Oesophageal Cancer - Symptoms, causes and treatment

Causes of Esophageal Cancer

The cause of esophageal cancer is not yet known. However, this cancer is thought to arise because the cells in the esophagus undergo genetic changes or mutations, so that they grow abnormally and uncontrollably. These abnormal cells accumulate to form a tumor in the esophagus.

Although the exact cause is not known, there are several conditions that can increase a person's risk of developing esophageal cancer, including:

• Smoking habit. The content of toxins and harmful compounds in cigarettes can cause irritation to the lining of the esophagus, thereby increasing the risk of esophageal cancer
• Excessive alcohol consumption. Just like cigarettes, alcohol can irritate and inflame the esophageal tract, which can trigger abnormal cell growth
• Oesophageal disorders, such as Barrett's esophagus and achalasia
• Obesity
• A diet lacking in fiber
• Radiotherapy, for example for the treatment of other cancers in the neck area

Symptoms of Esophageal Cancer

In the early stages, esophageal cancer rarely causes symptoms. Symptoms usually only appear when the cancer has reached an advanced stage. Symptoms of esophageal cancer include:

• heartburn
• Pain in the throat or behind the sternum
• Chronic cough that occurs continuously
• Difficulty swallowing (dysphagia)
• Drastic weight loss
• Coughing up blood or vomiting blood
• Chapter bloody or dark in color

When to see a doctor

If you feel the symptoms of esophageal cancer, immediately do an examination to the doctor. In addition, people who suffer from Barrett's esophagus also need to regularly check with a doctor. Barrett's esophagus is a precancerous condition that increases a person's risk of developing esophageal cancer.

Patients with esophageal cancer or esophageal cancer should have regular check-ups with a doctor, both during treatment and after treatment is complete. This is necessary so that doctors can evaluate treatment and detect early if the disease reappears.

Diagnosing Esophageal Cancer

In the early stages, the doctor will diagnose esophageal cancer by asking the patient's symptoms and medical history. After that, the doctor will perform a physical examination and some supporting examinations. The supporting examinations include:

• Endoscopy

  Endoscopy is performed to determine the occurrence of irritation or the presence of cancer in the esophageal tract.

• X-Ray

  In this examination, the patient is asked to drink a dye (contrast), so that the esophageal tract will be clearly visible when an X-ray is performed.

• Biopsi

  In this examination, the doctor will take a sample of esophageal tissue for later examination in the laboratory. The purpose of the biopsy is to determine the presence of cancer cells.

After confirming the presence of cancer cells, the doctor can perform other tests to determine the stage and spread of cancer. The examination is in the form of a chest X-ray or CT scan. From this examination, the doctor can determine the stage of the cancer which consists of:

• Stage 1

  At this stage, the cancer is still in the lining of the esophagus and has not spread to surrounding tissues, such as the lymph nodes.

• Stage 2In stage 2A, cancer cells have grown to cover the outer layer of the esophagus. In stage 2B, the cancer has passed through the muscle layer and spread to the lymph nodes.

• Stage 3Stage 3A indicates that cancer cells have reached the tissue that covers the lungs (pleura) and the muscles under the ribs. Stage 3B indicates cancer cells have grown to cover the outer layer of the esophagus and spread to the lining of the lymph nodes around the esophagus.

• Stage 4This stage indicates that the cancer is in an advanced stage and has spread to other organs of the body, including the liver or lungs.

Oesophageal Cancer Treatment

Treatment of esophageal cancer will be adjusted according to the location and stage of the cancer. The types of treatment for esophageal cancer are:

1. Operation

Surgery can be performed to remove small cancerous tissue, part of the cancerous esophagus (esophagectomy), or part of the esophagus and upper part of the stomach (esophagogastrectomy).

Surgeons can perform operations by open surgical methods or by laparoscopy. The type of surgery performed will be adjusted to the patient's condition.

2. Chemotherapy

This procedure is done by giving drugs to kill cancer cells. Chemotherapy can be done before or after surgery, as well as in combination with radiotherapy.

Chemotherapy can cause a number of side effects, including nausea, weight loss, diarrhea, fatigue, loss of appetite, infection, easy bleeding and bruising.

3. Radiotherapy

This therapy is done by using a special light to kill cancer cells. Usually this therapy is combined with chemotherapy. Radiotherapy is done every day, for 2-6 weeks.

Side effects that patients can feel after undergoing radiotherapy include skin reactions such as burning or pain, difficulty swallowing food and drinks, and damage to organs around the tumor growth site.

4. Target therapy

This method of treatment is aimed at inhibiting the growth and spread of cancer cells growing in the esophagus, using special drugs.

5. Other therapy

In addition to the four methods above, esophageal cancer can also be treated with the following procedures:

• Immunotherapy, to increase the immune system to attack cancer cells with special drugs.
• Electrocoagulation, to destroy cancer cells with electricity.
• Cryotherapy, to freeze and help shrink cancer cells.

Esophageal cancer can cause sufferers to have difficulty swallowing (dysphagia). This condition is at risk of causing nutritional deficiencies. To overcome dysphagia, doctors can ask patients to improve their diet, train the muscles in the esophagus, and improve body position when eating.

Complications of Esophageal Cancer

Oesophageal cancer can cause a number of complications, namely:

• Oesophageal obstruction

  Esophageal cancer can cause the diameter of the esophagus to shrink so that food and drink will be difficult to pass through the esophagus.

• Pain around the neck

  Esophageal cancer that has reached an advanced stage can cause pain in the neck and surrounding areas.

• Bleeding in the esophagus

  Bleeding in the esophagus due to cancer usually appears gradually, but can also appear suddenly.

• Complications after surgery

  After esophageal cancer surgery, patients are at risk for complications such as infection, bleeding in the operating area, and tearing of the esophagus.

Treatment that can be done if complications occur include removing esophageal obstruction by installing special medical devices to keep the esophagus open.

Another action is to install a tube to provide food intake, if the patient has difficulty swallowing after undergoing esophageal surgery.

Esophageal Cancer Prevention

There are several steps you can take to prevent esophageal cancer and reduce its risk, including:

• Limiting alcohol consumption
• Quit smoking
• Increase the consumption of high-fiber foods, such as vegetables and fruit
• Maintaining ideal body weight