Esophageal Cancer

Esophageal cancer develops in the food pipe which runs from the throat to the stomach in the abdomen. Esophageal cancer usually begin in the cells lining the inside of the food pipe and can occur anywhere along its entire length. More men than women get esophageal cancer. Recently there has been an increase in incidence of esophageal cancer mainly attributed to consumption of tobacco and alcohol, nutritional habits and obesity.

The most common symptoms are difficulty in swallowing (dysphagia), weight loss, chest pain, pressure or burning and worsening indigestion or heartburn. Advanced cases may present with unexplained cough or hoarseness. Unfortunately more people present in advanced stage leading to obstruction of esophagus leading to difficulty in swallowing, pain and rarely blood in vomitus. Diagnosis of esophageal cancer is made with endoscopy and radiological scans. During endoscopy, a flexible tube is passed down the throat to look into the inside of the esophagus and biopsy any suspicion areas or lesions to confirm cancer. Contrast CT Scan or PET Scan is done to determine the extent of disease.
Surgery remains the main treatment modality for most cases and may be performed alone or in combination with chemoradiation, depending on the stage disease at presentation. During esophagectomy, the portion of the esophagus that contains the tumor, along with a portion of the upper part of the stomach are removed with nearby lymph nodal dissection. The remaining esophagus is reconnected to the stomach, by pulling it up and joining the remaining esophagus in the neck. Esophagectomy may be performed with keyhole surgery (Laparoscopic and Thoracoscopic). Patients with locally advanced cancers often receive concurrent chemo radiation to downsize and shrink the tumor before surgery.