What is Esophagus ?
The esophagus, also known as the food pipe, is a muscular tube measuring 20-25 cm long and 2-3 cm wide that serves as a conduit for moving food and drink from the mouth to the stomach.
What is esophageal cancer?
Cancers that start in the area where the esophagus joins the stomach (the GE junction), which includes about the first 2 inches of the stomach (called the cardia), tend to behave like esophagus cancers (and are treated like them, as well); they are grouped with esophagus cancers.
Cancer of the esophagus typically occur in one of two forms, squamous cell carcinomas arising from the stratified squamous epithelial lining of the organ, and adenocarcinomas affecting columnar glandular cells that replace the squamous epithelium. Sarcomas and small cell carcinomas generally represent less than 1%-2% of all esophageal cancers. On rare occasions, other carcinomas, melanomas, leiomyosarcomas, carcinoids, and lymphomas may develop in the esophagus as well. In India, it is the sixth most common cause of cancer-related deaths.
- Gender: The incidence of esophageal squamous cell carcinoma is generally higher in men than women in most countries.
- Smoking: Smoking is one of the major risk factor for developing esophageal squamous carcinoma. Smokers have a 5-fold risk of developing this disease compared to non-smokers
- Alcohol: Alcohol is a clear risk factor for squamous carcinoma.
- Tobacco and nutritional deficit: The “chewers of arecanut” (often mixed with tobacco), are common in regions such as Southeast Asia and India and have been linked to the development of squamous carcinoma.
- Gastroesophageal reflux disease and Barrett’s esophagus
Known Carcinogens: Alcoholic beverages, Betel quid with tobacco, Betel quid without tobacco , Smokeless Tobacco, Smoking, X-radiation, Gamma-radiation
- Difficulty swallowing (dysphagia)
- Unexplained weight loss
- Worsening indigestion or heartburn
- Chest pain, pressure or burning
- Coughing or hoarseness
Early esophageal cancer typically causes no signs or symptoms.
How can it be prevented?
Esophageal cancer is a health problem worldwide with high mortality due to its natural history and diagnosis in advanced stages. There is no sure way to prevent development of esophageal cancer as a variety of physical, lifestyle, and environmental factors can make some people more likely to develop esophageal cancer than others. Still healthy habits such as quitting smoking, stopping consumption of alcohol, exercising regularly and avoiding becoming overweight and seeking medical consultation routinely can help you in reducing the risk.
Since squamous cell carcinoma and adenocarcinoma of the esophagus have different risk factors, they require different approaches to prevention. For esophageal squamous cell carcinoma, the major environmental risk factors are cigarette smoking and alcohol abuse, smoking cessation and limiting alcohol intake decreases the risk of squamous cell carcinoma. Gastroesophageal reflux disease (GERD) and Barrett esophagus significantly increase the risk for adenocarcinoma of the esophagus. However, eliminating GERD has no documented impact on reducing the subsequent risk of developing adenocarcinoma
Screening for esophageal cancer isn’t done routinely except for patients with Barrett’s esophagus because of a lack of other easily identifiable high-risk groups.
Squamous dysplasia is the precursor lesion of esophageal squamous cell carcinoma; Barrett’s esophagus is the pre-neoplastic lesion preceding adenocarcinoma. Detection and management of these precancerous stages can reduce the incidence/ mortality of esophageal cancer.
Source : India against Cancer portal