Deborah Denise Kane
Esophageal cancer is a malignant cancerous tumor that forms in the tissue lining the esophagus; the esophagus is a muscular tube that moves food from the mouth to the stomach. It is more common in male patients over the age of 60, who were or are heavy smokers or tobacco users, heavy drinkers, and are overweight. It is thought to affect African Americans more in the United States than Caucasians. The mortality rate for African Americans continues to be higher than that of Caucasians. In 2012 there have been 17,460 new cases and an estimated 15,070 death so far. There are two major types of esophageal cancer: squamous cell carcinoma and andenocarcinoma. These two types can be determined by looking at them under a microscope. Squamous cell carcinoma is the most common type of esophageal cancer worldwide. This type of cancer starts in the squamous cells that line the esophagus and is usually found in the upper and middle part of the esophagus. Normally this cancer is caused by heavy alcohol consumption and smoking but there have been other documented risk factors. South Central Asia is known as the “esophageal cancer belt” due to the over abundant cases known in both males and females. Andenocarcinoma is the most common type known in the United States and Western Europe. It’s the fastest most increasing cancer in the United States. This type starts in the glandular cells in the lower part of the esophagus and may occur at or near the junction of the esophagus and the stomach, known as the gastro-esophageal junction. Normally this type is caused by acid reflux and often linked to obesity.
These two types are the most common, but there are several other types such as, lymphoma, melanoma, sarcoma, small cell, choriocarcinoma and spindle cell carcinoma. Although they are rare they have been seen in patients and are most often caused by the spreading of cancer from various other body parts; like the lungs, liver or breast and spread into the esophagus via the lymph or blood systems. Esophageal cancer has few, if any signs or symptoms’ in its early stages. However as the cancer grows the most common symptoms may include; * Difficulty or painful swallowing
* Weight loss and loss of appetite
* Blood in stool
* Feeling very tired
* Heartburn or GERD
* Pain in the throat or back
* Hoarseness or coughing
There are several different tests that can be performed to determine what exactly the cause of your symptoms is. The Barium Swallow test where a patient swallows a liquid mixture while at an x-ray machine. The barium is opaque to the x-ray therefore allowing narrowing in the esophagus to be shown in pictures. The Endoscopy is a medical instrument that consists of a narrow flexible tube with a light and camera at the end in which it is used to look into the esophagus. It may also be equipped with a small attachment to take a sample or biopsy of the esophageal tissue. A biopsy is the removal of cells or tissue for the examination by a pathologist. The patient is usually slightly sedated. Next there is the PET scan or the Positron Emission Tomography Scan this is where the patient is given a dose of glucose that is altered so it is radioactive. Tumor cells require much more sugar in the form of glucose for energy than normal cells in the body. After receiving the glucose the patient usually is instructed to wait about an hour, this giving the cells in the body time to absorb large amounts of glucose before the scan. The PET scanner is able to locate where in the body there is an excess of radioactive glucose and where there are likely to be tumor cells. The radioactivity rapidly decays, so that it does not cause any lasting effects on the patient. If your doctor orders a biopsy and the test comes back as a positive for cancer the next step would be to determine at what extent or stage of...