Seven Common Questions About Esophageal Cancer
In recognition of esophageal cancer month, Dr. Paul Bierman, a gastroenterologist with GI Specialists, a part of Baptist Medical Group, is this month’s Ask the Expert on the topic.
[toggle title=”How common is esophageal cancer?” state=”open”]Esophageal cancer involves the esophagus, a long, hollow tube that runs from your throat to your stomach. The esophagus carries the food you eat to your stomach to be digested. The disease is diagnosed in about 20,000 Americans and more than 500,000 people worldwide every year.[/toggle] [toggle title=”What causes this type of cancer to form?” state=”close”]Esophageal cancer begins in the cells that line the esophagus. In the United States, it occurs most often in the lower esophagus, however, in Asia and Africa, esophageal cancer most often involves the middle of the esophagus. It is more common in men than women, and in the U.S., it is most commonly found in white men. Symptoms of esophageal cancer include difficulty swallowing, weight loss, chest pain or pressure and/or hoarseness of the voice.
[/toggle] [toggle title=”Can esophageal cancer be prevented?” state=”close”]There are two main types of esophageal cancer: the first type is called adenocarcinoma, more common in the U.S., which affects the lower esophagus. Causes for this type include gastroesophageal reflux disease, smoking, alcohol abuse and obesity.
The other type of esophageal cancer is called squamous cell carcinoma. It is the most common type of esophageal cancer worldwide and mostly affects the middle of the esophagus. Risk factors for this type of cancer include drinking hot beverages, poor nutrition, low intake of fruits and vegetables, smoking and alcohol abuse.
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It is diagnosed in one of two ways: with an endoscopy, where the doctor passes a long, thin camera into the esophagus and takes a biopsy, or by X-ray.[/toggle]
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Treatment for esophageal cancer depends on how advanced it is. In early stages, where the cancer is localized to the surface of the esophagus, the cancer can be removed surgically alone or in combination with radiation or chemotherapy. More advanced cancers require a combination of all three.[/toggle]
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Prognosis for esophageal cancer is not good. Even with localized disease only 38 percent of people diagnosed with esophageal cancer will survive five years. Once the cancer has spread to one’s lymph nodes, the survival drops to 20 percent in five years.
If it is distantly spread at presentation, only 3 percent of those patients survive five years.
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Prevention in the U.S., where the most common form is adenocarcinoma, includes treating reflux and urging people to stop smoking and limit alcohol intake.
In the U.S., many people first develop a precancerous stage called Barrett’s esophagus. With aggressive treatment, reducing the amount of acid in the stomach and by removing this harmful lining, the risk of developing cancer can be minimized.
Across the world, where squamous cell carcinoma predominates, prevention focuses on eating more fruits and vegetables and avoiding tobacco products.
There’s constant research going on to try to find ways to prevent esophageal cancer and provide better treatment. Targeted therapies, which attack the abnormal cells directly, is the hope of the future.[/toggle]