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Oesophageal cancer: Treatment, symptoms, advice and help

About oesophageal cancer

Oesophageal cancer (abnormal growth of cells) refers to the malignancy of the oesophagus, also called the food pipe. Oesophagus is a muscular tube-like structure of gastrointestinal tract which connects the mouth to the stomach. Oesophageal cancer arises from the cells lining the oesophagus. If the cancer arises from upper and middle part of oesophagus, then it is termed as squamous cell cancer whereas cancer arising from the lower part of the oesophagus is called adenocarcinoma.

Oesophageal cancer: Incidence, age and sex

Oesophageal cancer is a rarely encountered gastrointestinal cancer. Individuals of more than 50 years of age are more susceptible, though it can occur in any age group. It is more common in men than women. Upper or middle part of the oesophagus (squamous cell cancer) is frequently involved than lower part (adenocarcinoma).

Signs and symptoms of oesophageal cancer: Diagnosis

The clinical features of oesophageal cancer include difficulty in swallowing food which may gradually progress to painful swallowing of both solids and liquids. Some individuals may also experience backflow of food from the food pipe into the mouth. Chest pain or vomiting of blood is usually seen late in the course of cancer. Other concurrent clinical symptoms include fever, loss of appetite and weight loss.

Such features need to be evaluated comprehensively by a gastroenterologist who may conduct investigations like endoscopy which helps in direct visualization of the interior of the food pipe. A small specimen of tumour tissue can also be taken during endoscopy to study under microscope and confirm the diagnosis. MRI scan of the chest may be required to assess the extent and spread of oesophageal cancer.

Causes and prevention of oesophageal cancer

The exact cause of oesophageal cancer is not very clear. However, several risk factors may pose a risk for cancer occurrence. For example repeated reflux of gastric acid juice into oesophagus may damage the wall of lower end of oesophagus. This results in structural damage to the cells and is termed as ‘Barrett’s Oesophagus’. Other risk factors include positive family history, drinking hot liquids, smoking and alcohol.

Oesophageal cancer: Complications

Oesophageal cancer may spread to the adjacent tissues and also distant sites like the lymph nodes and lungs through the bloodstream and lymphatic route. The spread of cancer is a sign of poor prognosis. Moreover in certain cases, the regurgitated food can be aspirated into lungs, resulting in pneumonia, which is a serious infection of the lungs.

Oesophageal cancer: Treatment

The management of oesophageal cancer depends upon the severity and spread of the cancer. The health status and age of the affected individuals also play a role in determining the treatment plan. Surgical resection of the affected part of the oesophagus (oesophagectomy) is the first line of management in cancer which is small and localised. However, if the cancer has spread to other tissues, then chemotherapy and radiotherapy may also be considered. A newer treatment modality named ‘photodynamic therapy’ is also considered. This is a type of laser therapy wherein the cancer cells absorb anti-cancer drugs and destroy them when exposed to a special type of light.

The overall prognosis of oesophageal cancer is poor. The cancer has a fair chance of cure if it is localised and has not yet spread. However, the survival rate is very poor if the cancer has spread to other body tissues.