Esophageal Cancer

The esophagus is a muscular tube in the chest that is about 25 cm long. It helps food pass from the mouth to the stomach. The walls of the esophagus have four main layers:

• Inner layer : moist, which helps food slide easily into the stomach.
• Submucosa : Layer containing glands that produce mucus, keeping the esophagus moist.
• Muscle layer : Muscles help push food toward the stomach.
• Outer layer : covering that maintains the structure.

Esophageal Cancer Facts

• The exact causes are unknown, but certain factors increase the risk.
• The risk increases with prolonged irritation of the esophagus, such as from smoking, alcohol, or Barrett’s esophagus.
• Cancer is diagnosed through barium tests and confirmed by endoscopy and biopsy.
• It can cause pain and difficulty swallowing.
• Treatment depends on the size, location, and extent of the tumor, as well as the patient’s age.

Tumor cells

Cells are the basic unit of tissue. Healthy cells grow, divide, and die. Sometimes, this process goes awry and unnecessary cells form, creating a tumor.

• Benign tumors :
  • They are rarely life-threatening.
  • They can be removed and are unlikely to grow back.
  • They do not invade nearby tissues.

• Malignant tumors (cancer) :
  • They can be life-threatening.
  • They may grow back after removal.
  • They invade and damage surrounding tissues and organs.
  • They can spread to other parts of the body (metastasis).

Esophageal cancer usually begins in the cells of the inner lining and can penetrate deep through the various layers of the esophagus.

Types of Esophageal Cancer

• Adenocarcinoma : in the lower part of the esophagus, near the stomach.
• Squamous cell carcinoma : in the upper part of the esophagus.

Risk factors

• Age : highest risk over 65 years.
• Gender : More common in men.
• Smoking : significantly increases the risk.
• Alcohol : especially if combined with smoking.
• Diet : low in fruit and vegetables.
• Obesity : linked to adenocarcinoma.
• Gastroesophageal reflux : can damage tissues.
• Barrett’s esophagus : It changes the cells, increasing the risk.

Symptoms

Esophageal cancer often does not show early signs. Over time, the following may appear:

• Regurgitation of food.
• Pain when swallowing.
• Chest or back pain.
• Weight loss.
• Burning.
• Hoarseness persisting for more than two weeks.

These symptoms can also be caused by other, less serious disorders.

Diagnosis

Your doctor may recommend the following tests:

• Barium esophagoscopy : visualization using contrast medium.
• Endoscopy : exploration with a flexible instrument (gastroscope).
• Biopsy : sampling of tissue for analysis.

Staging

After diagnosis, the extent of the cancer’s spread is assessed to decide on the appropriate treatment:

• Depth of the tumor.
• Involvement of nearby tissues.
• Spread to other organs.

Cancer stages :

• Stage 0 : Abnormal cells only in the inner layer.
• Stage I : penetrates the submucosa.
• Stage II : Involves lymph nodes and deeper layers.
• Stage III : Reaches the outer layer and nearby organs.
• Stage IV : It has spread to other organs (metastasis).

Treatment

Options include:

• Surgery
• Radiotherapy
• Chemotherapy

The choice depends on:

• Location of the tumor.
• Extension and diffusion.
• General condition of the patient.

A multidisciplinary team is needed to personalize the treatment plan.

Useful questions to ask your doctor

• What is the stage of the disease?
• Has the cancer spread?
• What is the goal of therapy?
• What are the treatment options available?

This is a serious condition. Being informed will help you make clear decisions about your health.