Oncology / / May 02, 2016
esophageal cancer video
Esophageal cancer, what is it?
What is the esophagus?
types of esophageal cancer
Causes of esophageal cancer
esophageal cancer risk factors
Symptoms of esophageal cancer
diagnosis of esophageal cancer
stages of esophageal cancer
esophageal cancer Treatment
Supportive care and treatment of complications
Nutrition for cancer of the esophagus
complications of esophageal cancer
esophageal cancer - Cancer of the esophagus is a disease accompanied by a progressive disorder of the swallowing function and a decrease in body weight of from 80 to 90% of all diseases of the body.
cancer cells begins building blocks that make up the fabric.Tissues make up the organs of the body.
Normal cells grow and divide - to form new cells as the body needs them.When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes this process goes wrong.New cells form when the body does not need them, and old or damaged cells do not die as th
- rarely a threat to life;
- can be removed and usually do not grow again;
- not penetrate into the tissue around them;
- do not spread to other parts of the body.
- may pose a greater threat to life;
- it can often be removed, but can sometimes grow back;
- can invade nearby tissues and organs and damage them;
- could spread to other parts of the body.
Esophageal cancer starts in the cells in the inner layer of the esophagus.Over time, the cancer may invade deeper layers of the esophagus and surrounding tissues.
Cancer cells may spread, breaking away from the original tumor.They enter the blood or lymphatic vessels, which ramify all tissues.Cancer cells can be found in the lymph nodes of the esophagus.These cells can spread to other tissues and grow to form new tumors that may damage these tissues.The spread of cancer is called metastasis.
What is the esophagus?
The esophagus is part of the digestive tract.In adults - muscular tube is some 25 cm long, which helps to get the food from the mouth to the stomach. esophageal wall consists of several layers:
- an inner layer or lining (mucosa) - esophageal mucosa is moist, so that food can pass into the stomach;
- submucosa: cancer in this layer create mucus moisturizing esophagus;
- muscular layer: muscles push the food into the stomach;
- outer layer: the outer layer covers the esophagus.
types of esophageal cancer
Esophageal cancer is classified according to cell type.type cells in cancer of the esophagus helps determine treatment options for the patient.There are two main types of esophageal cancer:
- Adenocarcinoma. It begins in the cells of mucus-secreting glands in the esophagus, and occurs most often in the lower part of the esophagus.Adenocarcinoma - the most common form of esophageal cancer, and, primarily in white men;
- Squamous cell carcinoma. forms a flat and thin cells lining the surface of the esophagus.Squamous cell cancer occurs most often in the middle of the esophagus.This type of cancer - the most common worldwide esophageal cancer.
Both of these types of diagnosis and treatment are the same.
- other rare species. Rare forms of esophageal cancer include choriocarcinoma, lymphoma, melanoma, sarcoma and small cell.
Cancer Causes of esophageal cancer are not clear.esophageal cancer occurs when cells develop erroneously in the esophagus due to a mutation in the DNA.Cells grow and divide uncontrollably.Accumulating abnormal cells form a tumor in the esophagus that can grow, invade nearby tissue and spread to other parts of the body.
esophageal cancer risk factors
When a patient receives a diagnosis of "cancer", he naturally wonders what could be the cause of the disease.Doctors can seldom explain why one person develops cancer of the esophagus and the other is not.Nevertheless, we know that people with certain risk factors are more likely than others to get esophageal cancer.Risk factor - is something that can increase the likelihood of getting the disease.Here they are:
- Age 65 years and older .Age is a major risk factor for esophageal cancer.Chance to get the disease increases when a person gets older;
- Male gender. Men 3 times more likely than women develop cancer of the esophagus;
- Smoking. People smoking esophageal cancer develops more often than people who do not smoke.Chewing tobacco - also among the risk factors;
- Drunkenness. People who consume more than 3 alcoholic drinks every day, squamous esophageal cancer develops more often than people who do not drink.Heavy drinkers who also smoke have a much higher risk than alcoholics who do not smoke.That is, these two factors acting together, further increasing the risk;
- Power. Studies show that dieting low in fruits and vegetables may increase the risk of esophageal cancer.However, dietary analysis results are not always the same, and more research is needed to better understand how diet affects the risk of developing cancer of the esophagus;
- Obesity .Being overweight increases the risk of developing esophageal adenocarcinoma;
- Heartburn. Gastroesophageal reflux disease (GERD) is heartburn and abnormal backflow of stomach acid into the esophagus.Reflux is very common.One of the symptoms of reflux - heartburn, but some people have no symptoms.Gastric acid can damage esophageal tissue.After many years of reflux is tissue damage in some people can lead to esophageal adenocarcinoma;
- Barrett's esophagus. Heartburn may result in damage to the esophagus, and over time - a condition known as "Barrett's esophagus".Most people who have Barrett's esophagus, do not know about it.The presence of Barrett's esophagus greatly increases the risk of adenocarcinoma of the esophagus.Here, the risk factor is considerably higher than one heartburn;
- Swallowing problems. Difficulty swallowing due to esophageal sphincter that does not allow the muscles to relax (achalasia);
- hot food. Drinking very hot drinks, etc.
Researchers continue to study all of these risk factors.
The presence of a risk factor does not mean that a person will definitely develop cancer of the esophagus.Most people who have some of these risk factors never develop esophageal cancer.
Those who have pre-cancerous changes in oesophageal cells (Barrett's esophagus), are radiation therapy of the chest or upper abdomen.
Symptoms of esophageal cancer
Early esophageal cancer may not cause symptoms.With the development of the most common symptoms of cancer - following:
- difficulty swallowing (dysphagia), when food gets stuck in the esophagus;
- pain when swallowing;
- pain in the chest or back;
- weight loss;
- hoarse voice or a cough that does not go away within 2 weeks.
These symptoms may be caused by esophageal cancer or other health problems.
diagnosis of cancer of the esophagus
If the patient has at least one symptom that refers to oesophageal cancer, the doctor must find out, it's really because of cancer or some other reason.The doctor conducts a physical examination and asked about personal and family history of the patient's health.Perhaps the patient will have to take blood tests.Also, it can offer to pass such procedures:
- X-ray with barium. Once the patient drinks a barium solution, it will be assigned to an x-ray of the esophagus and stomach.Barium in the esophagus contributes to obtaining a clearer picture of the X-rays;
- Endoscopy (or esophagoscopy, or EGD).The doctor uses a thin tube - an endoscope to examine the esophagus.Then the doctor numbs the throat with an anesthetic spray, and the patient can get medicine to help him relax.The tube is passed through the mouth or nose into the esophagus;
- biopsy. cancer usually starts in the inner layer of the esophagus.The doctor uses an endoscope to remove tissue from the esophagus, then it checks the tissue under a microscope for cancer cells.A biopsy is the only sure way to know whether cancer cells are present.If the biopsy shows that the cancer patient, the physician must determine the extent (stage) of the disease to help patients choose the best treatment.Diagnosis and identification of the stage of cancer - a careful attempt to find out the following:
- how deeply the cancer penetrates the wall of the esophagus;
- whether the cancer invades adjacent tissue;
- whether the cancer has spread, and if so, to what parts of the body.
Most esophageal cancer has spread to nearby lymph nodes.If the cancer has reached these nodes, it can also spread to other lymph nodes, bones or other organs, including - on the liver and lungs.
For more accurate staging of esophageal cancer doctor may prescribe one or more of the following tests and procedures:
- Ultrasonic endoscopy. doctor passes an endoscope into the throat, numb from the anesthetic.Probe tube end sends sound waves that can not be heard.The waves are reflected from the patient's esophagus tissue and to nearby organs.Computer generated image with an echo, which may show how deep the cancer invaded the wall of the esophagus.The doctor may also use a needle to take tissue samples from lymph nodes;
- Computed tomography (CT). X-ray machine linked to a computer that can do a series of detailed pictures of the chest and abdomen.Doctors use a CT scan to look for esophageal cancer that has spread to the lymph nodes or other areas.The patient may receive contrast material by mouth or by injection into a blood vessel - with the help of abnormal areas easier to see;
- Magnetic resonance imaging (MRI). Use a powerful magnet linked to a computer to make detailed images of the inside of the patient's body.MRI can show whether cancer has spread to lymph nodes or other areas of the body.Sometimes the contrast agent is administered by injection into the blood vessels of the patient.The contrast agent makes abnormal areas show up more clearly in the picture;
- Positron emission tomography (PET). The patient receives an injection through a small amount of radioactive sugar that emits signals.These signals PET scanner picks up and makes a picture of the place in the patient's body - where currently there is sugar.Cancer cells appear brighter in the image, because they take sugars is much faster than normal cells.PET shows if esophageal cancer has spread;
- Bone scan. The patient receives an injection through a small amount of a radioactive substance.It passes through the blood and accumulated in the bones.The machine scanner detects and measures the radiation that makes bones picture.Pictures can show cancer that has spread to the bone;
- Laparoscopy. Once the patient is given general anesthesia, the surgeon makes a small cut (or cuts) in the abdomen.The surgeon inserts a small tube - laparoscope - into the abdominal cavity.The lymph nodes or other tissue samples may be removed.
Sometimes the diagnosis statement is not complete - before surgery to remove a cancerous tumor and nearby lymph nodes.
When cancer spreads from its original site to other parts of the body, the new tumor has the same abnormal cells and the same name as the primary tumor.For example, if the esophagus cancer spreads to the liver, the liver cancer cells - is, indeed, esophageal cancer cells.Disease - metastatic esophageal cancer, not liver cancer.He is regarded as cancer of the esophagus.Doctors call the new tumor "distant" or metastatic disease.
esophageal cancer stages
There are five stages (stages degrees) of esophageal cancer - from 0 to IV, wherein 0 - is the least invasive (introduction into the body) and IV - the most aggressive stage whenesophageal cancer has spread to distant organs.
- Stage 0 - abnormal cells are found only in the inner layer of the esophagus.This is also called "carcinoma in situ".
- Stage I - the cancer has grown into the inner layer of the submucosa.
- Stage II expressed in the spread of tumor as follows:
- the cancer has spread into the inner layer of the submucosa, and cancer cells have invaded the lymph nodes;
- the tumor has invaded the muscle layer.Cancer cells can be found in the lymph nodes;
- the cancer has grown to the outer layer of the esophagus.
- Stage III characterized by one of the following criteria:
- the cancer has grown into the outer layer, and cancer cells have spread to the lymph nodes;
- cancer invaded a number of structures - such as the respiratory tract.Cancer cells can spread to the lymph nodes.
- Stage IV - cancer cells have spread to distant neighboring organs - such as the liver, pancreas, etc.
Treatment of cancer of the esophagus
For people with esophageal cancer have several treatment options: surgery, radiation therapy, chemotherapy or a combination of these treatments.For example, radiation therapy and chemotherapy may be given before or after surgery.
treatment that is appropriate to each patient depends mainly on the following factors:
- exactly where the cancer is in the esophagus;
- whether the cancer has invaded nearby organs and tissues;
- whether the cancer has spread to the lymph nodes or other organs of the body;
- general health of the patient.
esophageal cancer is difficult to control the current, generally accepted procedures.For this reason, many doctors encourage people with this disease to consider taking their participation in clinical trials, trials of new treatments.Clinical trials are an important option for people with all stages of cancer of the esophagus.
patient may have a team of a variety of health professionals to plan your treatment.Since cancer therapy often damaged healthy cells and tissues, the side effects are common.
Barrett's esophagus is considered a precancerous condition and is associated with an increased risk of incidence of cancer cardioesophageal zone and adenocarcinoma of the lower third of the esophagus (esophageal cancer).
Modern technologies allow to effectively treat Barrett's syndrome.
Minimally invasive treatment called "radiofrequency ablation '(RFA - surgery, which is performed with the help of special catheters - electrodes probes introduced into the puncture of the cavity for the burning of pathological areas using an electric high frequency generator - radio frequency).This is one of several types of ablation can be an alternative when surgery for certain types of cancer is not an option.
Ablation involves the destruction of tissue by means of high temperatures - that is, the cells are killed by heating them up to a certain temperature (cautery).