Oesophageal Cancer

Overview

Oesophageal cancer is a type of cancer in the digestive system, located in the oesophagus (a hollow fibromuscular tube that communicates the throat and the stomach and its principal function is therefore the pass of food in order to be subsequently digested).

Food is firstly ingested and processed through the mouth through the mechanical digestion exerted by the teeth and tongue movement, reinforced by a chemical digestion carried out by the salivary enzymes. When swallowed, this food passes into the pharynx and after to the oesophagus that is one of the first components of digestive system and gastrointestinal tract. The oesophagus is assisted by several muscular rings, the upper and lower Oesophageal sphincter, and their functions are basically to allow the swallow of the food bolus and coordinate with the Oesophageal muscles with the aim of reinforce peristaltic contractions to carry the bolus until the stomach.

Oesophageal Cancers typically start in the squamous cells lining and in the glands or columnar tissue in the oesophagus.

Types of Oesophageal Cancer

Doctors classify Oesophageal cancer according to the type of cells that are involved, such as:

  • Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the oesophagus. Adenocarcinoma occurs most often in the lower portion of the oesophagus.
  • Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the oesophagus. Squamous cell carcinoma occurs most often in the middle of the oesophagus. This is the most prevalent Oesophageal cancer worldwide.
  • Other rare types. Rare forms of Oesophageal cancer include choriocarcinoma, lymphoma, melanoma, sarcoma and small cell cancer.

Risk Factors

A number of factors may increase your risk of Oesophageal Cancer. Some risk factors can be managed, for instance, by having a healthier lifestyle but other factors cannot be controlled, such as family history.

Risk factors for Oesophageal Cancer include:

  • Drinking alcohol
  • Having bile reflux
  • Having difficulty swallowing because of an Oesophageal sphincter that won’t relax (achalasia)
  • Drinking very hot liquids
  • Eating few fruits and vegetables
  • Having gastroesophageal reflux disease (GERD)
  • Being obese
  • Having precancerous changes in the cells of the oesophagus (Barrett’s oesophagus)
  • Undergoing radiation treatment to the chest or upper abdomen
  • Smoking

Signs and Symptoms

Although most Oesophageal Cancers do not cause any symptoms until they have spread too far to be cured people with early Oesophageal Cancer may have any of next symptoms:

  • Difficulty swallowing (dysphagia)
  • Weight loss without trying
  • Chest pain, pressure or burning
  • Worsening indigestion or heartburn
  • Coughing or hoarseness

In the case to be previously diagnosed with Barrett’s oesophagus, a precancerous condition that increases your risk of Oesophageal cancer caused by chronic acid reflux, it is important to consult doctor what signs and symptoms to watch for that may signal that this condition may be worsening.

Prognosis

Generally, in early stages (I and II) around 40 out of 100 people (40%) live for 5 years or more if the cancer is only in the oesophagus. As long as the tumour is more developed, the chances to survive low drastically being around 21 out of 100 people (21%) if the cancer has spread to nearby lymph nodes. Most people with advanced Oesophageal cancer live for between 3 to 12 months after their cancer is diagnosed. Around 4 out of 100 people (4%) live for 5 years or more. In patients whose cancer has grown from squamous cells, it has been reported slightly lower rates when compared to those with adenocarcinoma.

Oesophageal Cancer Diagnosis

PLEASE NOTE: EARLY DIAGNOSIS IN CANCER IS VERY IMPORTANT BECAUSE CANCER THAT’S DIAGNOSED AT AN EARLY STAGE ―BEFORE IT’S HAD THE CHANCE TO GET TOO BIG OR SPREAD―, IS MORE LIKELY TO BE TREATED SUCCESSFULLY. IF THE CANCER HAS SPREAD, TREATMENT BECOMES MORE DIFFICULT, AND GENERALLY A PERSON’S CHANCES OF SURVIVING ARE MUCH LOWER.

State of the Art

For years, imaging techniques such as the contrast radiography of the upper gastrointestinal tract and the endoscopy have been at the forefront of cancer diagnosis. Unfortunately, these procedures are inherently limited: first of all, the toxicity linked with the use of radiocontrast agent such as barium sulphate can be harmful for the patients; secondly, the use of endoscopy in an unappropriated way can lead to some injuries in the gastrointestinal tract while developing the imaging; thirdly, this kind of scans difficultly provide essential molecular information; and finally, all these procedures add significant costs over the course of treatment.

 

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