The esophagus is a hollow tube about ten inches long that connects the oral cavity to the stomach. Once ingested, food and liquids travel through the esophagus to the stomach where the digestive process continues. The esophagus is lined with a thick protective mucous membrane and muscles that help propel the food downward.
Like everything else in our bodies, the esophagus is composed of cells. These cells grow and divide, and are regulated by genes within the cells. When an abnormal cell starts growing and dividing without control, a tumor appears in the area.
Researchers don't know exactly what causes esophageal cancer, but they believe that certain risk factors increase the chance of developing a cancer of the esophagus. Some of those risk factors include:
Key Statistics on Esophageal Cancer Statistics reveal that: An estimated 14,250 people in the US are diagnosed with cancer of the esophagus each year. Approximately 14,000 people die as a result of esophagus cancer each year.
Esophageal cancer can be divided into two different types, which are determined by the affected cells:
A Leiomyoma A leiomyoma is a common, smooth muscle tumor, often found in the uterus or a section of the gastrointestinal tract, such as the esophagus. The word "leiomyoma" comes from the roots "leio," meaning "smooth" and "myo," meaning "muscle."
A leiomyoma is a common, smooth muscle tumor, often found in the uterus or a section of the gastrointestinal tract, such as the esophagus. The word "leiomyoma" comes from the roots "leio," meaning "smooth" and "myo," meaning "muscle."
Unfortunately, cancers of the esophagus show no early symptoms. While the prognosis for an early diagnosis is good, esophageal cancer that shows no symptoms is often diagnosed by accident. Symptoms for esophageal cancer normally become evident in the later stages of the cancer. If you experience any of the following symptoms, see your doctor as soon as possible:
Like many other cancers, cancer of the esophagus is staged using the TNM system of the American Joint Committee on Cancer (AJCC). The TNM cancer staging system uses three important pieces of information:
Staging of the cancer depends on these three pieces of information. Below is a chart of the stages and sub-stages of esophageal cancer and their relative five-year survival rates.
Note: Keep in mind that cancers of the esophagus start from the inside and grow outward so, in the earliest stages, the cancer is limited to the inner layers of the esophagus and moves outwards with each progressive stage.
Stage
TNM Stages
5-year Relative Survival Rate
(Information obtained from the American Cancer Society and the MD Anderson Cancer Center 1970-2000)
The treatment method used for esophageal cancer depends on a number of factors, including:
Often, the doctor or a team of specialists and the patient discuss the available treatment options and determine together which may be the best option.
Surgery: Surgery is the most common esophageal cancer treatment method. The surgeon usually performs an esophagectomy, where the tumor and some or the entire esophagus and nearby lymph nodes are removed. If part of the esophagus is removed the surgeon connects the remaining esophagus to the stomach. If the entire esophagus is removed the surgeon inserts a plastic tube or part of the patient's intestine to make the connection between the oral cavity and stomach.
Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells. It is usually the treatment option of choice for those unable to undergo surgery due to poor health. Radiation therapy can be external (from a machine) or internal (radioactive material is placed near the cancer).
Radiation therapy is often combined with chemotherapy, and is sometimes done before surgery. Many doctors believe that radiation therapy combined with chemotherapy can be just as effective as surgery. Side effects such as fatigue, skin problems, and painful swallowing while undergoing radiation therapy are common, but generally go away once the therapy is complete.
Chemotherapy: Chemotherapy is the use of drugs to kill cancer cells. The drugs are often administered through the blood stream so they have systemic effects. Chemotherapy is most effective if the cancer has spread to distant organs.
Laser Therapy: Laser therapy uses high intensity light to destroy cancer cells.
Photodynamic Therapy: Photodynamic therapy is a type of laser therapy used to treat esophagus cancer. Nontoxic chemicals are initially injected into the body and, over the course of a few days, they accumulate in the cancer cells. A special laser is then focused on the cancerous cells; the chemical inside the cells changes into a different chemical that destroys them. This method is often used in the early stages of cancer because the light can reach only cancers found in the inner lining of the esophagus.
While no surefire way to prevent cancer of the esophagus exists certain risk factors can be minimized to reduce the risk of cancer. Smoking and excessive alcohol multiply the risk of esophageal cancer up to 44 times, so avoiding these two factors decreases the risk and improves your overall health.
Maintaining a healthy diet can also help reduce the risk of esophageal cancer. A diet rich in fruits and vegetables reduces the risk of cancer and may also reduce the likelihood of obesity, another risk factor for esophageal cancer.
American Cancer Society. (updated 2005). Detailed guide: Esophagus cancer.
CancerAnswers. (2004). Esophagus cancer.
MedicineNet, Inc. (2005). Tylosis with esophageal cancer.
National Cancer Institute. (updated 2002). What you need to know about cancer of the esophagus.
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