What is esophageal cancer?
The esophagus is in the form of a tube made of muscles, 35-40 cm long, that carries food from the mouth to the stomach. Esophageal cancer is a disease that occurs when normal cells in the esophagus turn into abnormal cells and grow out of control. There are two distinct types with completely different causes. The type called squamous cell (squamous) is associated with smoking, sooty foods and hot food and drinking and tends to be seen more in some regions of the world. The second type, called adeno, is mostly associated with obesity and reflux disease.
What are the symptoms of esophageal cancer?
Unfortunately, most patients do not have any complaints in the early period. In some of the patients, the diagnosis is made incidentally during endoscopy performed for another reason.
Still, some patients MAY have the following findings:
●Difficulty in swallowing (especially solid, dry foods) beginning or increasing with time.
●Weight loss
Pain or burning sensation in the chest
●Voice changes (Muffled voice, hoarse voice)
All of these symptoms can also be caused by non-cancerous conditions.
Is there a test for esophageal cancer?
Yes. If your doctor suspects you have esophageal cancer, he or she will do one or more of the following tests:
●Upper endoscopy (esophagogastroscopy) is a procedure in which your esophagus is examined up to the stomach and duodenum through your mouth through a thin tube with a camera and light at the end, called an endoscope. This allows us to examine the inside of your esophagus by magnifying it tens of times.
●The thoracic cavity and upper abdomen tomography: shows the condition of the relevant organs.
●Barium esophageal radiography: Although it is not performed as much as before, it is an imaging method that distinguishes esophageal movements, strictures, leaks and diseases involved. Here, a substance that appears on the film is swallowed by the patient and films are taken at the same time.
●Biopsy – It is a procedure that allows us to make the most accurate decision about diseases by examining small tissue pieces taken from suspicious places in the esophagus during upper endoscopy with special dyes under the microscope.
Is a biopsy necessary?
A biopsy is the only way to know for sure if you have esophageal cancer. In addition, esophageal cancer is divided into two main types (squamous cell and adenocarcinoma), whose causes, course and treatment differ considerably. These types are absolutely necessary for the creation of the treatment scheme.
What is cancer staging?
As with all other cancers, staging is essential to determine the extent of the disease and to decide on the treatment methods.
Various imaging methods (ultrasound, EUS, PET CT, MR, etc.) or additional biopsies (lymph gland biopsy, stomach biopsy, etc.) may be requested for staging.
How is esophageal cancer treated?
Most people with esophageal cancer have one or more of the following treatments:
●Surgery – Cancer of the esophagus can be treated with surgery to remove the cancerous part along with its surroundings. Swallowing can be continued by extending the stomach instead of the removed part.
●Radiation therapy – It is highly beneficial in certain cell types and parts of the esophagus, either alone or in combination with other treatments.
●Chemotherapy – Cell typing is decisive in the selection of drugs to be used. It is usually given in the form of serums lasting several hours at regular intervals. It is recommended to insert a port before treatment for patients with vascular access problems.
●Immunotherapy – certain drugs that stimulate the body’s immune system can be used to stop cancer growth.
● Reliever treatments: interventions that help the patient to improve their complaints and not to starve during the treatment. Operations such as cage-shaped devices (Stent) that keep the narrowed or blocked esophagus open, and direct food delivery pipes to the stomach or intestines (gastrostomy, jejunostomy) can be counted.
What should be done after treatment?
After treatment ends, the cancer needs to be kept under control to see if it has come back. Detailed examination, blood tests, imaging tests and sometimes upper endoscopy may be requested in the follow-ups that are more frequent at first and gradually become less frequent. Surgical branches should also check in patients undergoing surgery. If any complaint recurs, patients should definitely share it with their doctor.
