National Esophageal Cancer Month: Here’s What You Need to Know
By Jane Meggitt
Esophageal cancer is not common, but it can prove devastating. Worldwide, it is the sixth leading cause of cancer deaths. April is National Esophageal Cancer Awareness Month, raising awareness of the risk factors and symptoms involved, as well as potential prevention.
The Esophageal Cancer Action Network (ECAN) started National Esophageal Cancer Month in 2009. In 2020, more than 18,000 people in the U.S. succumbed to this disease.
Esophageal Cancer
The esophagus is the tube through which food and liquid travel from the throat to the stomach.
There are two primary types of esophageal cancer. Adenocarcinoma is most often found in the part of the esophagus near the stomach. Squamous cell carcinoma generally affects the middle and upper section of the muscular tube.
Esophageal Cancer Risk Factors
Smoking, a factor in many types of cancer and other diseases, is a major risk factor for cancer of the esophagus. A history of heavy alcohol consumption also increases the risk of developing esophageal cancer. Other risk factors include:
- Chronic acid reflux
- Lack of fruits and vegetables in the diet
- Obesity
- Radiation treatment to the chest
- Regularly drinking hot liquids
Esophageal cancer strikes men three times more frequently than women. Older people are also more vulnerable to this disease.
A precancerous condition known as Barrett’s esophagus, resulting from acid reflux, places patients at additional risk. Any person with gastroesophageal reflux disease (GERD) should talk to their doctor about ways to control acid reflux to lower their esophageal cancer risk.
The good news is that many of these risk factors are preventable. There are various therapies available to help smokers kick the habit. Those struggling with alcohol issues should seek help from a doctor or substance abuse treatment program.
Esophageal Cancer Symptoms
In its earliest stages, esophageal cancer is usually asymptomatic. As it progresses, symptoms may include:
- Chest pain or pressure
- Coughing
- Difficulty swallowing
- Heartburn
- Hoarseness
- Lump beneath the skin
- Unexplained weight loss
Because symptoms generally appear in the later stages of the disease, treating esophageal cancer is challenging. Visit a doctor as soon as possible if experiencing any of these symptoms. Early diagnosis saves lives.
Esophageal Cancer Diagnosis
Several diagnostic procedures are used when esophageal cancer is suspected. In a barium swallow study, the patient swallows a liquid containing barium. X-rays are then taken. The barium coats the esophagus, and any tissue changes appear on the X-ray.
An esophagoscopy is a procedure in which a thin tube with a light and lens, known as an esophagoscope, is inserted into the esophagus via the nose or mouth. The device may have a tool with which the doctor can perform a biopsy. A small tissue sample is removed from the esophagus and sent to a pathologist who looks for cancer cells.
Additional tests are conducted once an esophageal cancer diagnosis is made. These tests can help the doctor determine the stage of the cancer, ranging from early Stage I to advanced Stage IV. Such tests may include:
- Bronchoscopy
- Computerized Tomography (CT) scan
- Positron Emission Tomography (PET) scan
Esophageal Cancer Treatment
If the tumors are small, they are surgically removed. This surgery is often performed endoscopically. When the tumor is larger, an esophagectomy, or surgery to remove part of the esophagus, is necessary. The remaining part of the esophagus is then connected to the stomach. In an esophagogastrectomy, surgery is performed to remove the upper part of the stomach along with part of the esophagus. The remaining stomach is reattached to the esophagus. A portion of the colon is sometimes removed and used to connect the two.
Patients may undergo chemotherapy both before and after surgery. Radiation is often combined with chemotherapy, especially prior to surgery.
When a tumor has grown too large, it can interfere with food reaching the stomach. Radiation therapy can help relieve this particular complication.
Patients may receive immunotherapy, which helps the immune system combat cancer. Targeted drug therapy is sometimes combined with chemotherapy to hone in on and kill cancer cells.
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