The esophagus (esophagus) is an organ located in the middle of the pharynx (pharynx) and the stomach and ensures that the food taken is taken to the stomach.
The incidence of esophageal cancer varies according to geographical regions. The most common types are squamous cell carcinoma and adenocarcinoma. While squamous cell carcinoma is more common in the Far East, adenocarcinoma is more common in developed countries. The disease is more common in eastern provinces in our country.
There are some risk factors for the development of esophageal cancer. Smoked foods, nitrite-containing foods (canned, pickled), smoking and alcohol use, consumption of very hot foods, radiation, advanced age and male gender are known risk factors. Again, Barrett’s esophagus (conversion of the cell structure to the stomach cell structure due to the destruction caused by reflux in the lower part of the esophagus) obviously increases the risk of adenocarcinoma.
Likewise, esophageal swallowing disorders, strictures (especially after corrosive element ingestion), HPV infections increase the risk of cancer development.
Symptoms of esophageal cancer are difficulty in swallowing, weight loss, loss of appetite (anorexia), bleeding and symptoms related to surrounding organ involvement. Due to the absence of the outer layer of the esophagus, the symptoms often occur in the late period, and the involvement of the surrounding organs is frequent.
Upper gastrointestinal endoscopy is the gold standard for diagnosing esophageal cancer. A biopsy may be taken during the process. For staging, computed tomography is performed to evaluate local involvement, lymph node status and possible distant organ metastases. In doubtful cases, PET provides additives. In recent years, endoscopic ultrasonography (EUS) for staging has gained invaluation.
Treatment of esophageal cancers depends on the stage of the tumor. The treatment to be applied in a one-to-one time also depends on the location of the tumor. The patient’s age, health status, and the extent of the disease determine the treatment to be reapplied.
About 8% of esophageal cancers are found in the cervical (neck) esophagus. Depending on the anatomical neighborhood of the region, larynx, main vessels or trachea (windpipe) involvement is common in tumors of this region. For treatment, radical surgery such as esophagolaryngectomy, stereotactic radiotherapy and then chemotherapy can be applied.
In esophageal cancers, lymph node dissection should be performed together with resection. During surgery, a part of the stomach is also removed and the stomach is formed into a tube, and the removed part is replaced and a new mouthing is performed.
In the presence of metastatic disease or surrounding organ involvement, palliative chemo-radiotherapy is applied. Stents can be placed in the esophagus to ensure swallowing. Laparoscopic feeding jejunostomy can be performed for patients who are not able to.
