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Esophageal cancer
What should I do about esophageal cancer?
Currently, effective treatments for esophageal cancer include surgical treatment, radiation therapy, and chemotherapy. Integrated treatment with surgery as the main approach is the primary method for treating esophageal cancer. This may include preoperative radiotherapy followed by surgery, preoperative chemoradiotherapy followed by surgery, preoperative chemotherapy followed by surgery, or direct surgery followed by adjuvant chemoradiotherapy. These are all major treatment methods for esophageal cancer. However, the choice of a personalized integrated treatment should be based on factors such as the stage of the disease, the location of the lesion, age, and physical condition.
Esophageal cancer screening methods
The screening methods for esophageal cancer primarily involve checks of the esophagus, including upper gastrointestinal barium meal and gastroscopy. Gastroscopy, in particular, is a relatively accurate method for examining patients. This is because during a gastroscopy, biopsy samples can be taken, and pathology can definitively determine whether cancer is present. There might be issues regarding whether a patient can undergo a gastroscopy as it requires significant patient tolerance. Therefore, depending on the patient's health condition, if a gastroscopy is not feasible, an upper gastrointestinal barium meal can be conducted first.
Will esophageal cancer recur after resection?
This depends on the actual situation and the specific postoperative pathology of the patient. Generally, a comprehensive examination is conducted before esophageal cancer surgery, and surgery is only performed if there is no metastasis and the patient's physical condition permits it. Therefore, postoperatively, if it is very early-stage esophageal cancer, the likelihood of recurrence is generally small. However, if it involves mid-to-late stages, the possibility of recurrence must be considered. However, essentially, all cases of esophageal cancer are prone to recurrence after resection.
What are the symptoms of esophageal cancer?
The symptoms of esophageal cancer generally include progressive difficulty in swallowing, because the esophagus itself is a tubular cavity, similar to a water pipe. Esophageal cancer typically forms a tumor within this tubular cavity, creating an obstruction. Consequently, the most common symptoms include difficulty swallowing and a sensation of blockage during eating, since food must pass through the esophagus. Other symptoms can include nausea, vomiting, acid reflux, heartburn, and pain below the breastbone. Moreover, the difficulty in swallowing generally worsens progressively, as the tumor grows from small to large, increasingly narrowing the esophagus and exacerbating the swallowing difficulties.
What are the early signs of esophageal cancer?
The early symptoms of esophageal cancer are often nonspecific and intermittent, thus many patients do not take them seriously and delay the condition. Clinically, common early symptoms of esophageal cancer include a choking sensation when swallowing food, which is more noticeable in patients who swallow dry food or other foods that are not well chewed in large bites. Additionally, there is discomfort or a feeling of fullness behind the sternum. Thirdly, there is a sensation of a foreign body in the esophagus, with about 20% of patients experiencing this sensation when swallowing, as well as dryness and a feeling of tightness in the throat. Furthermore, there is a slow passage and a sense of retention of food.
Typical symptoms of esophageal cancer
The most typical symptom of esophageal cancer is progressive difficulty swallowing, and a progressive sensation of swallowing obstruction is the most typical symptom. It's actually quite simple; the esophagus is akin to a water pipe or a tubular cavity. Esophageal cancer is like having a tumor grow inside this cavity, similar to something blocking the pipe, which causes the flow of water to be impeded. However, not only water passes through this esophagus, but also food. Therefore, if there's something inside the cavity, both water and food cannot pass through, leading to this difficulty swallowing and discomfort while swallowing.
Esophageal cancer screening methods
The best and clearest method for screening esophageal cancer is still gastroscopy, which can also be referred to as esophagoscopy. Endoscopic examination is very significant for this type of luminal tumor. Of course, if some people truly cannot tolerate a gastroscopic exam, they might consider initially undergoing a barium meal for the esophagus or iodized oil radiography for diagnosis. Additionally, a chest CT scan can be performed to determine whether there is narrowing in the esophageal lumen or if there is metastasis in the surrounding lymph nodes, among other issues. However, the best and most important method is certainly the esophagoscopy, or taking a biopsy of the pathological tissue under gastroscopy, which is very important for the definitive diagnosis of esophageal cancer.
What are the symptoms of esophageal cancer recurrence?
The symptoms of recurrent esophageal cancer are similar to those at its initial onset, primarily characterized by difficulties in swallowing and eating obstructions. Some may also experience nausea, vomiting, and reflux symptoms of the digestive tract. Of course, when recurrence occurs, if there are metastases to other distant organs, then clinical manifestations corresponding to those metastatic locations will appear. For example, if esophageal cancer metastasizes to the lungs, it could lead to coughing, expectoration, shortness of breath, or chest pain, and even clinical symptoms related to coughing up blood. If there is liver metastasis from esophageal cancer, symptoms might include abdominal pain, fatigue, poor appetite, and even ascites among other clinical manifestations related to liver metastasis.
How long can one live with esophageal cancer?
The life expectancy of esophageal cancer patients depends on several factors such as the stage of the cancer at the time of diagnosis, the patient's sensitivity to treatments like radiotherapy and chemotherapy, the effectiveness of these treatments, the patient's general condition, and whether they have other underlying diseases. Patients who can undergo radical surgery, especially those diagnosed at an early stage, generally have a better prognosis. Patients who respond well to treatment can also expect a better outcome. Therefore, there is significant individual variation in prognosis.
Will esophageal cancer recur after resection?
After the removal of esophageal cancer, there is indeed a possibility of recurrence. This is because not only are there tumors on the esophagus, but some mediastinal lymph nodes around the esophagus may also have metastasized. It must be acknowledged that thoracic surgeons will definitely remove the tumor completely during surgery, but they can only remove the tumors that are visible to the naked eye. Many tumor cells that cannot be seen by the naked eye are impossible to remove. If the cancer is at a relatively advanced stage, many of these invisible tumor cells cannot be eliminated, just like air is invisible but still exists. Therefore, invisible does not mean there are no cancer cells. Thus, if there is no follow-up auxiliary treatment to kill the cancer cells, the cancer may very likely recur.