Updated 9 October 2023 | Approved By Dr. Umberto Russo
What is Oesophageal Cancer?Oesophageal cancer is a disease that affects the oesophagus, a tube-like structure connecting the throat to the stomach that is responsible for carrying food and liquids to the digestive system. This cancer begins when normal cells in the oesophagus undergo genetic changes, causing them to multiply uncontrollably and form a tumor. Over time, this tumour can grow and potentially spread to other parts of the body.
Oesophageal Cancer SymptomsOesophageal cancer manifests with various symptoms, and these signs can be crucial for early detection. Recognising these symptoms and seeking medical attention promptly is vital in the diagnosis and treatment of oesophageal cancer. Common indicators include :
- Difficulty swallowing
- Persistent chest pain, especially behind the breastbone
- Unexplained weight loss
- Chronic heartburn, or indigestion
- Persistent cough
- Ongoing hiccups
- Persistent regurgitation of food or blood.
Causes of Oesophageal CancerOesophageal cancer has several known causes, which are mainly linked to lifestyle and environmental factors. One major cause is smoking, as it exposes the oesophagus to harmful chemicals that can lead to genetic mutations in its cells. Other causes include :
- Excessive alcohol consumption
- Chronic acid reflux
- Having a condition called Barrett's oesophagus
- A diet lacking in fruits and vegetables
- Poor nutrition
Testing and Diagnosis of Oesophageal CancerThe testing and diagnosis of oesophageal cancer are crucial steps in managing this condition. When a patient presents with symptoms such as difficulty swallowing, chest pain, or unexplained weight loss, doctors will often begin with a thorough medical history and physical examination. To confirm the diagnosis, several tests may be recommended. Upon diagnosis, a team of medical professionals will discuss treatment options, which may include surgery, chemotherapy, radiation therapy, or a combination of these approaches .
EndoscopyEndoscopy is a vital procedure for diagnosing oesophageal cancer. It involves the insertion of a flexible tube with a camera (an endoscope) through the mouth and into the oesophagus. This allows direct visualisation of the oesophageal lining and enables doctors to identify abnormalities. Endoscopy is used to evaluate the tumour's size, location, and any potential obstruction.
Imaging StudiesImaging studies play a pivotal role in diagnosing oesophageal cancer. Various imaging techniques, such as CT scans, PET scans, and barium swallows, are employed to create detailed visual representations of the oesophagus and adjacent structures. These imaging studies aid in determining the extent of cancer, whether it has spread to other areas, and helping clinicians make informed decisions regarding treatment strategies.
BiopsyA biopsy is a procedure used to help diagnose oesophageal cancer. During this process, a small sample of tissue is taken from the oesophagus, typically during an endoscopy. This tissue sample is sent to a laboratory, where a pathologist examines it under a microscope to determine if cancer is present. Biopsies not only confirm the presence of cancer but also help identify the cancer's type and grade, which is essential for planning the appropriate treatment.
Endoscopic UltrasoundEndoscopic ultrasound is a specialised procedure used in the diagnosis of oesophageal cancer. During endoscopic ultrasound, a thin, flexible endoscope equipped with an ultrasound probe is passed through the mouth and into the oesophagus. This ultrasound technology creates detailed images of the oesophageal wall and its surrounding tissues, offering precise insights into the cancer's depth, size, and proximity to nearby structures, including lymph nodes.
Oesophageal Cancer TreatmentThe treatment of oesophageal cancer involves a multi-faceted approach tailored to the individual's specific condition. The choice of treatment depends on the cancer's stage, the patient's overall health, and other factors. It's crucial for patients to work closely with their medical team to determine the most suitable treatment plan, as early diagnosis and timely intervention are key factors in improving outcomes for individuals with oesophageal cancer.
SurgerySurgery can be pivotal for treating oesophageal cancer. The type of surgery performed depends on the stage and location of the cancer. Common procedures include oesophagectomy, which involves the removal of a portion or the entire oesophagus, and lymph node dissection to check for cancer spread. In some cases, minimally invasive or laparoscopic techniques may be used to reduce surgical trauma. Surgery aims to remove the cancer and potentially affected tissues.
ChemotherapyChemotherapy involves the use of powerful drugs to target and destroy cancer cells or slow their growth. Chemotherapy is often recommended before surgery to shrink the tumour and make it more operable, or after surgery to kill any remaining cancer cells. In cases where surgery is not an option, chemotherapy can be used as the primary treatment to control the cancer and manage symptoms. While chemotherapy can have side effects, such as nausea and fatigue, it can improve the chances of survival.
RadiotherapyRadiotherapy uses high-energy rays to target and destroy cancer cells in the oesophagus. It plays a significant role in cases where surgery may not be a viable option or as an adjunct to surgery to improve treatment outcomes. Radiotherapy can also help alleviate symptoms such as difficulty swallowing or pain by shrinking the tumour.
Stent ProcedureOesophageal stents are tube-like devices that can be placed within the oesophagus to alleviate symptoms caused by the tumor, particularly when the cancer is blocking or narrowing the passage. By expanding and holding open the oesophagus, stents help patients with oesophageal cancer regain their ability to swallow and reduce discomfort.
Nutritional SupportOesophageal cancer can hinder the ability to consume food and maintain proper nutrition, leading to weight loss and a weakened physical condition. Nutritional support includes dietitian/nutritionist support and the placement of feeding tubes. These interventions aim to ensure patients receive the necessary nutrients and calories, improving their overall health and ability to tolerate cancer treatments.
Oesophageal Cancer ComplicationsOesophageal cancer can give rise to various complications that significantly impact a patient's health. One of the main complications is difficulty swallowing, which can lead to malnutrition and weight loss as patients struggle to eat and drink. Additionally, the cancer can block the oesophagus, causing pain and discomfort, and even lead to the regurgitation of food. Oesophageal cancer can also spread to nearby organs or lymph nodes, resulting in more advanced cancer. Furthermore, treatment-related complications like those arising from surgery, chemotherapy, or radiotherapy can also occur.
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