Esophageal cancer

Esophageal cancer occurs when cancer cells develop in the esophagus, a tube-like structure that runs from your throat to your stomach. Food goes from the mouth to the stomach through the esophagus. Cancer starts at the inner layer of the esophagus and can spread throughout the other layers of the esophagus and to other parts of the body (metastasis).

There are two main types of esophageal cancer:

• Squamous cell carcinoma begins in the cells (called squamous cells) that line the esophagus. This cancer usually affects the upper and middle parts of the esophagus.
• Adenocarcinoma develops in the tissue that produces mucus that aids in swallowing. It generally occurs in the lower part of the esophagus.
• Other rare types. Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma, and choriocarcinoma.

Dr. Manoj Dongare is one of the best esophageal cancer specialist in Pune which handles each and every case with utmost care.

During the early stages of esophageal cancer, you probably won’t experience any symptoms. As your cancer progresses, you may experience:

• unintentional weight loss
• indigestion
• heartburn
• pain or difficulty when swallowing
• frequent choking while eating
• vomiting
• food coming back up the esophagus
• chest pain
• fatigue
• chronic cough

Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

• Consuming alcohol
• Smoking
• Having a reflux disorder, such as gastroesophageal reflux disease (GERD)
• Having precancerous changes in the cells of the esophagus (Barrett’s esophagus)
• Being obese
• Drinking alcohol
• Having bile reflux

As esophageal cancer advances, it can cause complications, such as:

• Obstruction of the esophagus. Cancer may make it difficult for food and liquid to pass through your esophagus.
• Pain. Advanced esophageal cancer can cause pain.
• Bleeding in the esophagus. Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.

The doctor will ask you about your medical history, including your current symptoms. After a physical examination, the doctor might order certain tests that can help in diagnosing and assessing esophageal cancer.

• Barium swallow uses a special series of X-rays to visualize the esophagus. The patient drinks a liquid containing barium, which makes the esophagus easier to see on the X-ray.
• esophagoscopy is a procedure that allows the doctor to look at the inside of the esophagus using a thin, lighted tube called an endoscope. For the test, the endoscope is passed through the mouth and down the throat into the esophagus while you are asleep. The endoscopy can also be used to relieve the obstruction.
• Biopsy: During the esophagoscopy, the doctor may remove a small piece of tissue to examine under a microscope to see if there are any cancer cells.

Once a diagnosis of esophageal cancer is confirmed, Cancer Specialist may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.

Tests may include:

• Bronchoscopy
• Endoscopic ultrasound (EUS)
• Computerized tomography (CT)
• Positron emission tomography (PET)

The approach to treatment depends on the stage and grade of cancer. Treatment options that may be used for esophageal cancer include:

A) Surgery:
To remove cancer can be used alone or in combination with other treatments.

• Surgery to remove very small tumors. If your cancer is very small, confined to the superficial layers of your esophagus, and hasn’t spread, your surgeon may recommend removing cancer and the margin of healthy tissue that surrounds it.
• Surgery to remove a portion of the esophagus (esophagectomy). During an esophagectomy, the surgeon removes the portion of your esophagus that contains cancer, along with a portion of the upper part of your stomach, and nearby lymph nodes. The remaining esophagus is reconnected to your stomach.
• Surgery to remove part of your esophagus and the upper portion of your stomach (esophagogastrectomy). During esophagogastrectomy, the surgeon removes part of your esophagus, nearby lymph nodes, and a larger part of your stomach. The remainder of your stomach is then pulled up and reattached to your esophagus.

B) Chemotherapy:
Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time. As explained above, chemotherapy and radiation therapy are often given at the same time to treat esophageal cancer, called chemo radiotherapy.

C) Radiation therapy
Radiation therapy uses beams of radiation to kill cancer cells. Radiation may be administered externally (with the use of a machine) or internally (with a device placed near the tumor, which is called brachytherapy).

Radiation is commonly used along with chemotherapy, and side effects are usually more severe when a combined treatment is used. Radiation therapy is also used to relieve complications of advanced esophageal cancer, such as when a tumor grows large enough to stop food from passing to your stomach.

D) Targeted therapy
Targeted therapy is a treatment that targets cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

E) Immunotherapy
Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that make it hard for the immune system cells to recognize the cancer cells as dangerous. Immunotherapy works by interfering with that process. For esophageal cancer, immunotherapy might be used when the cancer is advanced, cancer has come back or cancer has spread to other parts of the body.

Dr. Manoj Dongare at Dr. D. Y. Patil Hospital and Research Center provides the best treatment for various gastrointestinal diseases in Pimpri Chinchwad Pune. For more information about our comprehensive treatment options, or to request an appointment with the best Surgical Oncologist in Pune call 09881379573 or Click on Book Appointment for online booking with your near hospital.