Esophageal cancer is a common form of malignant tumors (5-7%), occurring much more often in men, mainly in adulthood and old age. Most often, cancer affects the lower and middle sections of the esophagus.
External factors contributing to the development of esophageal cancer include malnutrition:
- abuse of very hot food;
- abuse of alcohol and its surrogates.
The role of the geographical factor is noted. The frequency of carcinomas is many times higher in some areas of China, Iran, Central Asia, which is believed to be due to the inclusion in the diet of a large amount of pickled food, nitrosamines, mold fungi, very hot food (tea) and a reduced content of selenium, fresh fruits in the diet and vegetables.
The risk of disease increases with a lack of vitamins, especially A and C.
Smoking increases the risk of developing the disease by 2-4 times. Alcohol abuse – 12 times.
The chance of developing esophageal cancer is increased by alkali burns (even many years after exposure).
Precancerous diseases can be considered such diseases as achalasia of the esophagus, Barrett’s esophagus (the risk of subsequent development of carcinoma is 10%).
Common non-specific symptoms that are alarming in relation to a malignant disease:
- a change in general well-being, expressed in the appearance of weakness, a decrease in the likelihood of work, fatigue, unreasonable rises in temperature;
- a persistent decrease in appetite or a complete loss of it up to an aversion to food without any objective reason;
- progressive weight loss, accompanied, along with the first two signs, by pallor of the skin, not explained by other diseases.
The clinical picture of esophageal cancer is quite bright. The first complaint of the patient is a feeling of difficulty in passing solid food through the esophagus. This symptom (dysphagia) is initially expressed slightly, therefore, the patients themselves and doctors do not attach due importance to it, attributing its appearance to the injury of the esophageal mucosa with a coarse lump of food or bone.
Due to the difficulty in passing food through the esophagus, patients avoid solid food, resorting to pureed, ground food, then they are forced to limit themselves to only liquid products – tea, milk, broth. Not often regurgitation joins. Sometimes dysphagia reaches such an extent that the patient cannot even swallow saliva. Progressive weight loss begins, rarely reaching exhaustion (cachexia).
With the development of the disease, with the germination of the tumor beyond the esophagus, chest pains, sometimes of a burning nature, may occur. Sometimes the timbre of the voice changes.
With the collapse of the tumor, complications can develop:
- esophageal bleeding, accompanied by nausea, vomiting of blood (scarlet, with clots), weakness, loss of consciousness. With a long, but not intense edema, a black “tarry” stool may appear from the tumor, associated with the release of “digested” blood that has passed through the entire digestive tract. This situation is an emergency and requires immediate medical attention;
- tumor perforation (simply – a hole in the esophagus) with the development of mediastinitis (inflammatory process in the mediastinum), accompanied by intense chest pain, difficulty breathing, high fever, intoxication.
All of the described complications require immediate medical attention!
The presence of the previously presented symptoms may prompt you or your doctor to conduct the necessary investigations.
Instrumental Methods
X-ray examination and endoscopy with biopsy are the main methods for diagnosing esophageal cancer. With a combination of gastroscopy and biopsy, the probability of making a correct and timely diagnosis, even at an early stage of esophageal cancer, is within 95%.
CT (computed tomography), MRI (magnetic resonance therapy) is used to determine the prevalence of the tumor process, damage to the lymph nodes, and identify possible distant metastases.
Bronchoscopy is performed to assess the likelihood of tumor invasion of the esophagus into the trachea or bronchi if there is suspicion.
In difficult cases, the use of mediastinoscopy is likely (examination within the esophageal space using an endoscope.
Also, in terms of a comprehensive examination and in order to detect metastases, an overview radiography of the chest organs, ultrasound of the liver, and an isotope study of the bones of the skeleton are shown. It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.
Treatment of esophageal cancer is carried out surgically, radiation therapy and a combined method (a combination of surgical and radiation treatment methods).
Chemotherapy as an independent method of treatment is ineffective. The choice of treatment method depends on the prevalence of the tumor and its localization.
In case of damage to the lower and middle third of the esophagus, surgical treatment is used (with subsequent radiation therapy and chemotherapy, if indicated). With a widespread process and the improbability of surgical treatment, radiation therapy is used as an independent method.
When the upper third of the esophagus is affected, radiation therapy is mainly used.
Surgical treatment of esophageal cancer consists in the removal of the esophagus (there are various modifications of surgical treatment) followed by plastic surgery of the gastric or intestinal (colon or small intestine) tube.
To improve the results of surgical treatment after surgery, chemotherapy or radiation therapy is performed.
With a neglected process, with the improbability of surgical treatment and a high degree of dysphagia, when the patient cannot eat, a gastrostomy is applied for nutrition – under local anesthesia, the stomach is sutured to the anterior abdominal wall and a feeding tube is inserted into it.
Esophageal cancer metastasizes to the lymph nodes of the mediastinum; with distant metastasis, it affects the liver (20%), lungs (10%), the skeletal system, and the brain.
The prognosis, as with other cancer localizations, depends on the prevalence of the tumor lesion and the presence of metastases, the age of the patient. Each case must be considered separately.
The basis for the prevention of all forms of cancer (including cancer of the esophagus) is the timely detection and treatment of precancerous diseases (in this case, achalasia of the esophagus, Barrett’s esophagus), as well as early detection of cancer, which makes it possible to carry out successful radical treatment.
All this is achieved by timely passage of preventive examinations, attentive attitude to one’s health.
It is also advisable to give up bad habits and normalize nutrition.
Articles from the forum on the topic ” Tumor of the esophagus “
what is an exophytic formation overlapping the lumen of the esophagus?
Answer #1
This means a tumor that grows inside the esophagus and closes its lumen, preventing food from passing through.
Answer #2
Exophytic growth – expansive growth of a tumor into the lumen of a hollow organ, the tumor covers part of the lumen of the organ, connecting with its wall with a leg;
Endophytic growth – infiltrating tumor growth deep into the wall of the organ.
Answer #3
Not necessarily a tumor, a varicose vein is also possible with varicose veins of the esophagus, echinococcus calcification … Yes, you never know, even a spasm from yesterday’s blowjob and not yet identified, but obviously not from the esophagus and narrowing its lumen …