Esophageal cancer: what it is, symptoms and treatment

Esophageal cancer is a serious type of cancer that happens due to changes in the cells of the esophagus, which become malignant, resulting in the appearance of some signs and symptoms such as difficulty in swallowing, the appearance of a lump in the upper stomach and dark stools, however, the symptoms of cancer in the esophagus only appear when the disease is already in more advanced stages and with metastases, with less chance of cure.

According to the location of the affected cells, esophageal cancer can be classified into two main types:

• Squamous cell carcinoma, which is the most common type of cancer in the esophagus and affects the upper part of the esophagus and, therefore, is more common in smokers and / or alcoholics; Adenocarcinoma, which most often appears in the portion that joins the esophagus to the stomach and is more frequent in people with chronic gastric reflux, Barrett's esophagus and when the person is overweight.

This type of cancer is more common to happen in people over 50 and who have risk factors such as obesity, reflux, gastritis or are smokers. Therefore, if the person has any sign or symptom related to cancer in the esophagus and has any of the risk factors associated with the disease, it is recommended that you consult the gastroenterologist so that the diagnosis and treatment can be made, being in the majority Often recommended to perform surgery to remove a portion of the esophagus, as well as chemo and radiation to eliminate cancer cells that may not have been eliminated during surgery.

Main symptoms of esophageal cancer

Some signs and symptoms that may indicate the development of cancer in the esophagus are:

• Difficulty and pain to swallow, initially solid foods and then liquids; Hoarseness and constant cough; Loss of appetite and weight; Tiredness when performing simple exercises, such as making a bed or climbing stairs; Feeling of a full stomach; Vomiting with blood and nausea; Stools dark, pasty and with a strong smell or with blood; Abdominal discomfort that does not pass; Lump in the stomach, which is palpable; Swollen tongues on the left side of the neck; Nodules around the navel.

Usually, esophageal cancer does not cause any signs or symptoms, however as the disease progresses, the characteristic symptoms may begin to be noticed. Thus, the onset of symptoms indicates that the disease is already at a more advanced stage, and rapid diagnosis and treatment is important.

How the diagnosis is made

The diagnosis of esophageal cancer is made through endoscopy, which is an examination performed with the aim of visualizing the interior of the esophagus and stomach and checking for any signs of alteration. If a lump or any other alteration is found during the examination, it is recommended to perform a biopsy of a sample of the esophageal tissue to check the characteristics of the cells, in addition to performing an esophageal X-ray, especially if the person has difficulty swallowing.

In addition, the doctor may indicate a blood test that includes the blood count to check for anemia and a stool test to check for blood in the stool.

During the endoscopic examination, it is also possible for the doctor to check the stage of the disease according to the characteristics observed:

• Stage I - Tumor on the wall of the esophagus with about 3 to 5 mm and without metastases, with greater chances of cure; Stage II - Enlargement of the esophageal wall with more than 5 mm and without metastases with some chances of cure; Stage III - Thickening of the esophageal wall that affects the tissue around the esophagus with little chance of cure; Stage IV - Presence of metastases by the body, with very little chance of cure.

However, these stages can be described in more detail according to the type of esophageal cancer that was diagnosed by the doctor.

Main causes

The appearance of esophageal cancer is associated with some risk factors, such as:

• Excessive consumption of alcoholic beverages and cigarettes; Ingestion of hot drinks above 65º C such as coffee, tea or chimarrão, for example; Ingestion of alkaline substances, such as chlorine used for cleaning that leads to narrowing of the esophagus; History of head cancer or neck.

In addition, this type of cancer is more common in patients with diseases such as gastritis, gastroesophageal reflux or Plummer-Vinson syndrome, achalasia or Barrett's esophagus for example, with irritation of the esophagus usually due to reflux of the stomach juice or of bile.

How is the treatment

Treatment for esophageal cancer takes into account the location of the tumor and stage of the disease, in addition to the person's clinical history, age and symptoms. Thus, the treatment for this type of cancer indicated by the oncologist and gastroenterologist may include:

• Surgery to remove the esophagus: the portion with the tumor is removed and the rest is joined to the stomach. However, when the esophagus has to be removed completely, it is necessary to place an artificial esophageal prosthesis or remove a portion of the intestine to replace the esophagus, for example; Radiotherapy: it is done to prevent the growth of tumor cells in the esophagus; Chemotherapy: through injections into the vein or muscle and in some cases through pills to also promote the elimination of cancer cells that may still be present.

In most cases these treatments do not completely cure the cancer, they only help to reduce the symptoms of cancer and prolong the life of the patient. The life prognosis of this type of cancer varies with the type of cancer, staging, treatments performed and the patient's response to treatment, but as this disease is in most cases detected at an advanced stage and, therefore, the patient's life expectancy is about 5 years old.

In addition, the life prognosis of a patient with cancer in the esophagus is greater when the tumor is only located in the esophagus and there are no metastases.

Food for esophageal cancer

In the case of esophageal cancer, it may be necessary to make some changes to the diet, due to the difficulty in swallowing and the side effects of the treatments, especially chemotherapy that causes nausea and abdominal discomfort.

Thus, it may be necessary to prepare pasty foods, such as porridge and soup in a blender, or to add thickeners to liquid foods. In addition, it may be necessary to receive nutrients directly through the vein or use a nasogastric tube, which is a tube that runs from the nose to the stomach, to help receive the proper foods. Check out some food options for when you can't chew.