Esophageal cancer is also known as esophageal cancer in medical terminology. This is a malignant growth in the area of the esophagus.
What is esophageal cancer?
Schematic diagram showing the anatomy of esophageal cancer. Click to enlarge. Esophageal cancer is a rather rare form of cancer that occurs mainly in people over 60 years of age. Men are about three times more likely to be affected than women. The esophagus is the part of the body that carries food from the mouth to the abdomen. This is a muscular cord and a rather stretchable organ. Esophageal cancer causes the esophagus to become more and more constricted, which usually leads to problems with food intake in the advanced stages of the disease. The esophagus is lined with a layer of mucus; it is from this mucosa that the malignant tumor usually originates.
Causes
Excessive consumption of alcohol and cigarettes is thought to be the main cause of esophageal cancer. An unhealthy diet, however, can also promote esophageal cancer; especially too fatty food should be avoided. Those who constantly eat food that is too hot are also particularly at risk for esophageal cancer. Last but not least, congenital malformations of the esophagus can ultimately lead to esophageal cancer. Patients suffering from the so-called reflux disease are also particularly at risk. In this, stomach acid flows unhindered back into the esophagus, which naturally attacks and irritates it.
Symptoms, complaints and signs
Because of the stretching ability of the esophagus, clear symptoms do not appear until the late stages of cancer. Esophageal cancer may manifest as problems swallowing, often accompanied by pain and a nonspecific feeling of pressure. Many affected persons describe the feeling as squeezing or constricting. In addition, retching and heartburn may occur, although many patients experience these symptoms only intermittently or not at all. A clear sign is cramping in the esophageal area. These spasms occur suddenly and may radiate to the face and back. If the tumor is localized in the area of the larynx, hoarseness and changes in voice color occur. Parallel to these symptoms localized near the esophagus, various general symptoms occur. Possible signs include weight loss, loss of appetite, and bleeding. In addition, nausea and vomiting and other gastrointestinal symptoms may occur. Esophageal cancer develops insidiously and does not produce clear symptoms until later in its course, when they become permanent or clustered. If the disease progresses further, there is loss of voice and eventually metastasis, which is associated with further complications (such as organ failure or circulatory problems), some of which can be life-threatening.
Diagnosis and course
Esophageal cancer is a gradual disease that usually does not show symptoms until late in its course. When these finally appear, they are a feeling of pressure in the throat area; in some cases, pain may also occur in the back. These are usually much less severe when liquid food such as soups or porridge is ingested. Hoarseness and a sudden unexplained loss of weight are further symptoms that may become apparent as the disease progresses. Finally, in the very advanced stage, swallowing difficulties and associated problems with food intake occur. The diagnosis of esophageal cancer can usually be made precisely with the help of an esophagoscopy, the so-called endoscopy. During this procedure, various tissue samples are taken and then examined in the laboratory. During this examination, the patient must swallow a tube, similar to the gastroscopy. With a little luck, the treating physician can remove the cancer during the esophagoscopy. However, to determine how far the cancer has already spread in the body, further examinations are necessary, such as computer tomography.
Complications
Esophageal cancer can be associated with various complications. The disease is often associated with weight loss, which, if left untreated, leads to dehydration and deficiency symptoms. The typical bleeding causes anemia and thus can exacerbate the feeling of illness.Typically, sufferers suffer from severe fatigue and are generally less able to perform. Serious complications arise when physical and mental weakness leads to falls or accidents. In addition, cancer also affects the mental state. Patients often suffer from depressive moods and anxiety, which increase in intensity if the disease progresses unfavorably. Treatment of esophageal cancer is not risk-free. Surgery can result in injury to the vocal cord or esophagus, in addition to infection, bleeding and wound healing problems. Depending on the location of the tumor and the depth of the incision, this can result in loss of voice or permanent difficulty swallowing. Chemotherapy causes hair loss and can also cause organ damage and cardiovascular problems. Radiation therapy poses the risk of possible late reactions: Discoloration of the skin, damage to the mucosa and digestive tract, and permanent skin changes.
When should you see a doctor?
A doctor should always be seen immediately for esophageal cancer. Death of the affected person may occur, so that in this case an early diagnosis and treatment of the disease can always have a positive effect on the further course. The earlier esophageal cancer is detected, the better the prognosis. For this reason, a doctor should be consulted at the first signs of this disease. The doctor should be consulted in the case of esophageal cancer if the affected person suffers from difficulties and discomfort when swallowing, so that there is permanent pain. Likewise, strong heartburn or a strong gag reflex can indicate this cancer and should always be examined by a doctor. In many cases, bleeding or a severe loss of weight may also indicate esophageal cancer and should also be examined by a physician. In the further course, the affected usually suffer an organ disease and die from it. If esophageal cancer is suspected, a general practitioner or an internist can be consulted. Further treatment depends strongly on the exact manifestations of this complaint.
Treatment and therapy
The treatment of esophageal cancer depends on how advanced it is, or at what stage it is. The best prospects for complete recovery are patients in whom the tumor can be completely removed in surgery. This is a rather large and not harmless operation, after all, the chest and usually also the abdominal cavity must be opened. Now a part of the esophagus is removed and then the stomach is pulled up a bit and connected to the rest of the esophagus. Often, however, surgery alone is not enough; radiation therapy or chemotherapy must also be administered. Especially if the tumor is too large, it usually cannot be removed surgically. In this case, radiation initially serves to shrink the tumor and make it operable. Without prompt and appropriate treatment, esophageal cancer can quickly spread to other organs in the body, such as the trachea or bronchi. The best chance of recovery is for all patients in whom the cancer has not yet spread, that is, where there are no metastases in adjacent organs.
Prevention
To prevent esophageal cancer, the first thing to do is to maintain a healthy lifestyle. This includes abstaining from alcohol and cigarettes as well as a healthy lifestyle. Above all, diet plays a decisive role; at best, too much fat should be avoided. Also on foods, which contain nitrosamines, one should do without as far as possible, because these are known as carcinogenic.
Aftercare
The therapy of esophageal cancer is followed by aftercare. One of the most important tasks of aftercare is to take action against concomitant and secondary diseases. In addition, it helps the patient to cope with physical, psychological or social problems arising from the disease or its treatment. It is also important to recognize a possible relapse at an early stage and to treat it accordingly. If the esophagus has been partially or even completely removed during surgery, various follow-up examinations are required, as this is a considerable intervention in the system of food intake.The examinations take place either by the family doctor or in a clinic. Which and how many examinations are ultimately required depends on the patient’s individual state of health and the way in which he or she was previously treated. During the follow-up examination, the physician talks to the patient and inquires about his or her condition. In addition, the patient is examined and his or her body weight is checked. Furthermore, examinations such as sonography of the upper abdomen, laboratory tests and X-rays of the lungs are possible. In addition, a mirror examination of the remaining esophagus as well as the surgical site may take place. Follow-up care for esophageal cancer can take several years. At intervals of 6 to 18 months, it is recommended that examinations such as a bone scintigraphy or computed tomography of the abdomen and thoracic region be performed.
What you can do yourself
A diagnosis of esophageal cancer always requires intensive medical treatment. Surgery and radiation as the means of choice leave no room in the realm of self-help when it comes to removing the tumor. Since esophageal cancer can also grow aggressively, sufferers should waste no time after diagnosis and seek specialist treatment. There are no known home or herbal remedies that have been scientifically proven to make an esophageal tumor disappear. Alternative medical offers that promise a cure should therefore be examined very critically and discussed with the attending physician. Basically, when esophageal cancer is diagnosed, it is not advisable to turn down conventional medical therapies in the hope of self-help. In everyday life, patients with esophageal cancer can nevertheless become active in the area of self-help in order to improve their quality of life. For example, many experience that abstaining from certain foods or stimulants reduces pain. Many health insurance companies and care support centers also offer training courses on the subject of nutrition, which can impart valuable knowledge. Particularly after an operation in which parts of the esophagus were removed, knowledge about special foods and forms of nutrition can also be very valuable for family caregivers.