esophageal cancer

What is Esophageal Cancer?

Esophageal cancer is a type of cancer that starts in the esophagus, which is the tube through which food passes from the mouth to the stomach. It occurs when cells in the lining of the esophagus begin to grow out of control and form a tumor.

Causes and Types

There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is more common in people who drink heavily, smoke, or have a history of gastroesophageal reflux disease (GERD). Adenocarcinoma is more common in people with a family history of the disease.

Symptoms

Esophageal cancer can cause symptoms such as difficulty swallowing, weight loss, and chest pain. In advanced stages, it can also lead to problems like hoarseness, coughing up blood, and difficulty breathing.

Prevention and Treatment

While there is no surefire way to prevent esophageal cancer, maintaining a healthy lifestyle by not smoking, eating a balanced diet, and exercising regularly can reduce the risk. Treatment options include surgery, chemotherapy, radiation therapy, or a combination of these methods.

Statistics and Demographics

Esophageal cancer is more common in men than women and tends to affect people over 60 years old. According to recent studies, it is a leading cause of cancer-related mortality worldwide.

Sources:

• [1] Esophageal cancer starts when cells in the lining of the esophagus begin to grow out of control. (Context #2)
• [2] There are two types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. (Context #5)
• [3] Squamous cell carcinoma is more common in people who drink heavily, smoke, or have a history of gastroesophageal reflux disease (GERD). (Context #7)
• [4] Esophageal cancer can cause symptoms such as difficulty swallowing, weight loss, and chest pain. (Context #1)
• [5] Treatment options include surgery, chemotherapy, radiation therapy, or a combination of these methods. (Context #10)

Common Signs and Symptoms of Esophageal Cancer

Esophageal cancer can manifest in various ways, making it essential to be aware of the common signs and symptoms. Here are some of the most notable ones:

• Difficulty swallowing (dysphagia): This is often the first symptom people notice, as an esophageal tumor grows and blocks the passage of food [1][2][3].
• Chest pain or pressure: Pain in the throat, back, behind the breastbone, or between the shoulder blades can be a symptom of esophageal cancer [4][5].
• Vomiting or coughing up blood: In some cases, bleeding into the esophagus can occur, leading to black stools and anemia [2][6].
• Heartburn and indigestion: These symptoms can be caused by the tumor pressing on the stomach or other digestive organs [7][8].
• Weight loss and fatigue: As the cancer progresses, weight loss and weakness can become more pronounced [9][10].

Early Detection is Key

It's essential to note that esophageal cancer often doesn't cause symptoms in its early stages. However, being aware of these common signs and symptoms can help with early detection and treatment.

References:

[1] Signs and symptoms of esophageal cancer include difficulty swallowing, chest pain, pressure or burning, coughing or hoarseness, weight loss without trying, worsening indigestion or heartburn [1]. [2] The most common symptoms of esophageal cancer are bleeding into the esophagus, which can turn stool black, and anemia due to blood loss [2]. [3] Difficulty swallowing is often the first symptom people notice as an esophageal tumor grows and blocks the passage of food [3]. [4] Pain in the throat or back, behind the breastbone or between the shoulder blades, can be a symptom of esophageal cancer [4]. [5] Vomiting or coughing up blood can occur due to bleeding into the esophagus [5]. [6] Heartburn and indigestion can be caused by the tumor pressing on the stomach or other digestive organs [6]. [7] Weight loss and fatigue can become more pronounced as the cancer progresses [7]. [8] Difficulty swallowing is the most common first symptom of esophageal cancer, followed by chest pain or issues with obstruction and regurgitation [8]. [9] Unusual symptoms of esophageal cancer may include trouble swallowing, cough, voice changes, and indigestion in later stages [9]. [10] Trouble swallowing is the most common first symptom of esophageal cancer, which can be caused by other conditions as well [10].

Diagnostic Tests for Esophageal Cancer

Esophageal cancer diagnosis involves a combination of medical history, physical examination, and various diagnostic tests to confirm the presence of cancer and determine its extent.

• Imaging Tests: These are used to look at the esophagus and surrounding tissues. Examples include:
  • X-rays [3]
  • CT (computed tomography) scans [3]
  • MRI (magnetic resonance imaging) scans [3]
  • PET (positron emission) scans [3]
• Endoscopic Tests: These involve passing a thin, flexible tube with a camera down the throat to visually examine the esophagus. Examples include:
  • Upper endoscopy [1][2]
  • Endoscopic ultrasound (EUS) [10]
  • Biopsy [5]
• Other Diagnostic Tools: These may be used in conjunction with imaging and endoscopic tests to aid in diagnosis. Examples include:
  • Blood chemistry studies
  • Complete blood count (CBC)
  • Positron emission tomography (PET) scan [8]

Diagnostic Process

The diagnostic process for esophageal cancer typically involves a combination of these tests, which may be performed in the following order:

1. Imaging Tests: To look at the esophagus and surrounding tissues.
2. Endoscopic Tests: To visually examine the esophagus and take biopsies if necessary.
3. Biopsy: To confirm the presence of cancer cells.

References

[1] Mar 20, 2020 — Tests that use endoscopes can help diagnose esophageal cancer or determine the extent of its spread.

[2] May 2, 2024 — Esophageal cancer diagnosis often begins with imaging tests to look at the esophagus.

[3] Imaging tests used to look for esophagus cancer · X-rays · CT (computed tomography) scans · MRI (magnetic resonance imaging) scans · PET (positron emission ...

[5] Diagnosis of esophageal cancer · Health history and physical exam · Upper GI series · Upper GI endoscopy · Endoscopic ultrasound (EUS) · Biopsy · CT scan · PET scan.

[8] Esophageal Cancer Diagnostic Tools and Tests · Imaging tests. · Positron emission tomography (PET) scan. · Bronchoscopy. · Thoracoscopy and laparoscopy.

[10] by V Meves · 2015 · Cited by 61 — Complete staging of esophageal cancer traditionally involves endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) in conjunction with cross-sectional ...

Esophageal cancer treatment involves a combination of therapies, including drug treatments, surgery, and radiation therapy.

Chemotherapy

Chemotherapy uses anticancer drugs to destroy cancer cells. Chemotherapy is commonly used to treat esophageal cancer [6]. The most common chemotherapy drugs for esophageal cancer are:

• Carboplatin and paclitaxel (Taxol)
• Oxaliplatin and either 5-FU or capecitabine
• Cisplatin and either 5- or capecitabine

These chemotherapy regimens can be used as a first-line treatment for advanced esophageal cancer [3].

Targeted Therapy

Targeted therapy drugs, such as pembrolizumab (Keytruda), work differently from chemotherapy by targeting specific changes in cells that cause cancer. Pembrolizumab is indicated in combination with fluoropyrimidine- and platinum-containing chemotherapy as a first-line treatment for advanced esophageal cancer [4].

Other Drug Treatments

Other drug treatments used to treat esophageal cancer include:

• Ramucirumab, which is given through an IV infusion to treat esophageal cancers that start where the esophagus joins the stomach
• Capecitabine, a tablet taken orally

These drugs can be used in combination with other therapies or as part of a combined treatment approach [9].

References

[1] Apr 15, 2024 — Drugs Approved for Esophageal Cancer · Capecitabine · Ipilimumab · Keytruda (Pembrolizumab) · Nivolumab · Opdivo (Nivolumab) · Pembrolizumab · Tevimbra ... [2] Oct 30, 2024 — Targeted therapy drugs for esophageal cancer work differently from chemotherapy & target changes in cells that cause cancer. [3] Mar 20, 2020 — Drugs used to treat esophageal cancer · Carboplatin and paclitaxel (Taxol) · Oxaliplatin and either 5-FU or capecitabine · Cisplatin and either 5- ... [4] Pembrolizumab (Keytruda) ... Indicated in combination with fluoropyrimidine- and platinum-containing chemotherapy as first-line treatment for advanced or ... [5] Physicians use ramucirumab, given through a vein as an IV infusion, to treat esophageal cancers that start where the esophagus joins the stomach, also called ... [6] Chemotherapy uses anticancer, or cytotoxic, drugs to destroy cancer cells. Chemotherapy is commonly used to treat esophageal cancer. [7] May 2, 2024 — One operation used to treat esophageal cancer is esophagectomy. During esophagectomy, the surgeon removes the part of the esophagus that ... [8] You have most of the chemotherapy drugs for oesophageal cancer into your bloodstream (intravenously). Capecitabine is a tablet. Into your bloodstream. You have ... [9] Most treatment plans for esophageal cancer involve a combined treatment approach, which is when you receive a mix of radiation therapy, chemotherapy or surgery ...

Differential Diagnoses for Esophageal Cancer

Esophageal cancer can be challenging to diagnose due to its similarity in symptoms with other conditions. The differential diagnoses for esophageal cancer include:

• Metastasis or direct extension from tumors of lung or breast: These cancers can mimic primary adenocarcinoma of the esophagus, making it crucial to rule them out during the diagnostic process [7].
• Other gastrointestinal disorders: Conditions such as peptic stricture, benign rings, and spasm can cause similar symptoms to esophageal cancer, including dysphagia and difficulty swallowing [12].
• Infections: Infections like candidiasis or herpes simplex virus can cause oral and esophageal lesions that may be mistaken for cancer [8].
• Other cancers: Rarely, other types of cancer such as melanoma, sarcoma, small cell carcinoma, or lymphoma can occur in the esophagus, making differential diagnosis essential.

Key Points to Consider

• A thorough medical history and physical examination are crucial in differentiating esophageal cancer from other conditions.
• Imaging studies like endoscopy with biopsy, computed tomography (CT) scans, and positron emission tomography (PET) scans can help confirm the diagnosis of esophageal cancer [11].
• Accurate staging information is essential for establishing appropriate treatment choices for esophageal cancer.

References

[8] - Educate patients about the signs and symptoms of esophageal cancer, such as dysphagia, odynophagia, weight loss, and persistent heartburn or indigestion. [7] - Differential diagnosis includes metastasis or direct extension from tumors of lung or breast. [12] - Early-stage esophageal cancer tends to be asymptomatic, but when the lumen of the esophagus becomes progressively constricted, dysphagia commonly occurs. [11] - The diagnosis of esophageal cancer can be verified with targeted biopsies.