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Esophageal Cancer

Esophageal cancer, cancer of the esophagus

Esophageal cancer is a malignant tumor that affects the cells of the esophagus, a muscular tube of 2 cm to 3 cm in diameter and 25 cm to 30 cm in length, which connects the pharynx (the throat) to the stomach. The esophagus is composed of several layers. Cancer usually develops in the innermost layer and spreads outwardly. The disease can affect any portion of the organ, but most cases occur in the lower third of the esophagus: lower third, middle third, and upper third. Without a proper treatment, the tumor will continue to grow until becomes fetal. Early diagnosis and treatment are vital. It is therefore important to seek medical care at the very first symptom or sign. For more info please see esophageal cancer symptoms.

The esophagus, also called known as the foodpipe or gullet, is a fibromuscular tube lined by squamous epithelial cells, flat, scale-like cells. This organ plays the principal role in transporting saliva, liquids, and foods from the mouth to the stomach. Once eaten, the food enters the esophagus and down to the stomach, driven by the contraction of muscles of its wall. The input and output of the esophagus are closed by “muscular rings” that open and close to manage the passage of food. They are called sphincters: upper esophageal sphincter and lower esophageal sphincter.  

If the sphincter at the entrance of the stomach does not function well, it can lead to gastroesophageal reflux which will cause irritation in the esophagus wall. This chronic irritation of the esophagus is the factor that is most known to cause esophageal cancer, although there are several other risk factors. For more info, Please see esophageal cancer causes and risk factors.  

Cancer of the esophagus is quite frequent and serious for which only an early diagnosis and effective treatment can lead to lasting survival. It is estimated that less than 1 out 7 people diagnosed with the disease survive more than 5 years after diagnosis. However, mortality from esophageal cancer decreased in recent years. To increase your chance of survival, it is very important to maintain a good nutritional status before, during and after treatment. Please see esophageal cancer treatment for more details. 

There are two main types of esophageal malignant tumor which are distinguished by microscopic analysis: 

Squamous cell carcinoma – this form of cancer of the esophagus is account for the vast majority of cases worldwide. It is favored by excessive use of tobacco and alcohol consumption. Esophageal squamous-cell carcinoma occurs most often in men. 

Adenocarcinoma – this tumor occurs especially in the distal esophagus (lower third of the esophagus), and it is favored by chronic gastroesophageal reflux disease (GERD), which can be promoted by hiatal hernia, obesity, smoking, dry mouth, asthma, diabetes, scleroderma (a chronic autoimmune disease), and delayed stomach emptying (gastroparesis). Adenocarcinoma of the esophagus is more prevalent inEurope and North America, mostly in the United States.  

 

Esophageal cancer is three times more common in men than in women, and people of African origin appear to be at higher risk than Caucasians. Although cancer of the esophagus is less frequent in Canada and the United States and is responsible for less than 1% of all cancer cases, in certain areas of Asia it ranks second in term of frequency. For more info Please esophageal cancer incidence.  

 

References:

 

  1. North DA, Schlegel M, Martin RC: Gastroesophageal reflux disease-related symptom assessment in subjects with malignant dysphagia receiving esophageal stents.
    Am Surg. 2014; 80(12):1260-5 [PubMed]  
  2. US Department of Health & Human Services: Anatomy of the Esophagus - seer.cancer.gov 
  3.  Devesa SS, Blot WJ, Fraumeni JF Jr: Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83 (10): 2049-53, 1998.  [PUBMED Abstract]  
  4. Blot WJ, McLaughlin JK: The changing epidemiology of esophageal cancer. Semin Oncol 26 (5 Suppl 15): 2-8, 1999.  [PUBMED Abstract] 

 

         

                                                                                                       Incidence