What are the precancerous lesions of esophageal cancer?

Written by Peng Li Bo
Oncology
Updated on September 22, 2024
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The most common precancerous lesion of esophageal cancer is Barret's esophagus, which is formed by the chronic stimulation of the esophageal epithelium by chronic reflux esophagitis. Of course, this includes some chronic esophageal ulcers and long-term leukoplakia of the esophagus. These recurrent esophageal ulcers could potentially transform into atypical hyperplasia and then further into carcinoma in situ. However, the progression from precancerous lesions to actual cancer can take a very long time, possibly many years or even over a decade. Therefore, having a precancerous lesion does not necessarily lead to esophageal cancer.

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How to treat esophageal cancer metastasis?

The metastasis of esophageal cancer involves several aspects. The first aspect is the metastasis of lymph nodes, including those around the esophagus. If the number of metastatic lymph nodes is small and the tumor's location is suitable for surgical removal, then surgery can still be considered. The second issue involves cases where there is lymph node metastasis but with a higher number and wider spread, making surgical treatment unfeasible. In such cases, radical radiotherapy and chemotherapy can be considered to treat the esophageal cancer. Of course, there are also some new methods available now, such as immunotherapy, which can be considered along with others. Also, to improve symptoms of esophageal stricture, using an esophageal stent to control the difficulty of swallowing associated with esophageal cancer is also possible.

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The difference between esophagitis and esophageal cancer

The differences between esophagitis and esophageal cancer are significant. Esophagitis is an inflammation and is benign, but esophageal cancer is malignant, marking a stark contrast between the two. However, both esophagitis and esophageal cancer can have similar clinical symptoms, such as acid reflux, hiccups, heartburn, pain behind the breastbone, discomfort, and a burning sensation behind the breastbone, so symptoms can be similar. However, a more typical symptom of esophageal cancer is a sensation of swallowing obstruction, since there is actually something in the esophagus. Inflammation, after all, is just that, and it does not involve a mass forming inside the esophagus that could block it, hindering the ability to drink water, eat food, or swallow.

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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.

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Written by Zhai Guo Dong
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The difference between esophagitis and esophageal cancer.

Esophagitis and esophageal cancer have essential differences. Esophagitis is merely an inflammatory disease, which is relatively common in clinical settings and often related to excessive stomach acid, acid reflux, or other physical and chemical irritants. Esophageal cancer, on the other hand, is a malignant tumor. The mechanisms of their development, as well as the differences in prognosis and treatment plans, are very significant.

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Esophageal cancer symptoms

In fact, the early symptoms of esophageal cancer are not very obvious. Some people only experience a slight discomfort when swallowing, and others might feel mild pain behind the sternum. However, in the advanced stages, the symptoms become more noticeable, such as progressive difficulty swallowing. Additionally, if the tumor compresses the laryngeal nerve, it can cause hoarseness. If it compresses the trachea, symptoms like shortness of breath and dry cough can occur. If the tumor erodes into the aorta, it can lead to severe bleeding.