Esophageal cancer or cancer of the food pipe is an aggressive cancer. In most cases, esophageal cancer is a treatable disease, although cure rates are low. According to the National Cancer Institute, the five-year survival rate in patients with proper definitive treatment ranges from 5 to 30 percent. However, it depends on several factors, such as the stage of cancer at the time of diagnosis and the overall health of the patient. Patients with v very early stage disease have a better chance of survival. For those who undergo curative treatment, 40 percent will survive one year or more, 15 percent will survive up to five years and 10 percent will survive 10 years or more. It depends on the stage of cancer and how quickly it was detected. Prognosis based on the stage of the cancer is
- Stage I: Five-year survival is 55 percent
- Stage II: Five-year survival is 30 percent
- Stage III: Five-year survival is 15 percent
- Stage IV: Sadly, many people don't live beyond a few months to maybe a year
When the cancer has not spread outside the esophagus, surgery may improve the chances of survival. When the cancer has spread to other areas of the body, a cure is generally not possible. Overall, esophageal cancer is considered an extremely aggressive cancer that has a poor prognosis compared to other malignant ulcers of the gastrointestinal tract. The common treatment options for esophageal cancer are
- When the cancer is only in the esophagus and has not spread, surgery may be the best option. The cancer and a part or all the esophagus are removed. The surgery may be done using
- Open surgery, during which one or two larger incisions are made.
- Minimally-invasive surgery, during which two to four small incisions are made in the abdomen. A laparoscope (a flexible tube with a camera) is inserted into the abdomen through one of the incisions.
- Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus.
- Either chemotherapy, radiation or both may be used to shrink the tumor and make surgery easier to perform.
- If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable. Besides, a change in diet and other treatments that may be used to help the patient swallow include
- Dilating (widening) the esophagus using an endoscope. Sometimes, a stent is placed to keep the esophagus open.
- Inserting a feeding tube into the stomach.
- Photodynamic therapy, which uses a special drug that is injected into the tumor and is then exposed to light. The light activates the medication that attacks the tumor.
What is esophageal cancer?
Esophageal cancer is a cancer of the esophagus, which is the tube that carries food and liquid from the mouth to the stomach. The exact developmental processes of esophageal cancer are still the subject of current research. However, it is assumed that the disease develops over a long time. The damage accumulates in the cell over time and affects normal cells until cancer results. The risk factors that may trigger cancer cells may include
- Gastrointestinal reflux disease (GERD) and Barrett esophagus: A ring or valve of muscle called the upper esophageal sphincter is present at the upper end of the esophagus. It relaxes to let food or liquid go through it into the esophagus. The lower part of the esophagus is connected to the stomach. Another sphincter called the lower esophageal sphincter (LES) is located at this connection that opens to allow the food to enter the stomach. This muscle also works to keep food and stomach contents from coming back up into the esophagus. When the stomach contents go back up into the esophagus (refluxes) repeatedly, it may cause GERD, leading to heartburn. Long-term reflux can change the cells in the lower end of the esophagus. This condition is known as Barrett esophagus. If these cells are not treated, they are at a much higher risk of developing into cancer cells. Having difficulty swallowing because an esophageal sphincter won’t relax can lead to severe irritation of the esophagus, leading to GERD.
- Tobacco use
- Heavy alcohol use
- Older age
The warning signs and symptoms of esophageal cancer may include
- Difficulty swallowing (also called dysphagia), which is the most common symptom
- Food coming back up after being swallowed
- Unexplained weight loss
- Chest pain, which may be in the center of the chest or less often, in the shoulder or back
- Indigestion or heartburn that doesn’t go away
- A hoarse voice or a cough that won’t go away
- Painful swallowing (also called odynophagia)
- Feeling like something is stuck in the chest
Having one or more risk factors does not mean one will get esophageal cancer. However, a risk factor affects the chance of getting a disease. As with all cancers, chances of successful treatment are better when the cancer is caught in its early stages. Therefore, it is especially important to see a doctor as soon as possible if a person suspects esophageal cancer.
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