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Esophageal Cancer: Diagnosis and Treatment

January 16, 2018

The esophagus is a hard-working muscle that has an important responsibility: moving food from the mouth to the stomach. It is approximately 10 inches long, and it is shaped like a tube. The innermost layer of the esophagus is called the mucosa, and the outermost layer is made of muscle. In-between, there is an additional layer called the submucosa. Though relatively rare, esophageal cancer does occur. Understanding possible symptoms and available treatments increase the likelihood of a speedy diagnosis, which may lead to a better long-term outcome.

Common Symptoms of Esophageal Cancer

Some symptoms of esophageal cancer are fairly general, and they should always be brought to the attention of a medical professional. For example, unexplained weight loss, fever, fatigue and feelings of weakness could be caused by a variety of conditions – cancer is just one possible explanation. Other symptoms of esophageal cancer are more specific to the area, though there are many reasons why these symptoms could be present.

These may include any or all of the following:

  • Burning or feeling of pressure in the chest
  • Coughing
  • Difficulty swallowing
  • Heartburn
  • Hoarseness
  • Indigestion
  • Recurring incidents of choking on food
  • Vomiting
  • Pain in the throat
  • Pain behind the breastbone
  • Hiccups
  • Black stool (blood in the stool)

As with any cancer, individual patients may not experience the same combination of symptoms. Some have no symptoms at all. Others have symptoms that are similar to those of esophageal cancer, but they are caused by an entirely unrelated medical condition. If any of these symptoms come up, it is best to consult a specialized physician for thorough testing and diagnosis as soon as possible to prevent unnecessary worry.

The Basics of an Esophageal Cancer Diagnosis

There are typically two types of cells lining the esophagus, which means that esophageal cancer usually falls into one of two categories. Cancer that starts in the squamous cells generally appears in the upper portion of the esophagus, and it is referred to as squamous cell carcinoma. If cancer begins in the cells of the glands that produce mucus, it is referred to as adenocarcinomas. This type of esophageal cancer usually originates in the lower portion of the esophagus.

As with other forms of cancer, physicians assign stages or levels of severity, depending on how far the disease has progressed. Higher-numbered stages indicate a more serious situation.

The stages of esophageal cancer are as follows:

  • Stage 0 – Abnormal cells have been located in the lining of the esophagus, but cancer has not yet developed.
  • Stage 1 – Cancer cells are present in the lining of the esophagus.
  • Stage 2 – Cancer has moved through all three layers of the esophagus, and it is found in the outer muscle. It may also have spread to a small number of nearby lymph nodes.
  • Stage 3 – Cancer has become deeply embedded in the muscle of the esophagus or the connective tissue around it. In some cases, it has spread to other organs and/or additional lymph nodes.
  • Stage 4 – Cancer cells can be found in multiple organs and lymph nodes located in other areas of the body.

Determining cancer stages impacts the type of treatment that most effectively reduces symptoms. Physicians use a number of tests and procedures to ensure the diagnosis is accurate so that they can develop a comprehensive treatment plan.

Options for Esophageal Cancer Treatment

There are several possible treatments for esophageal cancer, and often they are used in combination for maximum effectiveness. The most common include:

  • Chemotherapy – This form of treatment uses one or more strong medications to slow or stop cancer cell growth. Because the medications are so powerful, they may attack healthy cells as well. This results in well-known side effects such as loss of hair, nausea, and fatigue.
  • Radiotherapy – Most people have experienced an x-ray, and radiotherapy uses similar technology. However, the rays used for cancer treatment are much more intense than the type used to see broken bones. The rays are directed at the cancer cells to destroy them. In some cases, healthy cells may also be destroyed in the process. Fortunately, healthy cells can repair and regenerate after radiotherapy, while cancerous cells cannot.
  • Chemoradiotherapy – Individuals diagnosed with squamous cell cancer may undergo chemoradiotherapy. This treatment is a blend of chemotherapy and radiotherapy, ensuring patients get the benefits of both. The two types of treatment might be administered simultaneously, or they might be one after the other.
  • Surgery – In many cases, physicians recommend surgery to treat esophageal cancer. The goal of the procedure is to remove cancerous cells. In some situations, this requires removing a portion of the esophagus as well. While surgery may be done before chemoradiotherapy, it is just as common for the procedure to take place after chemoradiotherapy is complete.

Providers determine which treatments to use and in what order based on the specific diagnosis and stage of cancer.

A cancer diagnosis is always frightening, but there are treatments available. For more information on esophageal cancer treatment in San Antonio, contact the experts at the Digestive & Liver Disease Center to schedule an appointment today.