Oesophageal cancer

About

Oesophageal cancer is a type of cancer that affects the oesophagus (or food pipe), which is the tube that carries food and drink from the mouth to the stomach. It can start anywhere along the oesophagus and is more common in men than women. Oesophageal cancer can either be squamous cell carcinoma, which starts in the cells that line the oesophagus, or adenocarcinoma, which starts in the cells that make and release mucus and other fluids. Symptoms can range from difficulty swallowing to pain or discomfort in the chest or back. Risk factors include smoking, drinking too much alcohol and having an unhealthy diet. Treatment usually involves surgery, chemotherapy, radiation and targeted therapy.

Symptoms

The symptoms of oesophageal cancer can vary depending on the location and stage of the cancer, however the most common symptoms include difficulty swallowing, painful swallowing, feeling full very quickly when eating, hoarseness or a dry cough, regurgitating food, and weight loss. Other less common symptoms may include chest pain and a general feeling of fatigue.

Causes

The most common known cause of oesophageal cancer is smoking and alcohol use. Other risk factors that may play a role include: being over the age of 50, being male, having Barrett’s oesophagus (abnormal cells in the oesophagus), having gastro-oesophageal reflux disease (GERD), being exposed to certain chemicals, and having a family history of oesophageal cancer. Obesity can also increase the risk of oesophageal cancer.

Risk factors

The risk factors for oesophageal cancer include:

Smoking and heavy alcohol consumption.
Acid reflux or gastroesophageal reflux disease (GERD).
Poor diet, including a diet low in fruits and vegetables.
Obesity.
Older age.
Barrett’s oesophagus.
Certain genetic syndromes, such as familial adenomatous polyposis (FAP).
Achalasia.
Radiotherapy to the chest.
Certain viruses, such as human papillomavirus (HPV) 16 or 18.

Diagnosis

Oesophageal cancer is typically diagnosed through a series of tests and procedures, including:

Endoscopy: a thin, flexible tube with a light and camera at the end is inserted through the mouth and down the throat to look for any changes in the oesophagus.
Biopsy: If a change is spotted, a biopsy may be taken to further examine the cells for cancerous or pre-cancerous changes.
Imaging tests: X-rays, computerised tomography (CT) scans, and positron emission tomography (PET) scans may be used to check for any spread of the cancer to other areas of the body.
Blood tests: Blood tests may be performed to check for specific markers that can help diagnose and stage the cancer.

Sub-types

Oesophageal cancer is divided into two main types based on the type of cell affected by the cancer. The two types are squamous cell carcinoma and adenocarcinoma.

Squamous Cell Carcinoma (SCC) is the most common type of oesophageal cancer. It starts in the cells that line the upper part of the oesophagus and usually affects middle-aged or older adults.

Adenocarcinoma is the second most common type of oesophageal cancer and starts in the cells that form the mucus-producing glands of the oesophagus. This type of cancer occurs more often in people who have chronic gastroesophageal reflux disease (GERD) and is usually found in the lower part of the oesophagus.

Less common types of oesophageal cancer include small cell carcinoma, lymphoma and sarcoma. Small cell carcinoma is an aggressive cancer that is very responsive to chemotherapy and is usually found in the upper third of the oesophagus. Lymphoma is a cancer of the immune system that normally affects the lymph nodes and surrounding tissues, but can also affect the oesophagus. Sarcomas affect the supportive tissue of the oesophagus and can either be benign or malignant.

Treatments

Treatment options for oesophageal cancer typically depend on a variety of factors such as the stage of the cancer, the location of the tumour, and the overall health of the patient.

Surgery is the most common form of treatment for oesophageal cancer. Surgery options may include minimally invasive endoscopic procedures, such as endoscopic mucosal resection (EMR) or a gastroplasty. These procedures remove the cancerous cells from the surface of the oesophagus. Other surgical options may include an oesophagectomy, which is an operation to remove part of the oesophagus in order to eliminate the cancer.

Radiotherapy is another option to treat oesophageal cancer. It involves using high energy radiation to kill the cancerous cells. It is generally used in combination with chemotherapy to provide greater effectiveness.

Chemotherapy is another form of treatment that uses drugs to attack the cancer cells. It is generally used in combination with radiation or surgery.

Newer treatments may also be available depending on the patient’s condition and stage of the cancer. These may include targeted therapies, immunotherapies, and photodynamic therapy. These treatments can also be combined with other treatments to increase the effectiveness.

Prevention

Stop smoking and avoid secondhand smoke.
Avoid drinking alcohol in excessive amounts.
Maintain a healthy weight by eating a balanced and nutritious diet and exercising regularly.
Avoid foods that are high in fat and salt.
Eat more foods that are high in fruits, vegetables, and fiber.
Talk to your doctor about getting the HPV vaccine if you are at risk of the virus.
Avoid regularly taking certain medications, such as aspirin or ibuprofen (NSAIDs).
Have regular screenings for Barrett’s esophagus, a precancerous condition.
Limit your exposure to air pollution.
0. Have any abnormal symptoms checked out by an experienced doctor.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of oesophageal cancer. Men are more likely to develop oesophageal cancer than women, and they tend to be diagnosed in later stages and with more advanced forms of the disease. Women may be more likely to present with early-stage oesophageal cancer, and their disease is likely to be more localized. Treatment for oesophageal cancer in women may also involve more targeted approaches such as endoscopic resection and ablation therapy, whereas men may be more likely to receive chemotherapy and radiation. Additionally, gender-based differences in the psycho-social aspects of oesophageal cancer have been reported in terms of self-efficacy and perceived effectiveness of treatments, as well as quality of life and symptom burden.

Nutrition

Nutrition plays an important role in the management of oesophageal cancer, as it helps to prevent the side effects of treatment, improve recovery times and boost immunity. Eating a balanced diet rich in whole grains, fruit and vegetables, low-fat dairy, fish and lean protein can help to reduce the risk of oesophageal cancer, as well as provide important nutrients that can help support the body during treatment. Additionally, certain foods can help to reduce common symptoms associated with oesophageal cancer, such as difficulty swallowing. Eating softer, more easily digestible foods that are high in nutrients can help to reduce the risk of blockages forming inside the oesophagus or stomach, which can make swallowing difficult. Finally, nutritional supplementation has been shown to reduce the risk of oesophageal cancer. Supplements containing antioxidants, vitamins, minerals and other nutrients have been found to reduce the risk by up to 50%. This is particularly important in patients who may not be able to meet their nutritional needs through diet alone.

Physical Activity

Physical activity has been shown to be beneficial for preventing and managing many types of cancer, including oesophageal cancer. Studies suggest that physically active individuals have a significantly lower risk of developing oesophageal cancer, potentially due to reducing chronic inflammation of the digestive tract and related digestive problems. Furthermore, physical activity may also help improve overall health, reduce the risk of other forms of cancer, and improve recovery from oesophageal cancer treatments. Regular exercise may also be beneficial in maintaining an overall healthier lifestyle, which may reduce the risk of oesophageal cancer. Therefore, engaging in regular physical activity may be beneficial for individuals looking to reduce their risk of oesophageal cancer and improve their overall health.