The oesophagus (food pipe) is the initial part of the digestive system. The oesophagus is a hollow tube that takes food and fluids from the mouth to the stomach. When you swallow, the muscular walls of the oesophagus push food down to the stomach. The oesophagus joins to the top part of the stomach. This is called the gastro oesophageal junction. There is a valve here that helps to keep the stomach contents from coming back up into the oesophagus. The valve is called the cardiac sphincter.
Glands in the wall of the oesophagus produce mucous to help food to slide down more easily when you swallow. It is the cells of these glands that have a tendency to become cancerous. The cells may multiply and form a lump that can block the passage of food and also difficulty in swallowing.
The inner lining of the oesophagus is made of different cells. The lower part has more gland cells and ‘adenocarcinoma’ is common at this site while ‘squamous cell carcinoma’ begins in squamous cells that line the middle and upper parts. The treatment of squamous carcinoma is different from adenocarcinoma.
There are lymph glands around the oesophagus. The lymph nodes are often the first place that cancer cells spread to when they break away from a tumour. So surgeons often remove them during cancer surgery and send them to the lab where a pathologist examines them to see if they contain any cancer cells.
The presence of cancer cells in the lymph nodes is part of the staging of the cancer. The stage is important because it helps the doctor to decide a suitable treatment for you.
What are the causes of oesophagus cancer?
The exact causes of cancer are still undetermined, but there are some known risk factors that can make a person more likely to get this disease.
Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may not have had any known risk factors.
Research has shown that some of these risk factors affect the DNA of cells in the stomach and oesophagus, which can result in abnormal cell growth and may cause tumors to form.
Risk factors for oesophageal cancer include:
Alcohol: Drinking large amounts of alcohol increases your risk of cancer of the mouth, throat, oesophagus (food pipe)
GERD: long-term gastro-oesophageal reflux disease where stomach juice frequently spills back into the food pipe.
Obesity: This may be because obese people are more likely to suffer from acid reflux and this is a risk factor for oesophageal cancer in itself.
Barrett’s oesophagus. This is a condition where some of the lining of the oesophagus changes, usually due to long-term reflux of stomach contents into the oesophagus with accompanying heartburn. The stomach acid comes back up into the oesophagus and irritates the lining. The risk of developing a cancer in Barrett’s oesophagus is high.
Occupational exposure to solvents used for dry-cleaning, and some other chemical fumes
Frequent drinking of very hot liquids.
What are the symptoms of oesophagus cancer?
difficult or painful swallowing
This is the most common symptom of oesophageal cancer. There may be some pain in the form of a burning sensation when swallowing food. Or you may feel that your food is sticking in your throat or chest and you can't swallow it
vomiting/coughing up blood
Regurgitation of saliva or food.
If you have not been diagnosed with oesophagus cancer and are just looking through this site, please be aware thatmany of these symptoms occur without any serious disease being present.
However, if you have any of the symptoms for more than two weeks, see your doctor for a check-up.
What are the tests carried out to diagnose oesophagus cancer?
This section lists common tests for the cancers. It is not necessary for all the tests to be performed for a patient. Your doctor will select the tests that will assist him / her to have the maximum information about the tumor/ disease. Before referring you for tests, your doctor will take a full medical history and examine you. You may also have a blood test and chest x-ray to check your general health.
Endoscopy / Gastroscopy
In this test, a thin, flexible ‘telescope’ (called an endoscope) will be passed down your throat so that the doctor can examine your oesophagus, stomach and the upper part of your bowel. If anything unusual is seen, the doctor can put instruments down the endoscope and remove tissue to examine under a microscope (biopsy).
Barium swallow and x-ray
This test is less commonly done now that endoscopy is available. If you have this test you will drink thick liquid called barium. This will coat the lining of your oesophagus, stomach and the first part of your bowel. You will lie down on a table and a radiologist will take x-ray pictures of your chest and abdomen. This will show up the lining clearly when x-rays are taken and abnormality in the lining can be detected.
Computerised tomography (CT) scan
A CT scan is a type of x-ray that gives a picture of organs and other structures (including any tumours) in your body. It is used to see more details of a cancer and its relation to the surrounding organs in your body. It also gives information related to cancer spread into the lymph nodes, liver or lungs.
Endoscopic ultrasound scan (EUS)
This is similar to having an endoscopy. It may be used for people who may have oesophageal cancer and occasionally for people who may have stomach cancer. For this test, the endoscope has a small ultrasound probe on the end for more detailed information about the local spread of the tumor. It can help the doctor decide whether you should have some other modality of treatment before surgery.
A biopsy is diagnosis made under a microscope by a pathologist using a small bit of tissue removed from a suspicious area or lump that is found to be abnormal. During the endoscopy/EUS, if the doctor sees anything unusual, they can pass small tools into the scope and take out some tissue that can then be examined under a microscope. This gives a confirmation of cancer.
Positron emission tomography (PET) scan
This test is combined with a CT scan by injecting a radioactive material in the body to highlight all areas where the tumor has or can spread. This test may be used to build up more information after an MRI or CT scan. PET-CT scan is not necessary for all patients. Your doctor will decide if you need to undergo this scan.
Copyright @ 2010. All Rights Reserved Dr.Deepak Chhabra Designed By SDA
"This website has been designed for informational and educational purposes only. Care has been taken to provide readers with the right information about various cancers and their treatment and it is not intended to replace medical advice offered by other surgeons, physicians or health care providers".