Complications | Esophageal cancer

Complications

When the tumor is advanced, it can grow through its space demanding (invasive) growth (infiltration) into the trachea. This can sometimes create an open connection between the two hollow organs, a so-called esophago-tracheal fistula. Through this fistula, food particles can enter the lungs and cause repeated (recurrent) severe pneumonia.

Especially under radiotherapy, the tumor can literally melt down and form fistulas. In esophageal Ca, small chronic bleedings can also occur, which can lead to relevant blood loss, sometimes unnoticed, and thus cause anaemia. Larger bleedings from the tumor can lead to vomiting of blood (hematemesis).

Metastasis

Two forms of metastasis (tumor spread) can be described:

  • Lymphogenic metastasis: The lymph vessels drain lymph fluid from all parts of our body and thus also from an esophageal tumor. Once the tumor has connected to a lymphatic vessel through its growth, some tumor cells detach from the tumor cell cluster and are carried along with the lymphatic flow. Lymph nodes lie in the course of a lymph vessel.

    As a seat of the immune system, they have the task of intercepting and fighting germs (bacteria).The tumor cells settle in the nearest lymph nodes and multiply again. This leads to a lymph node metastasis. This form of metastasis is the most common form in this type of cancer.

  • Hematogenous metastasis: When the tumor grows and connects to a blood vessel, cells can break away and spread throughout the body via the bloodstream, as in lymphogenic metastasis. Most frequently, the tumor cells settle in the liver, lungs, brain and ribs and form so-called distant metastases.

Life expectancy in esophageal cancer

Life expectancy in patients with esophageal cancer is usually short. This is particularly due to the fact that cancer is often diagnosed late. Overall, the 5-year survival rate, i.e. the number of patients still alive 5 years after diagnosis, is less than 20%.

If the diagnosis is made at an early stage and the tumor can be completely removed, the prognosis improves significantly. Studies have found an average survival time of 9 months after diagnosis. However, this is an average value, so all stages, including the final stages, are included here. Patients with early stage esophageal cancer often have a significantly higher life expectancy.