Esophageal Cancer Panama
What is esophageal cancer?
Esophageal cancer (also called esophageal cancer) develops when cells in the lining of this digestive structure grow out of control.
Basically, esophageal cancer starts anywhere along the tract, in the inner layer of the esophageal wall, and grows outward through the other layers.
Causes of esophageal cancer
Although it is not known exactly what causes esophageal cancer, there are risk factors that increase the chances of developing it.
Some specialists have referred to the use of tobacco and alcohol consumption as causing esophageal cancer by causing damage to the DNA of the cells that line its interior.
Likewise, long-term irritation of the lining of the esophagus can also cause DNA damage; a problem that occurs in people who suffer from gastroesophageal reflux, Barrett’s esophagus, achalasia, Plummer-Vinson syndrome or scarring by bleach ingestion.
There is also an identified risk among people who have been infected with the human papillomavirus (HPV), head and neck cancer, or who have received radiation therapy to the esophagus for the treatment of other malignant tumors in nearby regions.
Basically, esophageal cancer starts anywhere along the tract, in the inner layer of the esophageal wall, and grows outward through the other layers.
What are the main symptoms of esophageal cancer?
Although they highlight pain and difficulty swallowing as the most marked and difficult indicators to bear, both for the affected person and for their loved ones; There are other symptoms that are less frequent and vary from patient to patient.
However, this is one of the most complex types of cancer in this regard, since discomfort in general causes a lot of discomfort in the patient; Including:
- Vomiting.
- Weight loss.
- Chronic cough.
- Digestive bleeding.
How is esophageal cancer detected?
Screening tests certainly check for cancer even before the first symptoms appear. That is why preventive medicine is so important in the face of these pathologies, since a timely check-up can facilitate detection at an early stage.
Despite this, for the specific case of esophageal cancer there is no standard screening test or medical routine that allows for early detection. Among the procedures used to identify it are:
- Esophagoscopy.
- Biopsy.
- Cytology with brush.
- Balloon cytology.
- Chromoendoscopy.
- Fluorescence spectroscopy.
Types of esophageal cancer
There are two types of esophageal cancer, which look totally different when viewed under a microscope:
Esophageal squamous cell cancer; associated with smoking and excessive alcohol consumption.
Adenocarcinoma; the most common type of esophageal cancer, which is closely related to Barrett's esophageal syndrome as a risk factor (an additional fact is that gastroesophageal reflux disease can develop into Barrett's disease). On the other hand, cigarette smoking and obesity also predispose to this type of cancer.
Other very rare tumors of the esophagus constitute less than 1% of cases; These include small cell neuroendocrine cancers, lymphomas, and sarcomas.
Importance of early detection of cancer
Undoubtedly, the prognosis of patients with esophageal cancer is strictly dependent on its early detection. Consequently, the detection of esophageal cancer in its early stage is essential to reduce mortality figures, which place it at 82% in relation to the annual incidence.
Stages of esophageal cancer
As with any other type of cancer, the classification of the stage is related to the level of complexity and progress in which the disease is at the time of detection.
Stage 0 Esophageal Cancer
First, the tumor is located in stage 0, which contains abnormal cells called high-grade dysplasia (a type of precancer).
Basically, the abnormal cells look like cancer cells, but they are only found in the inner layer of cells that lines the esophagus (epithelium) and have not grown into the deeper layers of esophageal tissue.
Stage I Esophageal Cancer
It is usually cancer that has not grown deep into nearby tissues and has not spread to lymph nodes or other parts of the body.
Often called early-stage cancer, tumors grow in the lamina propria, the muscle layer of the mucosa (the tissue under the epithelium), the submucosa, or the thick muscle layer.
It is undoubtedly the stage that offers the best prognosis, since immediate intervention can stop the progression of the disease.
Stage II Esophageal Cancer
Second, tumors that have grown into the main muscle layer of the esophagus or into the connective tissue outside the esophagus are located.
In particular, this stage also includes some cancers that have spread to 1 or 2 nearby lymph nodes. As for life expectancy, in these patients there is around 46% survival.
Stage III Esophageal Cancer
At the same time, stage III tumors include some that have grown through the wall of the esophagus to the outer layer; as well as cancers that have grown into adjacent organs or tissues.
This classification also includes most cases in which the tumor has spread to nearby lymph nodes; making life expectancy in these cases around 26% of cases.
Stage IV Esophageal Cancer
From this stage on, esophageal cancer is very difficult to remove completely, and surgery is not a good option.
During this stage, treatment is mainly focused on keeping the cancer under control for as long as possible and relieving the symptoms that cause discomfort to the patient.
Chemotherapy (possibly with targeted therapy drugs or immunotherapy) and radiation therapy may be given to help the patient feel better, relieve pain, and live longer. However, only 5% of stage IV patients survive 5 years.
Metastasis of esophageal cancer
Esophageal cancer usually spreads to neighboring structures such as the lung, adjacent lymph nodes (including supraclavicular nodes), liver, and pleura.
In general, the process occurs through the lymphatic system, not excluding hematogenous spread, which rarely occurs in this type of cancer. Distant metastasis could be explained by hematogenous spread of cancer cells to tissues far from the main focus.
Likewise, bone metastasis occurs in approximately 9% of cases.
On the other hand, pulmonary or respiratory complications are often the result of esophageal tracheal fistulas or aspirations that lead to pneumonic symptoms and frequent infections.
Current Treatments for Esophageal Cancer
The treatment options are diverse, each of them oriented to a goal, adjusted to the stage of the disease, the patient’s conditions and taking into account the side effects that they can cause.
Local treatments
These are options that allow the tumor to be treated directly, without affecting the rest of the body.
These treatments are most effective in early stages (when they have not spread and are smaller); although they can also be used in other situations. Among these we have:
- Surgery for esophageal cancer.
- Radiotherapy.
- Endoscopic treatments.
Systemic treatments
In these cases, medications are used that can be administered orally or intravenously. They are called systemic therapies because they go all over the body looking for cancer cells.
Therefore, depending on the type of esophageal cancer, different medications may be used. The main treatments in this group are:
- Chemotherapy.
- Targeted therapy medications.
- Immunotherapy.
Common Treatment Approaches
As soon as the patient’s stage and overall health status have been determined, different types of treatment can be combined simultaneously or consecutively for best results.
It is also possible to use some of these resources as palliative treatment. In this sense, supportive therapies only seek to relieve symptoms such as pain and difficulty swallowing, without waiting for other changes in the evolution of the disease.
Nursing Care for Patients with Esophageal Cancer
The care offered by health personnel to a patient with esophageal cancer should include the necessary considerations to treat the complications of this type of tumor.
Obviously, malnutrition and infections are some of the most common situations. Among the care that nursing staff must cover are:
Adapt the consistency of the food.
Enrich foods with protein supplements.
If dysphagia does not allow intake by mouth, tube feeding (gastrostomy or jejunostomy) should be ensured.
Nutritional control.
Control of shock manifestations (monitor vital signs).
Proper oral hygiene.
Strict control of water intake.
Position control, always incorporated at 30 degrees.
Teaching of breathing exercises.
Adequate nutritional education.
Frequently Asked Questions – Esophageal Cancer
Find answers to your concerns and fears in the following lines.
At what stage does cancer become terminal?
In the final days or hours of their life, most patients lose the desire to eat or drink and refuse all kinds of food. During stage IV esophageal cancer or already in its metastatic phase, these tumors are considered irreversible. As a result of this, physical changes occur such as:
- Tiredness and weakness.
- Reduced urination or dark-colored urine.
- Spotted, cold or blue hands and feet.
- Irregular heartbeat.
- Reduced blood pressure.
- Irregular respiratory rate.
Is esophageal cancer hereditary?
As far as is known, there is no evidence linking the occurrence of esophageal cancer with any aspect of genetic inheritance. However, it is possible that people from the same family nucleus are exposed to some risk factor within their environment.
Is there a cure for esophageal cancer?
For some people with esophageal cancer, treatment may eliminate or destroy the cancer, as long as it is in its early stages.
In fact, completing the treatment can cause the patient as much tension as excitement. You may feel relief at the end of it, but it’s still hard not to worry about the cancer coming back.
For other people, the cancer may simply never go away completely.
What is the most common esophageal cancer?
Squamous cell carcinoma is the most common among the known types. It forms in the thin, flat cells that line the inside of the esophagus, most often in the upper and middle part of the esophagus.
How to prevent esophageal cancer?
Here are 5 simple tips to prevent esophageal cancer:
- Limit tobacco and alcohol consumption. Studies show that the risk of esophageal cancer is lower in people who do not use alcohol or tobacco products.
- Prevents gastric reflux. The irritation over time changes the cells and produces Barrett’s esophagus syndrome; a condition that predisposes the appearance of esophageal cancer if it is not treated in time.
- Improve your diet. A diet high in green fruits and vegetables can lower the risk of squamous esophageal cancer. In addition, being overweight causes gastric reflux, increasing the risks.
- Avoid drinking hot liquids regularly. If you are used to drinking liquids that are too hot, such as tea or coffee; Gradually switch to warmer drinks.
- Endoscopy. Although there is no standard screening test for esophageal cancer, endoscopy is a procedure that allows abnormal areas inside the digestive tract to be visualized and identified. It also allows samples to be taken for later study (biopsies).
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