Endoscopy of Esophageal Cancer

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• published: 22 Jan 2014
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Types of Esophageal Cancer There are two main types of esophageal cancer. Both types are diagnosed, treated, and managed in similar ways. The two most common types are named for how the cancer cells look under a microscope. Both types begin in cells in the inner lining of the esophagus: Adenocarcinoma of the esophagus: This type is usually found in the lower part of the esophagus, near the stomach. Squamous cell carcinoma of the esophagus: This type is usually found in the upper part of the esophagus. Around the world, however, squamous cell carcinoma is the most common type. Risk Factors When you get a diagnosis of cancer, it's natural to wonder what may have caused the disease. Doctors can seldom explain why one person develops esophageal cancer and another doesn't. However, we do know that people with certain risk factors are more likely than others to develop esophageal cancer. A risk factor is something that may increase the chance of getting a disease. The following risk factors for esophageal cancer as mentioned: Age 65 or older: Age is the main risk factor for esophageal cancer. The chance of getting this disease goes up as you get older. Being male: Men are more likely to develop esophageal cancer. Smoking: People who smoke are more likely than people who don't smoke to develop esophageal cancer. Heavy drinking: People who have more than 3 alcoholic drinks each day are more likely than people who don't drink to develop squamous cell carcinoma of the esophagus. Heavy drinkers who smoke are at a much higher risk than heavy drinkers who don't smoke. In other words, these two factors act together to increase the risk even more. Diet: Having a diet that's low in fruits and vegetables may increase the risk of esophageal cancer. Obesity: Being obese increases the risk of adenocarcinoma of the esophagus. Acid reflux: Acid reflux is the abnormal backward flow of stomach acid into the esophagus. Reflux is very common. A symptom of reflux is heartburn, but some people don't have symptoms. The stomach acid can damage the tissue of the esophagus. After many years of reflux, this tissue damage may lead to adenocarcinoma of the esophagus in some people. Barrett esophagus: Acid reflux may damage the esophagus and over time cause a condition known as Barrett esophagus. The cells in the lower part of the esophagus are abnormal. Most people who have Barrett esophagus don't know it. The presence of Barrett esophagus increases the risk of adenocarcinoma of the esophagus. It's a greater risk factor than acid reflux alone. Having a risk factor doesn't mean that a person will develop cancer of the esophagus. Most people who have risk factors never develop esophageal cancer. Symptoms Early esophageal cancer may not cause symptoms. As the cancer grows, the most common symptoms are: Food gets stuck in the esophagus, and food may come back up Pain when swallowing Pain in the chest or back Weight loss Heartburn A hoarse voice or cough that doesn't go away within 2 weeks These symptoms may be caused by esophageal cancer or other health problems. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated as early as possible. Diagnosis If you have a symptom that suggests esophageal cancer, your doctor must find out whether it's really due to cancer or to some other cause. The doctor gives you a physical exam and asks about your personal and family health history. You may have blood tests. You also may have: Barium swallow: After you drink a barium solution, you have x-rays taken of your esophagus and stomach. The barium solution makes your esophagus show up more clearly on the x-rays. This test is also called an upper GI series. Endoscopy: The doctor uses a thin, lighted tube (endoscope) to look down your esophagus. The doctor first numbs your throat with an anesthetic spray, and you may also receive medicine to help you relax. The tube is passed through your mouth or nose to the esophagus. The doctor may also call this procedure upper endoscopy, EGD, or esophagoscopy. Biopsy: Usually, cancer begins in the inner layer of the esophagus. The doctor uses an endoscope to remove tissue from the esophagus. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present. Staging If the biopsy shows that you have cancer, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. Staging is a careful attempt to find out the following: how deeply the cancer invades the walls of the esophagus whether the cancer invades nearby tissues whether the cancer has spread, and if so, to what parts of the body