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Oesophageal Cancer

The oesophagus or food pipe is a muscular, hollow tube that connects the mouth and stomach. A cancerous growth in the inner lining of this tube leads to oesophagal cancer. The abnormal growth is usually observed in the inner lining, however, in rare cases, it can also occur in the outer layers of the oesophagus. It is one of the major cancers in India due to excessive tobacco and alcohol consumption.

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Types of Esophageal Cancer

Depending on its origin, oesophagal cancer is of the following types:

Adenocarcinoma: This type of oesophagal cancer starts from the glandular cells located between the lower oesophagus and upper stomach.

Squamous Cell Carcinoma: This type starts from the squamous cells or the inner lining of the oesophagus.

Small Cell Carcinoma: This rare type starts from the neuroendocrine cells.

Oesophageal cancer can be detected in the early stages due to apparent symptoms. These are:

  • Difficulty swallowing
  • Choking sensation
  • Cough
  • Vomiting
  • Fatigue
  • Change in voice
  • Abrupt weight loss

The exact cause of oesophageal cancer is not known. The possible causes, however, are:

  • Gastroesophageal reflux disease (GERD)
  • History of gastrectomy
  • Obesity
  • Tobacco and alcohol consumption
  • HPV infection
  • Red meat

Oesophageal cancer is diagnosed by:

  • Barium Swallow Test: During this test, the doctor will ask you to swallow a liquid containing barium. After some time, an X-ray will be conducted to evaluate the presence of cancerous cells.
  • Esophagoscopy: In this test, the doctor will insert a flexible tube with a camera in your throat. This helps the doctor in identifying the level of cancer.
  • Imaging tests: Various imaging tests such as CT scans, and MRIs will be performed to gauge the size, location, and stage of the tumour.
  • Biopsy: The doctor will extract a small tissue from the area and examine for the presence of cancer cells.

The treatment strategy for oesophageal cancer depends on the stage and type of cancer, age, and overall health of the patient. Surgery is usually the mainstay of the treatment. It may be combined with chemotherapy and radiation therapy for better outcomes.

  • Surgery: Surgery is the mainstay of oesophagal cancer. The doctor will remove the tumour tissues along with surrounding healthy tissues and lymph nodes.
  • Radiation therapy: High-energy X-rays will be used to destroy cancer cells. These radiations may be administered before or after the surgery depending on the patient's condition.
  • Chemotherapy: High doses of anti-cancer drugs will be administered to destroy cancer cells. In some cases, chemotherapy is combined with radiation therapy to remove cells from the body.
  • Endoscopic laser therapy: In this procedure, the doctor will utilize a laser to punch a hole in the oesophagus and ease the swallowing difficulties in patients.
  • Photodynamic therapy: Some photoactive agents may also be administered to kill cancer cells and allow normal swallowing in patients.
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