Esophageal Cancer: Types, Causes, Symptoms, Diagnosis and Treatment Methods

Cancers that occur in the esophagus starting from the neck to the stomach are called esophageal or esophageal cancer. Esophageal cells are affected by stomach contents and reproduce uncontrollably by resembling the cells in the organs located in the lower parts of the digestive system. This causes the esophageal cells to become cancerous.

Esophageal Cancer is More Common in Who?

esophageal cancer in Turkey, especially, arises from the diet. Esophageal cancers, which are squamous cell types called squamous cells, are more common in eastern regions of our country such as Erzurum, Kars, Ağrı, Van, Bitlis and Muş. Nutrition based on meat and drinking hot tea play an important role in the occurrence of esophageal cancer in these provinces. Esophageal cancer with squamous cell is seen very frequently in regions starting from this eastern part up to China. Since this region is a cold and mountainous region, the preference of extremely hot drinks is an important factor. When alcohol and cigarettes are added to the consumption of these hot drinks, the incidence of esophageal cancer increases.

Esophageal cancer types are generally a disease that occurs in people over the age of 60. Although it is more common in men, it can occur at the same rate in women due to hot tea drinking in the Eastern region. Apart from all these, esophageal cancer can be seen much more frequently in people with colon cancer in their family.

What are the Types of Esophageal Cancer?

Esophageal cancer is classified according to the cell type and the region where it occurs. In this sense, esophageal cancer is divided into two groups as Adenocarcinoma and squamous cell esophageal cancer.

Adenocarcinoma Esophagus Cancer: In this type of cancer, the inner lining of the esophagus changes shape when exposed to bile and stomach acid and begins to resemble the inner lining of the stomach and glands. In other words, Adenocarcinoma esophagus cancer is a cancer originating from the cells that are transforming into this form. This type of esophageal cancer is more common than other cancer types in Western countries.

Esophageal Squamous Cell Cancer: Squamous called this type of cancer is caused by a thin membrane consisting of squamous cell cancer tissue lining the inside of the esophagus and frequently seen in Turkey.

Apart from these two types of esophageal cancer, other types originating from muscle tissue are very rarely seen. In addition, it is possible to separate esophageal cancer according to its location in the esophagus, as well as separating it according to cells.

Risk factors

Depending on the type, esophageal cancer can occur for the following reasons:

• Alcohol,
• Cigaret,
• HPV,
• Consuming very hot drinks,
• Achalasia,
• Various diseases such as Plummer Vinson and Tylosis,
• Ingesting caustic substances is considered as risk factors for esophageal cancer. In addition, the following conditions have also been associated with adenocarcinomas of the esophagus:
• Chronic acid reflux,
• Obesity,
• Barrett esophagus is also among the risk factors associated with adenocarcinomas.

Since bile reflux and stomach acid damage are located close to the stomach, esophageal cancer of the type of adenocarcinoma is generally seen at the entrance of the stomach or in the lower part of the esophagus. Squamous cancer also occurs in the upper or middle part.

What are the Symptoms of Esophageal Cancer?

The most common symptoms of esophageal cancer include difficulty swallowing and a feeling of stuffiness. First of all, there is difficulty in consuming solid foods. Later, it becomes in a state that even liquids cannot be easily consumed. Other symptoms of this disease include the following:

• Bleeding,
• Weight loss,
• Black or tarry stools
• Cough,
• Hoarseness,
• Constant weakness and fatigue are symptoms that occur in esophagus cancer.

Diagnostic Methods

When you consult a doctor with complaints such as difficulty swallowing or unexplained weight loss, your doctor will perform a physical examination after listening to your medical history. Then, some examinations may be requested to see if there is a growth that causes your complaints. These examinations are as follows:

Endoscopy

Generally, the first method used for diagnosis is endoscopy. In this method, the doctor can look into your esophagus with a flexible tube with a camera at the end, and take some samples for pathological examinations if deemed necessary.

Stomach and Esophagus and Stomach X-ray

This test is used to monitor the anatomical changes that occur in the esophagus. With this method, a liquid drug is swallowed under x-rays and its image is obtained during the passage of this drug through the esophagus.

Computed Tomography Scan

It is used in people with suspected esophageal cancer to detect whether the tumor has been in contact with surrounding organs, particularly lung and liver metastases.

Endoscopic Ultrasonography

Similar to the endoscopy method, but with a flexible tube with an ultrasonography device at its end, the tumor is examined with sound waves. The depth and spread of the tumor inside the esophageal wall and the general condition of the surrounding lymph nodes are examined.

Positron Emission Tomography

This test can be used to get information about possible cancer locations and to measure activity in cells. In particular, information about metastases to distant organs, lymph nodes and bones can be obtained.

What Are Esophageal Cancer Treatment Methods?

The treatment method in esophageal cancers depends on many factors, primarily the location and stage of the tumor. However, the most effective treatment option used in early cases is surgery. In some cases where only surgical treatment or radiotherapy may not be sufficient, combined therapies may also be considered.

The location of the tumor is very important in choosing the treatment. Generally, tumors located in the lower part of the esophagus are easily treated with surgery. However, the possibility of surgery is less for tumors in the upper part of the esophagus. In addition, early lesions are suitable for surgical method, while metastases and spread to surrounding tissues are reasons that require non-surgical methods. The depth and size of the lesion and the size of the mass can determine the choice of treatment. Because tumors longer than 7–8 cm are much more likely to spread to the surrounding tissues. On the other hand, the duration of the symptoms is of great importance for the stage of the disease.