ESOPHAGEAL CANCER

April is observed as the oesophagus cancer awareness month. Let us know some important facts about this disease. Oesophagus or commonly known as food pipe is a passage for food from the mouth to the stomach. In India, it is the fourth most common cause of cancer-related deaths.

What are the early signs of Esophageal cancer?

Early stage Esophageal cancer often has no symptoms. The commonest symptom is difficulty in swallowing, with a feeling like the food is stuck in the throat or chest. If cancer keeps growing even liquids might be hard to swallow. Other symptoms include weight loss, pain, pressure or burning sensation in the chest. Some people complain of worsening indigestion or heartburn, Persistent Cough or change in voice.

 What can cause Esophageal Cancer?

  • The common causes include consumption of alcohol and smoking. It is more common more than 60 years of age. Not consuming enough fruits and vegetables which are rich in anti-oxidants and have a family member with this condition increases the risk.
  • Gastroesophageal reflux disease (GERD): Both this disease and its main symptom, acid reflux, can lead to Barrett’s oesophagus. Barrett’s oesophagus increases the risk of future malignancy.
  • Long-term exposure to chemicals or irritants such as soot, metal dust, exhaust fumes, lye, and silica dust is also associated with this disease.

Is acid reflux dangerous?

Uncontrolled and long-lasting acid reflux, or gastroesophageal reflux disease (GERD), can cause serious health problems including Barret’s oesophagus and cancer.

What foods help acid reflux go away?

Foods to Stave Off Acid Reflux Symptoms include Bananas & Melons-low-acid /alkaline foods which coat the irritated Esophageal lining and thereby helping to combat discomfort. Other food items to reduce reflux include oatmeal, Yogurt and Green Vegetables.

 What foods make acid reflux worse?

Common trigger foods for people with reflux are fried and fatty foods. These can cause the LES to relax, allowing more stomach acid to back up into the oesophagus. Tomatoes and citrus fruit, chocolate, garlic, onions, spicy foods and caffeine also worsen reflux disorder.

What else can help reduce reflux?

Having an early meal and avoiding lying down immediately after meals can reduce reflux. Keeping a lean body weight by an active lifestyle is also beneficial for reflux.

What are the investigations required for diagnosing Esophageal cancer?

Tests and procedures include endoscopy to examine the food pipe. During endoscopy, the doctor passes a flexible tube equipped with a video lens (video endoscope) into the food pipe via the mouth and Collects a sample of tissue for testing (biopsy). PETCT scan is done to know the extent of the disease.

Is Esophageal cancer aggressive?

Esophageal cancer is an aggressive form of cancer. In most cases, Esophageal cancer is a treatable disease, although cure rates are low. The overall 5-year survival rate in patients amenable to definitive treatment ranges from 5% to 30%. Although it depends on several factors like the stage of cancer at the time of diagnosis. Patients with a very early disease have a better chance of survival.

How is Esophageal cancer treated?

Very early cases can be treated with local excision. In most cases, it is a triple modality treatment involving chemotherapy, radiation therapy and Surgery. Very advanced cases are treated with chemotherapy and placement of stents (tubes in food pipe) to allow feeding.

Are there some advancements in technology for the treatment of Esophageal cancer?

Nowadays, the treatment of these cancers is done by modern machines like linear accelerator where radiation is targeted specifically to the cancer-bearing area, thereby protecting the surrounding organs from the side effect of radiation therapy.

Dr. Kanika Sharma I Clinical Lead & Senior Consultant – Radiation Oncology I Dharamshila Narayana Superspeciality Hospital

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