Esophageal cancer develops during the degeneration of epithelial cells in different layers of the tube through which food from the oral cavity enters the stomach. The process involves the formation of atypical cells, the number of which grows along with the size of the tumor. The disease is more often detected in men. More susceptible to people from 45 years. In Europeans, pathology is 6 times more common than in Africans.
A malignant tumor in the esophagus develops in response to constant irritation or damage to the organ mucosa, which happens when:
- drinking strong alcohol;
- inhalation of dusty air, gases, vapors of volatile substances.
Doctors classify esophageal cancer in several ways:
- at the stage of development;
- by the presence of metastases in regional lymphatic structures and organs;
- by histological type;
- by the nature of the growth of an abnormal tumor;
- on the localization of the neoplasm.
At stage 2, the tumor metastasizes to the nearest lymph nodes. At 3 stages it forms metastases in other organs of the gastrointestinal tract and distant lymph nodes.
A tumor may be squamous if squamous cells are transformed. The number of such pathologies among all cases of cancer of the esophagus is 97%. The remaining 3% is adenocarcinoma – a tumor consisting of degenerated secretory cells of the organ.
Beginning of tumor development
The degeneration of normal cells to atypical occurs asymptomatically. The process can only be suspected if the patient complains of gastroesophageal reflux. Initial changes often look like a little erosion and are detected by chance during esophagogastroscopy. After a biopsy, the patient is carefully monitored, as with confirmed Barrett’s disease, appropriate treatment is prescribed.
Early manifestations of oncology of the esophagus
In stage 1 cancer, symptoms are often absent. The neoplasm is located in the plane of the mucosa, does not narrow the lumen of the esophagus, and in fact cannot declare itself in any way. Some patients feel a “scratch” behind the sternum, a slight tingling sensation when swallowing rough-fiber food. At this stage, the diagnosis of pathology occurs by chance. This can be called a “happy chance.”
A small tumor is easier to completely excise without significant injuries, and timely radio wave irradiation and chemotherapy can completely suppress the activity of tumor cells, which increases the patient’s chances of a full recovery. Even successful elimination of the tumor at stage 1 requires subsequent monitoring of the patient in the oncology dispensary.
Symptoms in the midst of tumor growth
A key symptom of esophageal cancer in stages 2–3 is dysphagia. The term means violation of the act of swallowing (starting from discomfort and ending with extreme difficulties, vomiting). When the tumor protrudes slightly into the lumen of the esophagus, the patient feels an obstacle when swallowing solid food. Food seems to “cling” to the walls.
As the neoplasm grows, difficulties increase. It is unpleasant and even painful for the patient to swallow fiber and coarse food. He/she seeks to chew it as well as possible, immediately drink it with liquid. Further, swallowing a dense meal is accompanied by prolonged discomfort in the chest. The patient tries to replace all the solid consistencies of the dishes with softer ones (mashed potatoes, crushed products). When the situation worsens, the patient completely switches to liquid food. However, over time, even it becomes difficult to swallow.
Chronic delays in food in the esophagus provoke putrefactive processes – it smells bad from the patient’s mouth, a whitish coating on the tongue appears. In the morning, these signs are most noticeable. With an impressive tumor size, the patient can vomit mucus, suffer from vomiting.
In parallel to these problems, new ones appear – aching, pulling, stitching pains behind the sternum, in the upper back. As cancer progresses, the intensity of pain increases, burning sensation is felt.
Signs of the final stage
In the last stage of cancer of the esophagus, the patient cannot eat normal food. Often, he/she uses only liquid. Due to a lack of nutrients, dystrophy develops:
- the patient loses weight;
- becomes pale due to anemia;
- constantly feels weak;
- gets tired in the absence of physical activity.
Symptoms of general intoxication of the body increase – body temperature, nausea, vomiting, headache increase. With the collapse of the tumor, the symptoms of dysphagia are weakened, however, with coughing and vomiting, bloody discharge from the esophagus is observed. If large vessels are damaged, bleeding develops.
The tumor grows not only in the esophagus, but also in the surrounding tissues, provoking the appearance of metastases. Additional damage entail the addition of other symptoms:
- hoarseness of the voice indicates damage to the vocal cords (in some cases, the recurrent nerve);
- coughing while drinking, symptoms of pneumonia indicate damage to the trachea or bronchi, the formation of fistulas;
- pain in the chest, shortness of breath and cough is manifested by the growth of a tumor in the lungs;
- signs of pericarditis indicate damage to the mediastinal tissue.
The spread of metastases throughout the body is not excluded. More often, tumors are detected in the stomach, liver, spinal cord.
When to see a doctor
The sooner the patient seeks help, the higher his/her chances of recovery. It is necessary to consult a doctor at the first discomfort in the chest cavity, if swallowed. You should not wait for additional signs – a feeling of a foreign body, light pressure, “scratching”. If such sensations are regular and long lasting – an occasion to visit a gastroenterologist or oncologist.
Palliative surgical therapy is required for patients with large inoperable tumors. During the intervention, sections of the tumor that interfere with the passage of food into the stomach are removed using an endoscope. Sometimes a stent is inserted into the esophagus. Its purpose is to ensure the normal passage of food.
After surgical removal of the tumors, a gastrostomy may be required. This is a device for introducing food into the stomach during the healing of postoperative injuries. Sometimes a gastrostomy is established until the esophagus is reconstructed.
Predictions for the patient
To make predictions for cancer, the indicator of 5-year survival of patients after a full course of treatment is used. If pathology is detected at stage 1 – the indicator is 90%, at 2 it reaches 50%, at 3 stage it does not reach 10%. Comprehensive treatment allows you to delay the death of only 10% of seriously ill patients for up to 1 year.
Esophageal cancer accounts for 6% of the total number of oncological pathologies. The disease is difficult to treat, and the prognosis cannot be called optimistic. Given the asymptomatic course of the first stages and the difficulty in treating the latter, doctors strongly recommend contacting medical facilities at the first discomfort when swallowed.