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Esophageal Cancer by Erin McCullough

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It is not news that maintaining a healthy lifestyle can reduce your risk for many health problems, including cancer.  What exactly does that mean?  Eat right, exercise, do not smoke, and drink in moderation seem to be the most common, and obvious, answers.  For esophageal cancer, this could not be more apparent.  The leading risk factors for this particular type of cancer include obesity, smoking, complications from acid reflux, and heavy drinking.

The esophagus is the hollow tube that joins your throat to your stomach.  It is located between your spine and your windpipe (trachea).  A normal, functioning esophagus uses its muscles to move the food you eat down into your stomach.  A special part of the muscle has two important jobs:  allowing food into the stomach and preventing stomach acid from entering the esophagus.

There are two different types of esophageal cancer: adenocarcinoma and squamous cell carcinoma.  Adenocarcinoma is the more common of the two.  This form is found more often in those with acid reflux problems and therefore is usually located near the bottom of the esophagus, closer to the stomach.  GERD, or gastroesophageal reflux disease, can eventually lead to Barrett’s esophagus, which is a leading risk factor for esophageal cancer.  Barrett’s esophagus is essentially when the lining of your esophagus resembles the lining of your stomach due to stomach acid eating away at it.   The damaged esophagus, as a result, can be more susceptible to developing cancer. Adenocarcinoma can also be brought on by obesity, smoking, and male gender.  Squamous cell carcinoma of the esophagus is on the decline among Americans but is still a real danger.  It is found in the squamous cells of the lining of the esophagus so it can grow anywhere along the esophagus.  Smoking and heavy alcohol consumption are risk factors for this type.

Symptoms of esophageal cancer do not always present themselves right away but as cancer grows, a person could experience several issues.  Unfortunately, this also means the cancer is more advanced, making it more difficult to treat.  (As scary as this sounds, it is important to remember here that someone with acid reflux does not guarantee a cancer diagnosis later in life.)

Symptoms associated with cancer of the esophagus include trouble swallowing, chest or back pain, food getting stuck in the esophagus and coming back up/out, and coughing or vomiting up blood.  The most common symptom is also one of the last to show.  Difficulty with swallowing or feeling like food is stuck in your esophagus is due to the narrowing of that tube.  It starts as a mild problem and people will usually adjust their diets without notice.  The problem worsens however and can reach the point where even getting liquids down is an issue.  At this point, the cancer is quite large.

There are various tests to determine if someone does have esophageal cancer.  There are imaging tests to figure out where it is, what stage it is in, and whether or not surgery is an option.  These tests include but are not limited to, a Barium swallow, a chest MRI, and an endoscopic ultrasound.  Treatment for esophageal cancer depends on the timing of diagnosis but commonly chemotherapy, radiation, surgery, or a combination of these and other options is the course of action.  If the cancer is detected early and has not spread, surgically removing it is preferred by some while others encourage endoscopic therapies.  Endoscopic therapies are said to cause less trauma at the site and have fewer complications.  If all of the cancer cannot be removed, there are still additional measures that can be taken.  Later-stage esophageal cancer can also be treated with surgery; however, at this point, the surgery would most likely be to remove a portion of your esophagus and/or upper stomach.

While esophageal cancer is indeed a scary diagnosis, the good news is that it is on the decline in America.  It is also promising to know that many of the risk factors associated with it are under our complete control.  Early detection, as with many other illnesses and cancers, is key to the treatment of esophageal cancer.  Additionally, treatment options are varied and accessible, somewhat lessening the sting of the reality of having cancer.


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