Esophageal Cancer

Esophageal cancer is the growth of malignant cells that occur in the esophagus ( gullet ) . The esophagus is the tube that carries food from the mouth to the stomach.

Esophageal cancer can be experienced by everyone, but it is more experienced by men over the age of 40. These cancer cells usually start from cells on the inside of the esophagus.

The sooner esophageal cancer is detected and treated, the better the treatment results will be.

Causes of Esophageal Cancer

The cause of esophageal cancer is not certain. However, this cancer is thought to arise because cells in the esophagus undergo genetic changes or mutations, so they grow abnormally and uncontrollably. These abnormal cells accumulate to form a tumor in the esophagus.

Although the cause is not known with certainty, there are several conditions that can increase a person's risk of developing esophageal cancer, including:

Smoking habits, because the content of toxins and harmful compounds in cigarettes can cause irritation to the lining of the esophagus thereby increasing the risk of esophageal cancer
Excessive consumption of alcoholic beverages, because alcohol can make the esophagus experience irritation and inflammation which can trigger the growth of abnormal cells
Abnormalities of the esophagus, such as Barret's esophagus and achalasia
Obesity
Diet low in fiber
Radiotherapy , for example for the treatment of other cancers in the neck area

Esophageal Cancer Symptoms

Esophageal cancer rarely causes symptoms in its early stages. Symptoms usually only appear when the cancer has reached an advanced stage. Some of the symptoms of esophageal cancer include:

Heartburn
Pain in the throat or behind the breastbone
Chronic cough that occurs continuously
Difficulty swallowing ( dysphagia )
Weight loss drastically
Coughing up blood or vomiting blood
Bloody or dark stools

When to see a doctor

Immediately do an examination to the doctor if you feel the symptoms of esophageal cancer. In addition, sufferers of Barret's esophagus also need regular checks to the doctor. Barret's esophagus is a precancerous condition that increases a person's risk of developing esophageal cancer.

Patients with esophageal cancer or esophageal cancer must routinely check with their doctor, both during treatment and after treatment is complete. This is necessary so that doctors can evaluate treatment and detect earlier if the disease reappears.

Esophageal Cancer Diagnosis

In the early stages, the doctor will diagnose esophageal cancer by asking about the patient's symptoms and medical history. After that, the doctor will carry out a physical examination and the following supporting examinations:

Endoscopy
Endoscopy is performed to check for irritation or the presence of cancer in the esophagus.
X-ray
photo X-ray photo aims to see an overview of the esophageal tract. During this examination, the patient will be asked to drink a dye (contrast) so that the esophagus can be seen more clearly.
Biopsy
In this examination, the doctor will take a sample of the esophageal tissue to be examined in the laboratory. The purpose of the biopsy examination is to detect cancer cells in the esophageal tissue.

After confirming the presence of cancer cells, the doctor can perform other tests, such as a chest X-ray or CT scan, to determine the stage of the cancer. From this examination, the doctor can determine the stage of the cancer, as explained below:

Stage 1
At this stage, the cancer is still in the lining of the esophagus and has not spread to surrounding tissues, such as the lymph nodes.
Stage 2
In stage 2A, cancer cells have grown to cover the outer lining of the esophagus. While in stage 2B, the cancer has passed through the muscle layer and spread to the lymph nodes.
Stage 3
Stage 3A indicates the cancer cells have reached the tissue covering the lungs (pleura) and the muscles under the ribs. Meanwhile, in stage 3B, cancer cells have grown to cover the outer layer of the esophagus and spread to the lining of the lymph nodes around the esophagus.
Stage 4
At stage 4, the cancer is in an advanced stage and has spread to other organs, including the liver or lungs.

Esophageal Cancer Treatment

Treatment for esophageal cancer will be adjusted to the location and stage of the cancer. The types of treatment for esophageal cancer are:

1. Operation

Surgery may be performed to remove small cancerous tissue, part of the affected esophagus (esophagectomy), or part of the esophagus and upper part of the stomach (esophagogastrectomy).

Surgeons can perform surgery using an open surgical method or by laparoscopy . The type of surgery performed will be adjusted to the patient's condition.

2. Chemotherapy

Chemotherapy is the administration of drugs to kill cancer cells. This procedure can be done before or after surgery, and can be combined with radiotherapy.

Chemotherapy can cause a number of side effects, including nausea, weight loss, diarrhea, fatigue, loss of appetite, infection, and easy bruising and bleeding.

3. Radiotherapy

Radiotherapy is performed using special rays to kill cancer cells. Usually this therapy is combined with chemotherapy. Radiotherapy is done every day, for 2–6 weeks.

Side effects that patients can feel after undergoing radiotherapy include skin reactions such as burning or pain, difficulty swallowing food and drink, and organ damage around the tumor growth site.

4. Target therapy

Target therapy is the administration of drugs to inhibit the growth and spread of cancer cells in the esophagus.

5. Other therapy

Apart from the methods above, esophageal cancer can also be treated with the following procedures:

Immunotherapy, which is the administration of drugs to boost the immune system to attack cancer cells
Electrocoagulation, to destroy cancer cells with an electric current
Cryotherapy , to freeze and help shrink cancer cells.

Esophageal cancer can cause difficulty swallowing (dysphagia) so that sufferers are at risk of experiencing nutritional deficiencies. To treat dysphagia, the doctor will ask the patient to improve their diet, train the muscles of the esophagus, and improve body position while eating.

Esophageal Cancer Complications

Esophageal cancer can cause a number of complications, namely:

Blockage of the esophagus Esophageal
cancer can cause the diameter of the esophagus to shrink so that food and drinks will be difficult to pass through the esophagus.
Pain around the neck
Esophageal cancer that has reached an advanced stage can cause pain in the neck and surrounding areas.
Esophageal
bleeding Bleeding in the esophagus due to cancer usually appears gradually, but can also appear suddenly.
Complications after surgery
Patients who have recently undergone surgery for esophageal cancer are at risk of complications in the form of infection, bleeding in the operating area, and torn esophagus.

If complications occur, the treatment that can be done includes removing the esophageal blockage through the installation of special medical devices to keep the esophagus open.

Another action is the installation of a tube to help overcome difficulty eating after undergoing esophageal surgery.