What Is Oesophageal Cancer?
Oesophageal cancer is a cancer that affects the oesophagus, which is the tube that carries food from the mouth to the stomach. This condition occurs when abnormal cells in the oesophagus grow uncontrollably, forming tumours that can interfere with normal swallowing and digestion. There are two main types – adenocarcinoma, which typically affects the lower part of the oesophagus, and squamous cell carcinoma, which usually develops in the upper portion. Understanding the causes, symptoms, diagnosis, and available treatments for oesophageal cancer is essential in managing this disease effectively.
What Causes Oesophageal Cancer?
The exact cause of oesophageal cancer is unclear, but certain factors can increase the risk of developing it. Frequent and long-term acid reflux, known as gastroesophageal reflux disease (GERD), is a major risk factor, as it can damage the oesophagus over time. Other risk factors include smoking, excessive alcohol consumption, obesity, a poor diet lacking in fruits and vegetables, and a family history of oesophageal cancer.
What Are the Symptoms of Oesophageal Cancer?
The symptoms of oesophageal cancer can vary depending on the stage of the disease and its location. Some common symptoms include:
- Difficulty Swallowing (Dysphagia) – One of the most common early symptoms is difficulty swallowing solid foods and, later on, even liquids. This occurs because the tumour narrows the oesophagus, making it hard for food and liquids to pass through.
- Persistent Chest Pain or Discomfort – Individuals with oesophageal cancer may experience pain or discomfort in the chest area, often behind the breastbone. The pain can be sharp or dull and may worsen when swallowing.
- Unintentional Weight Loss – Oesophageal cancer can cause a loss of appetite and unintended weight loss. This is because swallowing difficulties lead to reduced food intake and therefore reduced calorie intake.
- Chronic Cough – Some people with oesophageal cancer may develop a chronic cough that does not respond to typical treatments. This can result from irritation in the oesophagus or the cancer spreading to nearby structures.
- Hoarseness or Voice Changes – Cancer in the upper part of the oesophagus may affect the nearby vocal cords, causing hoarseness or changes in the voice.
How Is Oesophageal Cancer Diagnosed?
Diagnosing oesophageal cancer usually involves several steps. First, a doctor will perform a physical examination and inquire about the patient’s medical history. Next, imaging tests such as X-rays, CT scans, or endoscopy may be done to visualise the oesophagus and identify any abnormalities. A biopsy, where a small tissue sample is taken from the oesophagus for analysis, is typically done to confirm the presence of cancer cells.
What Are the Complications of Oesophageal Cancer?
Oesophageal cancer can lead to several complications, particularly as the disease progresses or if it is not promptly treated. Some of the potential complications include:
- Severe Difficulty Swallowing – As the tumour grows, it can further narrow the oesophagus, making swallowing increasingly difficult. This condition, known as dysphagia, can result in malnutrition, dehydration, and weight loss, as patients may struggle to eat enough food and drink sufficient fluids.
- Oesophageal Obstruction – In the advanced stages of oesophageal cancer, the tumour can completely obstruct the oesophagus, making it nearly impossible for any food or liquid to pass through. This can cause significant pain, discomfort, and a feeling of fullness after only small amounts of food.
- Regurgitation and Aspiration – Food and stomach acid can regurgitate back into the throat and mouth when the oesophagus is obstructed. This may lead to choking, difficulty breathing, and an increased risk of aspiration pneumonia, a serious lung infection caused by inhaling food, saliva, or stomach contents into the lungs.
- Spread of Cancer (Metastasis) – Oesophageal cancer can spread to nearby lymph nodes and other organs, such as the liver, lungs, and bones. When cancer cells metastasise, it becomes more challenging to treat effectively, and the prognosis may worsen.
- Bleeding and Anaemia – The cancerous tumour can erode the blood vessels in the oesophagus, leading to bleeding. This can cause symptoms like vomiting blood or passing dark, tarry stools. Chronic bleeding can result in anaemia, a condition characterised by a deficiency of red blood cells.
- Pain and Discomfort – Patients may experience persistent chest or upper abdomen pain as the tumour grows and affects nearby tissues and nerves.
Can Oesophageal Cancer Be Prevented?
While there is no guaranteed way to prevent oesophageal cancer, certain lifestyle changes can reduce the risk. These include quitting smoking, moderating alcohol intake, maintaining a healthy weight through diet and exercise, and managing acid reflux and GERD with the help of a healthcare professional.
What Are the Medications for Oesophageal Cancer?
The specific treatment for oesophageal cancer depends on the stage and type of cancer and the patient’s overall health. Medications may be combined with other therapies like surgery, radiation, and chemotherapy. Targeted therapies and immunotherapy are newer treatment options that can be used for certain types of oesophageal cancer, helping to target cancer cells more precisely and boosting the body’s immune response.
What Are the Surgical Interventions for Oesophageal Cancer?
Surgery is a common treatment option for early-stage oesophageal cancer. Depending on the tumour’s location and size, the surgeon may remove the cancerous part of the oesophagus and reconstruct it using a section of the stomach or part of the intestine. Surgery may also involve removing the nearby lymph nodes, and surrounding tissues to prevent cancer from spreading further.
