Esophageal Cancer

Overview

Esophageal cancer refers to a malignant tumor of the gullet. The esophagus is the tube that connects the throat with the stomach. It begins in the cells that line the inside of the food pipe.

Cancer can occur anywhere within the food pipe, and it occurs when abnormal cells in the food pipe grow in an uncontrolled manner.

This type of cancer is common among elderly people in their 60s and 70s and is more prevalent in men than women.

Esophageal cancer is the sixth most common cause of cancer deaths in the world. Incidence rates differ from one geographical location to another.

Kenya belongs to a high incidence region called Africa’s esophageal cancer (EC) corridor. It has one of the highest incidence rates of EC globally.

In certain regions, higher rates of esophageal cancer cases may be attributed to alcohol and tobacco use or specific nutritional habits and obesity.

Symptoms

Esophageal cancer does not normally cause any symptoms in the early stages when the tumor has just developed. The signs and symptoms mostly occur when the tumor gets bigger. These symptoms include:

  • Difficulty swallowing
  • Persistent indigestion or heartburn
  • Loss of appetite and weight loss
  • Bringing up food soon after eating
  • Pain and/or discomfort in your upper tummy, chest or back
  • Acid reflux
  • A cough
  • Vomiting
  • Voice changes
  • Dysphagia

Causes

Esophageal cancer results from uncontrollable cell growth. The disease harms the food pipe when damaged cells uncontrollably multiply and form a tumor in the channel.

Tumors grow with time and interfere with the normal function of the esophagus.

Some are benign and stay in a single location without growing bigger, while others (malignant) grow bigger and spread to different surrounding tissues or other body parts.

Risk Factors

The risk factors associated with esophageal cancer include:

  • Age: It is more common after the age of 60
  • Achalasia: It is a type of esophageal motility disorder
  • Alcohol and tobacco use: Either or both of them increase the risk
  • Diet: Lack of sufficient consumption of fruits and vegetables may increase the risk
  • Celiac disease: Increases the risk of squamous cell carcinoma
  • Genetic factors: Having a family member with this condition increases the risk
  • Human papillomavirus (HPV): It is a contagious STI
  • Gastroesophageal reflux disease (GERD)
  • Long-term exposure to chemicals or irritants that include soot, exhaust fumes, metal dust, silica dust, and lye.
  • Sex: Males are at higher risk
  • Obesity
  • Other Cancers
  • Radiation therapy

Diagnosis

The doctor will carry out a physical examination by assessing you and asking you questions concerning the symptoms and family history.

The physical examination will generally include feeling your tummy (abdomen) and the lymph nodes in your neck and under the arm.

If the doctor suspects the presence of esophageal cancer, he or she will conduct tests that include endoscopy and barium swallow.

Other diagnostic tests that may be required include biopsy, endoscopic ultrasound, and other imaging scans such as CT scan.

Staging

Esophageal cancer develops in 5 stages. Each stage highlights the spread and severity of cancer:

  • Stage 0: This stage refers to cells that have indicated signs of cancerous activity without becoming cancerous.
  • Stage 1: Cancer has already formed in the esophagus, but the location of the tumor is not clear.
  • Stage 2: Cancerous cells have spread to connectivity or muscular tissue of the esophagus and to one or two lymph nodes.
  • Stage 3: cancer has spread to the muscular or connective tissue of the esophagus and the diaphragm, the protective tissue around the lungs, the sac around the heart, or between 3 and 6 lymph nodes.
  • Stage 4: Cancer has spread to distant sites in the body.

Treatment

Esophageal cancer is diagnosed at an early stage; it may be possible to cure with:

However, if the diagnosis shows cancer in a later stage, the cure may become unachievable.

In such a case, the doctors may deploy surgery, chemotherapy, and radiotherapy to help keep cancer under control and relieve the patient from symptoms.

Prevention

To reduce your risk of esophageal cancer, take the following steps:

  • Quit smoking cigarettes and shisha
  • Drink alcohol in moderation, if at all
  • Eat more fruits and vegetables
  • Engage in safe sex to prevent HPV and other STIs
  • Maintain a healthy weight to avoid obesity
  • Avoid exposure to chemicals and irritants

For more information on diagnosis and/or treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.