Esophageal (Food Pipe) Cancer

About Esophageal Cancer

Esophagus or food pipe is a long muscular tube that delivers food from mouth to stomach. It starts in neck and courses through thorax to join with stomach in the upper abdomen. The cancer developing in the esophagus is known as esophageal cancer.

Risk Factors are: Smoking and Alcohol are most important risk factors. Prolonged acid reflux (heartburn) can also lead to this cancer. Other risk factors include obesity, older age, male sex, exposure to certain chemicals and history of head and neck cancer in past.

There are two main types of Esophageal Cancers:

• Squamous Cell Carcinoma
• Adenocarcinoma

What are the symptoms of Lung Cancer?

The most important and first symptom to develop is Difficulty in swallowing which is increasing progressively (i.e. initially to solids and progressing to liquids and even saliva). It may be associated with pain. Other important Symptoms are:

• Persistent pain and heartburn.
• Blood in vomiting.
• Hoarseness of voice
• Unintentional weight loss

How is it diagnosed?

When any of the above symptoms occur, do consult your doctor who may prescribe the following tests:

• Esophagoscopy or Upper GI Endoscopy: Used to look into the food pipe for the location of the tumor and biopsy the tumor.
• Biopsy: It is done to confirm the diagnosis
• CT scan/PET Scan: The scans are done to know the extent os the spread of the tumor and to assess the reesectability of the tumor.

How the disease is treated?

The treatment is devised according to general health of the patient, type, location and stage of the tumors. It involves

Surgery: Surgery is the mainstay of the treatment. It involves removal of the esophagus bearing the tumor along with the regional Lymph nodes. A gastric tube is then made and pulled up to replace the food pipe and joined to remaining food pipe in the neck or the chest. This can be done by various methods:

• Open Esophagectomy: Conventional method in which incision is given in the chest and abdomen to remove the tumor.
• Thoracoscopic Esophagectomy or Minimal Invasive Esophagectomy: In which the surgery is done with video assistance and small incisions are made in the chest and abdomen.
• Robotic Esophagectomy: The surgery is done with the Robot.

Minimal Invasive procedures lead to early recovery, less blood loss and similar oncologic outcomes.

Sometimes when the tumor is advanced the surgery is preceded by concurrent chemotherapy and radiotherapy to shrink the tumor. In some cases chemotherapy is given after the surgery also.

Radiotherapy: In majority of the cases where radiotherapy is required it is given preoperatively combined with chemotherapy. Radiotherapy along with chemotherapy may be primary mode of treatment in some cancers (usually in the upper part of esophagus).

Chemotherapy: Chemotherapy is usually given with radiotherapy. In some cases it is given before or after radiotherapy. Sometimes it may be used preoperatively to decrease the size of the tumors.

Targeted Therapy and Immunotherapy: Targeted therapy is treatment specifically meant to attack specifics targets on tumor cells, thus leading to minimal harm to normal cells. Immunotherapy is meant to modulate the immune e system to increase cancer cell kill. Immunotherapy is usually reserved for advanced spread out tumors.

Tags: Esophageal (Food Pipe) Cancer , Esophageal Cancer , types of Esophageal Cancers