Cancer that occurs in the esophagus from the pharynx is called esophageal cancer. There are 2 types of esophageal cancer; squamous (squamous cell) cancer and adeno cancer. Squamous cell cancer originates from the inner layer of the esophagus and is usually seen in the upper and middle part of the esophagus. Adenocancers originate from glands located at the lower end of the esophagus. While squamous cell cancer is common in China, Japan and the south of Africa, adenocarcinoma is more common in developed countries. Esophageal cancer is more common in the eastern region of our country.
What are the Risk Factors for Esophageal Cancer?
Environmental factors and dietary habits create risk in esophageal cancers. Storing foods without complying with proper storage conditions and consuming them for a long time, consuming smoked meat and raw food, and nitrosamines in canned foods pose a risk for cancer. Less chewing of foods, very hot drinks (drinking very hot tea), tobacco and cigarette use, exposure to radiation are other risky conditions.
Esophageal cancers are more common in middle and advanced ages. Especially people over the age of 60 are at risk.
It is more common in men. Chronic or excessive alcohol use is an important risk factor. In this disease called gastroesophageal reflux, stomach acid escapes back into the esophagus and causes destruction. In this irritated part, the esophageal cells are replaced by stomach cells. This change can lead to esophageal adenocarcinomas over the years.
Achalasia, a swallowing disorder, and esophageal strictures that occur as a result of accidentally drinking bleach in childhood can lead to cancer formation in the future.
What are the Symptoms of Esophageal Cancer?
Esophageal cancer usually does not show early symptoms. When the cancer reaches a certain size, the clinical symptoms may be as follows;
- Weight loss
- Difficulty swallowing
- Pain in swallowing
- Feeling of choking in the throat while eating
- In the back between the shoulder blades or pain that can hit the throat
- Enlarged lymph nodes in the neck
How is the Diagnosis of Esophageal Cancer Subject r?
Medicated film of the esophagus (barium esophageal radiography) is the first examination performed. The esophagus is examined with optical light cameras called endoscopy and a biopsy is taken. Ultrasound, computed tomography (CT), magnetic resonance (MR), positron emission tomography (PET) advanced imaging tests are requested in necessary cases.
How to Treat Esophageal Cancer?
The treatment is based on the patient's condition. depends on the location and spread of the tumor. The patients are treated by a multidisciplinary team consisting of a medical oncologist, radiation oncologist and surgeon.
The first treatment is surgical removal of the esophagus with the tumor unless the tumor is in a widespread stage and there is no involvement of other organs. Complete removal of the esophagus is called esophagectomy. In this procedure, the lymph nodes around the esophagus are cleaned. The stomach and the rest of the esophagus are combined to allow the patient to swallow. The operation is completed by placing the esophagus made from the stomach or intestines with different methods.
Radiation Therapy (Radiotherapy): It is the killing of cancer cells with high-energy rays. Radiotherapy treatment is used instead of surgery alone or in combination with chemotherapy, especially if the location and size of the tumor do not allow surgery. It can be combined with chemotherapy to shrink the tumor before surgery. In some cases, it can also be applied to prevent recurrences after surgery.
Chemotherapy: It is the use of anti-cancer drugs to kill cancer cells. It can be used together with radiotherapy to shrink the tumor before surgery or as a primary treatment instead of surgery.
Palliative Treatment Methods: In some of the patients, an expanding umbrella called a stent is applied to the area with esophageal obstruction caused by the tumor, so that nutrients can pass easily. Another method used to open the obstruction in the esophagus is laser application. External nutrition can be provided by placing tubes called gastrostomy in the stomach.
Is Early Diagnosis of Esophageal Cancer Possible?
It is possible to detect esophageal cancer in early stages only by gastroscopic examination. In case of doubt, both the esophagus and the stomach can be made safe by performing gastroscopy. examined in clay. A definitive diagnosis is made under the microscope by taking parts from suspicious areas.
What should be done about liquids that can burn the esophagus?
It is very important to keep liquids such as salt spirit and sodium hydroxide (caustic soda), degreaser, bleach only in their original packages, in places where children cannot reach. . Such solutions should never be placed in a glass or water bottle. They should not be kept in kitchens under any circumstances.
What are the Treatment Options for Stenosis in the Esophagus?
Unfortunately, when a rupture occurs, it can have consequences that can lead to death. However, it should not be forgotten that the risk of a surgical intervention to eliminate that stenosis may be much higher. The success rate of the enlargement is particularly dependent on the underlying cause. Generally, a single enlargement is not sufficient, and it is possible to solve the problem by doing it several times at regular intervals.
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