Esophageal Cancer
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Esophageal Cancer
Esophageal cancer is a type of cancer that forms in the tissues of the oesophagus, the muscular tube that moves food from the throat to the stomach. This cancer typically begins in the cells lining the oesophagus and can spread to nearby lymph nodes or other organs if not detected early. Esophageal cancer is generally classified into two main types:
- Adenocarcinoma: Begins in the mucus-secreting cells, often in the lower part of the oesophagus. It’s the most common form, especially in people with a history of gastroesophageal reflux disease (GERD).
- Squamous cell carcinoma: Begins in the flat cells lining the oesophagus, most commonly in the upper and middle sections. This type is more commonly associated with lifestyle risk factors, such as smoking and alcohol consumption.
Esophageal Cancer Symptoms
Esophageal cancer symptoms may vary, but common signs to watch for include:
- Difficulty swallowing (dysphagia): This is often the most noticeable symptom and may worsen over time as the tumour grows, making it harder for food or even liquids to pass through.
- Chest pain or discomfort: A sensation of pressure, burning, or pain in the chest or back, especially during swallowing.
- Unexplained weight loss: Many people with esophageal cancer experience weight loss due to difficulty eating.
- Hoarseness or persistent cough: If the tumour affects the vocal cords or nerves, it can lead to hoarseness.
- Heartburn or indigestion: Persistent heartburn that doesn’t respond to treatment could be a warning sign.
- Vomiting or regurgitation: In advanced cases, food may come back up due to obstruction in the oesophagus.
Causes & Risks of Esophageal Cancer
The exact causes of esophageal cancer are not always clear, but certain factors may increase the risk of developing this disease:
- Gastroesophageal reflux disease (GERD): Chronic acid reflux can lead to changes in the esophageal lining (Barrett’s oesophagus), which raises the risk of adenocarcinoma.
- Smoking and alcohol use: Both significantly increase the risk of squamous cell carcinoma, especially when combined.
- Obesity: Being overweight can increase the risk of esophageal adenocarcinoma due to higher levels of acid reflux.
- Dietary factors: Diets low in fruits and vegetables, or high in processed foods, may increase cancer risk.
- Age and gender: Esophageal cancer is more common in men and typically occurs in individuals over 60.
- History of other cancers: People with a history of head or neck cancers are at higher risk.
- Barrett’s oesophagus: This condition, where the cells lining the lower oesophagus become abnormal due to prolonged acid exposure, can significantly increase cancer risk if untreated.
Diagnosing Esophageal Cancer
Diagnosing esophageal cancer requires a combination of procedures to detect abnormalities and confirm a cancer diagnosis. These methods help determine the cancer’s location, type, and spread, guiding the most effective treatment plan.
Endoscopy
During an endoscopy, a thin, flexible tube with a camera is gently inserted down the throat into the oesophagus, allowing doctors to view the oesophagus’ lining for irregularities or growths. Any suspicious areas can be biopsied during the procedure, enabling microscopic examination for cancer cells.
Barium Swallow Test
This imaging test involves the patient swallowing a barium solution, which coats the oesophagus. X-rays are then taken to visualise the outline of the oesophagus and highlight any structural changes, blockages, or growths.
Biopsy
When abnormalities are found during an endoscopy, a small sample of tissue (biopsy) is taken from the suspicious area. This tissue is then analysed under a microscope to confirm whether it’s cancerous, providing essential information on the type and aggressiveness of the cancer.
Imaging tests
CT scans, PET scans, or endoscopic ultrasound (EUS) can help determine the extent of the cancer and whether it has spread.
Esophageal Cancer Treatment
Treatment for esophageal cancer depends on the cancer’s stage, the patient’s overall health, and preferences. Options may include:
Esophagectomy, the surgical removal of part or all of the oesophagus, is a primary treatment for localised esophageal cancer. Minimally invasive techniques are often used, especially in early stages, allowing for a faster recovery. If a large section of the oesophagus is removed, reconstruction is done using a portion of the stomach to maintain digestive function, enabling patients to eat and drink more normally after recovery.
Radiation Therapy
High-energy beams target and destroy cancer cells, often used before surgery to shrink the tumour or after surgery to target remaining cells. Radiation is sometimes combined with chemotherapy.
Chemotherapy
Drugs are used to destroy cancer cells or stop them from growing. Chemotherapy may be given before surgery to shrink the tumour, or after surgery to eliminate residual cells.
Targeted Therapy
For certain types of esophageal cancer, targeted drugs may be used to attack specific abnormalities in cancer cells.
Immunotherapy
For advanced cases, immunotherapy can help the body’s immune system recognize and fight cancer cells. This treatment is particularly considered when traditional therapies are no longer effective.
Esophageal Cancer Surgery in Singapore
If you or a loved one is experiencing symptoms of esophageal cancer, timely treatment is essential. At O2 Lung Centre, our team comprises specialised cardiothoracic surgeons with deep expertise and advanced training to deliver comprehensive and personalised care for patients from diagnosis to advanced treatments like esophagectomy.
For a consultation or more information, please WhatsApp us at our Gleneagles Hospital clinic or Mount Elizabeth Orchard Hospital clinic today. Our specialists are here to guide you through every step of your journey to better health.