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Esophageal Cancer Signs and Symptoms | Diagnosis | Treatments

RMG Perera by RMG Perera
August 10, 2022 - Updated on October 21, 2023
in Healthy A-Z
Esophageal Cancer Signs and Symptoms | Diagnosis | Treatments

Esophageal Cancer Signs and Symptoms, Diagnosis, Treatments

Esophageal Cancer Signs and Symptoms | Diagnosis | Treatments

Two types of Esophageal Cancer

  • Squamous Cell Carcinoma (SCC)
  • Adenocarcinoma

Epidemiology

  • More Likely to occur in males (3:1)
  • Onset occurs later in life (55-60)
  • Geographical differences in incidence of SCC and adenocarcinoma
  • Very poor prognosis with low survival rates
Esophageal 01
Image: iStockPhoto

Esophageal Cancer | Pathogenesis

Squamous Cell Carcinoma (SCC)

  • Cancer of squamous cells
  • Affects upper portion of esophagus
    • Mid-portion commonly affected
  • Often begins as plaques or small outgrowths

Adenocarcinoma

  • Affects lower 1/3 of esophagus
  • Many cases due to Barrett’s esophagus
    • Metaplasia of esophageal squamous cells into to gastric glandular cells

Esophageal Cancer | Risk Factors

Squamous Cell Carcinoma

  • Smoking and alcohol
  • Human papillomavirus (HPV)
  • Diet low in fruits and vegetables
  • Drinking hot liquids
  • Atrophic gastritis
  • Poor oral hygiene

Adenocarcinoma

  • Gastroesophageal reflux disease (GERD)
  • Smoking and Alcohol
  • Obesity
  • pylori infection
  • Cholecystectomy

Esophageal Cancer | Signs & Symptoms

  • Progressive dysphagia

Solids > Solids and Liquids

  • Pain with Swallowing (odynophagia)
    • As disease progresses, pain becomes constant
  • Regurgitation
  • Aspiration
  • Reflux (if concurrent GERD)
  • Hematemesis
  • Melena
  • Anemia

Constitutional Symptoms

  • Fatigue
  • Night Sweats
  • Weight Loss

Other Signs and Symptoms

  • Dry cough
    • May be caused by aspiration and/or aspiration pneumonia
  • Hoarseness of voice

Esophageal Cancer | Diagnosis

Esophageal Diagnosis
Image: Freepik
  • Barium swallow
    • May show narrowing but generally not a good test
  • Endoscopy with biopsy
  • Endoscopic ultrasound
  • Assess for metastases
    • CT scan, bone scan, PET scan

Esophageal Cancer | Treatment

Esophageal Treatment
Image: Freepik
  • Superficial, limited to mucosa
    • Endoscopic resection
  • Lesions that penetrate the submucosa
    • Surgical resection (esophagectomy) with lymphadenectomy (negative lymph nodes)
  • Lesions invading muscularis propria with affected lymph nodes
    • Surgical resection with neoadjuvant chemotherapy
  • Metastatic disease
    • Palliative
    • Esophageal stent
  • Combination therapy better than surgery alone

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