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Esophageal cancer

 

Esophageal cancer is a growth in the esophagus or the food pipe. It may be in the upper, middle or lower 1/3rd of the pipe. Elderly people are more prone to develop it.

Causes
Causes are not known. Anything from hot tea to tobacco or alcohol can be the cause.

Symptoms

  • Difficulty in swallowing or dysphagia
  • Weight loss
  • Pain
  • Vomiting blood

Treatment

  • Radio therapy
  • Chemotherapy
  • Surgery - transhiatal oesophagectomy/laparoscopy

First step of the treatment is biopsy with the help of endoscopy to asses the kind of tumor.
Next step is doing a CT scan to asses the extent of tumor.

If it is cancer of the upper 1/3rd of the food pipe then radiotherapy or chemotherapy is suggested, depending on the oncologist’s advice.

For cancer of the middle or lower 1/3rd of the food pipe, surgery is recommended. The entire food pipe is removed and the stomach is brought up into the neck and attached to the food pipe. This can be done either by transhiatal oesophagectomy or by laparoscopy.

Transhiatal oesophagectomy is a supera major surgery. Usually, it is done conventionally by opening the abdomen, dissecting the stomach, then putting the hand into the thorax and dissecting from the abdomen for lower 1/3rd of the food pipe. If it’s the middle 1/3rd then the thorax is opened, the esophagus or food pipe is dissected from the chest, then an opening is made in the neck, the stomach is brought into the neck and joined to the food pipe.

Laparoscopy is where we can dissect the food pipe from the stomach itself if the tumor is in the lower 1/3rd of the food pipe, then open the neck, bring the stomach up in the neck and join it to the food pipe. If it’s in the middle 1/3rd then we dissect the stomach, put the laparoscope in the thorax, chest and esophagus, then open the neck and bring the stomach up and join it to the food pipe. So laparoscopy lowers the morbidity and with minimal blood loss a patient is treated for cancer.

Prognosis
Prognosis is not very good. If esophageal cancer is detected very early, treatment may be effective. Otherwise, there is no cure for it. In fact, most surgeries are done to help the patients eat rather than live longer, and it is not a cure in majority of the cases. The patient’s survival may be prolonged from 6 months to 2 or 3 years and they live without the inability to eat and suffering, as in some cases they can’t swallow even the saliva.

Even after the operation, patients are unable to eat large quantity of food at a time. They can have small frequent meals and have to sleep in a cropped up position.

Prevention
There is no preventive measure other than maintaining a healthy lifestyle and avoiding smoking, consumption of tobacco and alcohol.