Esophageal cancer (malignant tumors) occurs mainly in people aged between 50 and 70 years, and it is three times more common in men than women. From histopathological point of view it comes in two forms: squamous cell carcinoma and adenocarcinoma. The risk of squamous cell carcinoma is related to chronic alcohol consumption, smoking, presence of hereditary disorders characterized by hyperkeratosis of palms and feet, ingestion of caustic substances, the existence of other cranio-cervical cancers. The squamous cell carcinoma histological type is more common in black people. The other histological type – adenocarcinoma – is more common in the Caucasian population (whites) and originates from mucosal and submucosal glands of the esophagus.
Esophageal cancer is one of the most common malignancies of the digestive tract, on the 4th place after gastric cancer, colon cancer and rectal cancer. Esophageal cancer marked characteristic is axial extension both in-depth and in surface and its very difficult treatment. As an aside, I wish to make known some of the differences between malignant tumors (neoplasms, cancers) and benign tumors. Benign tumors are well-defined, grow slower, and sometimes push neighboring formations. Malignant tumors are poorly defined, grow faster, invade neighboring tissues and metastasize to locoregional and distant sites. Metastasis is the detachment of cancer cells from the tumor “parent” cells entering the circulatory torrent, lymph nodes and other organs.
Esophageal Cancer Risk Factors
Risk Factors for esophageal cancer are: prolongued esophagitis, esophageal diverticula, stenosis scar, therapeutic irradiation of a preexisting thyroid cancer. Some chronic irritation of the esophageal mucosa by mechanical, chemical and toxic substances, too hot beverages , excessive ingestion of incomplete chewed food bowls were also incriminated in the development of cancer of the esophagus. Chronic esophagitis conditions can not be considered precancerous, but rather states that are potentially carcinogenic.
Esophageal Cancer Symptoms
Symptoms of esophageal cancer are dominated by esophageal syndrome secondary to esophageal stenosis (esophageal lumen size reduction due to the tumor volume). The first sign is dysphagia (difficulty in swallowing) that starts with solid foods and liquids afterwards. Sometimes, dysphagia may disappear for a while, if the tumor ulcerated. In cancers located in the upper esophagus, the patient feels pain when swallowing. Tumor extension into the lower esophagus translates into a constant retrosternal or back pain. In upper esophageal cancer that involves the vagus nerve, salivary hypersecretion occurs. Regurgitation may be present and fetid halitosis (bad smelling breath ). By extension of the tumor to the recurrent laryngeal nerve hoarseness occurs through by cervical sympathetic irritation. Claude-Bernard-Horner syndrome can occur and it is characterized by decreasing pupil, abnormal clogging eyeballs in their sockets and falling eyelids. In general, form the first suggestive clinical signs to diagnosis about 5-6 months are lost.
The diagnosis should not be delayed until clinical signs are well-defined, because most likely at this time the tumor is already in an advanced stage. It is recommended in the presence of swallowing disorder quite small in appearance, such as a sensation behind the sternum after the ingestion of solid foods that are too cold or too hot or a sensation of bowel that gives off spontaneously or after the patient drinks a glass of water, especially to a man in his 40s, to require Barium examination of the esophagus and stomach, to confirm or rule out cancer.
Regurgitations are in small quantities, possibly with bloody grooves. The condition of the patient declines quite rapidly and deeply, becoming pale, anemic and weak. Patients lose weight, about 15-20 kg in a few months by lack of appetite and cancerous intoxication. The pain is a late symptom and it is caused by the passage of food through the esophagus, ulcers and nerve involvement