Esophageal Cancer Surgery A Major Cause Of Health Problems In Long Term Survivors

Esophageal Cancer

According to a study conducted by researchers at Karolinska Institutet and published in the Journal of Clinical Oncology, patients operated for esophageal cancer have long-term health problems in postoperative and quality of life and is well below the national average.

Esophageal cancer is one of the most aggressive cancers and the main therapy  is esophageal resection. There are several surgical procedures depending on cancer location: if located mediotoracic the treatment consists of esophagectomy with lymphadenectomy , but if it is located at the esogastric junction, the stomach also has to be removed. Apart from surgery, there are also other therapies that can help  in the fight against esophageal cancer, such as chemotherapy and radiotherapy.

Esophageal Cancer Surgery

Histologically, esophageal cancer is of several types, but most common is squamous cell carcinoma and adenocarcinoma. Causes of the esophageal cancer are mainly related to diet (smoked foods, canned), but there are certain lesions with an increased risk of malignancy, such as Barrett’s esophagus, namely the appearance of islands of islands of intestinal metaplasia of the esophagus by the action gastro-oesophageal reflux.

In terms of symptoms, they appear relatively late and are nonspecific. Dysphagia, difficulty swallowing meaning seems to be the most common symptom, followed by heartburn (burning retrosternal pain character), abdominal discomfort, weight loss, hoarseness, cough. Therefore, esophageal cancer is usually found in late-stage and surgery, if it is suitable for this type of treatment, is an extensive operation, requiring sometimes a triple approach, thoracic, abdominal and cervical. Out of 25-30% of those undergoing surgery, only one-third have a period of 5 years survival. The quality of life in patients operated is well below the national average.

The study was conducted on 141 patients who had surgery for cancer of the esophagus and had a survival of at least 5 years postoperatively. The  purpose of the study was to assess the quality of life of patients operated for esophageal cancer who had postoperative complications compared with those who had not  such complications. Study results showed that nearly 45% of them had at least one serious health problem after surgery (postoperative infection or chronic respiratory failure).

In order to asses the quality of life, patients were given questionnaires that were completed periodically to 6 months, 3 years and 5 years. The questions focused on patients functional capacity (social life, the physical) and symptoms. Responses were then processed and scientists made a comparison between those who had at least one serious postoperative complication and those who had no complications. Most often, patients complained of dyspnea, fatigue, eating disorder, insomnia and heartburn.