Esophageal Cancer - Esophageal Cancer

Esophageal Cancer
Updated: May 24, 2006
Sharon Gilson
About.com

Cancer of the esophagus is a tumor that begins it's growth in the lining of the esophagus. It can then grow through the wall of the esophagus, and can spread to other parts of the body through the blood or the lymphatic system.
Most of the length of the esophagus is lined with squamous cells. If a malignant tumor grows here, it's called squamous cell cancer. The areas at the bottom of the esophagus and where the esophagus joins the stomach are lined with columnar cells. If a malignant tumor grows here, it's called adenocarcinomas. Some studies have shown that esophageal adenocarcinoma is the fastest growing cancer in the western world.

Studies show a relationship between frequency of reflux symptoms and risk of adenocarcinoma. The constant acid reflux will irritate the lining of the esophagus, and complications can occur, such as Barrett's esophagus. Individuals with Barrett's esophagus are at an increased risk of developing adenocarcinoma. Barrett's esophagus is a condition in which the lining of the esophagus is replaced by tissue that is similar to that which is normally found in the stomach and intestine. The process of this change is called intestinal metaplasis. Individuals with Barrett's esophagus are about 40 times more likely to develop esophageal cancer than individuals in the general population.

Symptoms of esophageal cancer
Heartburn
Difficulty swallowing
Inability to swallow solid foods (eventually liquids also)
Pain with swallowing
Food sticking in esophagus
Weight loss
Regurgitation of undigested food
Vomiting blood or passing old blood with bowel movements
Procedures used to diagnose esophageal cancer
Endoscopy
Barium x-rays
Computed tomography
CT scan

Treatment of esophageal cancer
As with any type of cancer, the treatment will depend on the stage the cancer is in at the time of diagnosis, the overall condition of the patient, and whether the cancer has spread to other organs.
If the cancer has not spread to other organs, thus making it potentially curable, surgery can be performed to remove the majority of the esophagus. In some cases, the surgery will also involve removing the stomach, spleen, and lymph nodes inside the chest. Then another part of the lower bowel is pulled up and attached to the remaining section of esophagus. They may receive chemotherapy and radiotherapy treatments after the surgery.

If the cancer has spread to other organs, combined chemotherapy and radiotherapy is the most common treatment. This form of treatment is also used in the cases where the patient can't have surgery.

Whether preoperative chemotherapy and radiation therapy can improve a patient's prognosis is still under study by many cancers centers.

Prognosis for those with esophageal cancer
If the cancer is diagnosed in it's earliest stages, the patient's chances of living and be cancer free five years after treatment is greatly inproved. Unfortunately, most cases of esophageal cancer is only discovered when the patient comes to their doctor because of swallowing difficulty, which doesn't happen until later stages of the cancer growth. The prognosis then is very poor.
Esophageal cancer will often recur, despite surgery, chemotherapy and radiation.

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