Book An Appointment1. What are causes of esophagus cancer?
Risk factors for esophagus carcinoma are
- Alcohol consumption
- Smoking
- Gastroesophageal reflux disease
- Obesity
- Barrett esophagus
2. What are types of esophagus cancer?
There are predominantly two types of esophagus cancers based on microscopic examination of tumor sample
- Squamous cell carcinoma
- Adenocarcinoma
Few other types of carcinoma can affect esophagus but are uncommon -e.g, smallcell carcinoma, neuroendocrine tumor, sarcomas etc.
3. What are symptoms of esophagus cancer?
Usual presenting symptoms are
- Difficulty in swallowing
- Stickiness of food while swallowing
- Retrosternal discomfort
- Pain chest
- Chronic cough especially while swallowing
- Weight loss
- Hoarseness of voice
4. How can esophagus cancer be detected?
First line of investigation for diagnosis are
- Barium swallow
- Upper GI endoscopy and biopsy
These two tests not only provide us diagnosis but also tells us about location of tumor that will further decide future course of action for treatment. Biopsy provides us with tissue diagnosis regarding type of cancer as mentioned above.
5. What are tests to be done before starting any form of therapy?
After diagnosis staging investigation are required to grossly stage the disease and planfurther treatment
- CT scan of chest and upper abdomen
- Endoscopic ultrasound (EUS)
- Whole body PET Scan
- Bronchoscopy depending upon location of tumor
6. What is treatment of esophagus cancer?
Surgery has been mainstay of treatment for carcinoma esophagus. But long term survival was poor. With recent advent of few chemotherapeutic agents along with radiation the rapyhas really improved overall survival and outcomes. Even in patients with locally advanced disease chemoradiation has resulted in down staging of tumor and increased resection rate as well as survival rates. So now according to protocol patient usually under goes chemoradiation first followed by surgery.
7. What if the type of surgery done for esophageal cancer?
Esophagus cancer is treated by minimally invasive methods now. Thoraco- laparoscopi cresection of esophagus with reconstruction by stomach tube is method of choice for cancer of esophagus. Robotic surgery is further advancement in surgical armamentarium that increases safety of surgery and improves outcome. With minimally invasive methods side effects of surgery has been reduced to minimum and patient’s recovery is enhanced.
8. What are side effects of treatment of esophagus cancer?
The patient can have side effects due to radiation, chemotherapy or surgery. Side effects due tochemoradiation are
- Nausea /vomiting
- Difficulty in swallowing
- Chest pain
- Loss of appetite
- Decreased cell counts
- Mouth ulcers
Complications after surgery can be
- Hoarseness of voice due to nerve injury- its usually temporary and recovers with time
- Swallowing problems due to uncoordinated effects of swallowing reflex
- Injury to trachea, blood vessels, thoracic duct (incidence has reduced considerablyafter using minimally invasive methods)
- Lung complications (reduced significantly with laparoscopic approach)