March 10, 2016 356
Today, let’s try a different approach in reviewing diseases by looking at a real life case scenario.
Habits meet Carcinoma
Mr. X is a 40-year-old Taiwanese businessman who works on a very tight schedule. He meets up clients on a daily basis and takes frequent coffee breaks to keep him active and alive. Due to his working culture, he has infrequent meals and often takes late night supper. He has been having this burning like sensation on his chest for quite some time now. Recently, his symptoms intensified, he started vomiting whenever he lies down after a meal and he has difficulty falling asleep every night ever since. This has rendered him more lethargic than usual to carry out his routine busy schedule. He subsequently visited a gastroenterologist for his symptoms and an endoscopic examination revealed oesophageal lining inflammation and cellular degeneration, which puts him at high risk of having cancer.
This scenario above sounds very much clichéd isn’t it? Well, to be honest the lifestyle that we practice defines our wellbeing as a whole. So, eat healthy and live happily. Anyways, after reading the case scenario above, I’m sure everyone must be wondering what I’m talking about. today we will discuss everything about oesophageal cancer. This is very much a rare topic among the community as it is not as common as the other cancers out there but it is a disease that has been easily dismissed by many. Among the top 10 list of common cancers in Malaysia, oesophageal cancer ranks at the 9th place and that clearly shows the prevalence of the disease in perspective.
By definition, oesophageal cancer refers to the cancer of the oesophagus, which is a long, hollow tube that runs from your throat to your stomach. It carries the food that we swallow to our stomach to be digested. Cancer can occur anywhere along the hollow tube but it’s more common in the lower portion of the oesophagus.
What are the symptoms of Oesophageal cancer?
As the general audience, I’m sure everyone wants to know the signs and symptoms of this debilitating disease. The following are the common ones: -
- Difficulty in swallowing
- Burning like chest pain
- Unintentional weight loss
- Hoarseness of voice
- Worsening heartburn or indigestion
Some may argue that they might be experiencing the above symptoms occasionally and often dismisses them because it is a norm to have those symptoms in our society. Well, of course having 24/7 “Mamak” stalls explains everything because you can eat anything at anytime in this country. This brings back to our culture of having late night dinners and suppers.
Do take note fellow readers, that in certain cases there are no signs or symptoms for early oesophageal cancer so always be aware of your general wellbeing at all times. As of now, there is no actual cause of oesophageal cancer just like the many others out there. However, as per general cancer theory, oesophageal cancer takes place when cells in the oesophagus develop errors in their mastermind, DNA. It is because of these errors, cells divide rapidly out of control causing the growth of a tumour that can further grow to invade nearby cells and spread to other sites in the body.
Hmmm…. So, what increases my risk of having oesophageal cancer?
It has been said through studies and researches that constant and frequent irritation to the oesophagus causes the DNA to change in the oesophagus thus resulting in cancer. Now that’s intriguing! The following are the factors that cause constant irritation to the oesophageal lining: -
- Having gastroesophageal reflux disease (GERD)
- Alcohol consumption
- Having bile reflux
- Being obese
- Drinking very hot liquids
- Having difficulty in swallowing because of the inability of the oesophageal sphincter to relax (Achalasia)
- Underwent upper chest or abdomen radiation
- Diet low in fruits and vegetables
So, for those frequent partygoers out there, go easy on the booze yeah!!! If not, you know what’s after you..
How do we test for oesophageal cancer?
Well, the rule of thumb for any cancer test applies here, i.e. endoscopy and tissue analysis. It is very crucial for the attending doctor to visualise the linings of the oesophagus to look out for any growth or abnormal tissue structure that lies within.
If any such abnormality is noted, then surgical devices are passed through, to sample the suspicious looking tissue or growth. This sample will then be sent to the lab for further analysis to confirm the diagnosis before informing the patient.
Staging of Oesophageal cancer:
Once the diagnosis of oesophageal cancer is made, the question of staging comes into the picture. The stages of oesophageal cancer are as following: -
- Stage 1: Cancer occurs at the upper layers of the cells lining of the oesophagus.
- Stage 2: Cancer has invaded deeper layers of the oesophagus lining and may have spread to close by lymph nodes.
- Stage 3: Cancer has invaded the deepest layers of the oesophageal wall and to nearby tissues or lymph nodes.
- Stage 4: Cancer has spread to the rest of the body.
Treatments involved in Oesophageal cancer:
Just like other cancers, the treatment depends on the extent of the disease, which basically means the staging of the cancer. In early stages, a surgical approach alone is sufficient to eradicate the disease without the need of chemotherapy or radiotherapy. The extent of the surgery as well depends on the location of the tumour.
If only a small tumour is seen along the oesophagus, then a simple endoscopic procedure can be done to remove it.
If a tumor is big enough, then a proper open surgery is required to remove part of the oesophagus or even to a certain extent, a part of the stomach as well. In this case, a surgical treatment alone would not be sufficient to eradicate the disease; the combination of chemotherapy and radiotherapy should be given to the patient to ensure a more positive health outcome.
Well, that’s it folks, a comprehensive review on Oesophageal cancer. Hope you guys enjoyed it. Till we meet again….
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by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.