer. Several unhealthy habits can increase a person's risk of developing esophageal cancer. However, having a risk factor or even several does not really mean that you will get esophagus cancer.

 Tobacco

 The use of various tobacco products including cigarettes, cigars, pipes, and chewing tobacco is one of the primary risk factors for esophageal cancer. The chemicals in tobacco products  cause damage to the DNA lining esophagus cells and hinder the healing process. Also,  tobacco weakens the esophageal sphincter muscles that maintain fluids in the stomach and  safeguards the esophagus.

 Alcohol

 Consuming excess amounts of alcohol increases the risk of getting esophageal cancer, which mainly increase the risk of squamous cell carcinoma more than adenocarcinoma.

 Obesity and Lack of Physical Activity

 Poor eating habits and lack of physical activity is the root cause of obesity. A person who is obese or overweight has a higher risk of getting adenocarcinoma of the esophagus. As obese people are more likely to have gastroesophageal reflux.

 Dietary Habits

 A diet abundant in processed meat and animal products may increase the chance of getting esophageal cancer. Also, a diet poor in vitamins, minerals, and fiberincreases the risk of esophageal cancer.

 Treatment

 Your healthcare provider decides the right treatment options based on the type of cells affected by cancer, the stage, and the overall health status of the patient.

 Surgery: Surgery to remove the tumour is done alone or in combination with other  treatments. An endoscopic surgical procedure is done to remove small tumours where the  surgeon removes the cancer cells and a margin of healthy tissue surrounding them. Esophagectomy is done to remove the parts of the esophagus that contains cancer,  together with a part of the upper area of the stomach and adjacent lymph nodes. The remaining esophagus is reconnected to the stomach.

 Chemotherapy: In chemotherapy treatment, medicine are administered in body  to kill cancer cells.  Chemotherapy can also be combined with surgery and/or radiation therapy. In very advanced stage of esophagus cancer, chemotherapy may be used alone to ease the signs and symptoms of the cancer

Targeted Therapy: Targeted therapy treatments focus on the specific weakness(targetable mutations) present within cancer cells and drugs can cause cancer cells to die.

 Immunotherapy: lmmunotherapy is used in treating advanced stages of esophageal cancer where drugs help the immune system combat cancer

Radiation Therapy: Radiation therapy uses high-energy like X-rays and protons to kill cancer cells. Radiation therapy is mostly combined with chemotherapy in patients with esophageal cancer and is usually given before surgery or rarely after surgery

Prevention

These effective steps can help a person reduce their risk of esophageal cancer

Eat a wholesome and balanced diet, packed with a rich array of colourful fruits and  vegetables that offers you essential vitamins, minerals, and antioxidants that can fight cancer.

Quitting smoking can lower the risk of esophageal cancer. Though it can be hard to quit smoking, talk with your healthcare provider for help. If you haven't used tobacco, then don' start.

 Drinking alcohol in moderation, if at all. For healthy adults, one drink a day for women and up to two drinks a day for men.

Maintain a healthy weight. If you are overweight or obese, consult your nutritionist for a  healthy diet regimen that would help you to lose weight. Get about 30 minutes of  moderate-intensity workouts daily. And always aim for slow and sustainable weight loss.

 Consult your medical professional if you have any persistent signs and symptoms that  bother you. Regular screening may be an option for people with Barrett's esophagus, as it is a precancerous condition caused by chronic acid reflux and can increase your risk of  esophageal cancer.

Authored by:

Dr. Jaykumar Patel, Consultant - Medical Oncologist, HCG Cancer Centre Vadodara.