Esophageal cancer

The esophagus is the muscular organ that carries food from the throat to the stomach.

Esophageal cancer is a malignant tumor that forms in the cells lining the lumen of the esophagus.

There are two types of esophageal cancer:

1. Squamous cell carcinoma of the esophagus (develops from the flat cells of the mucosa covering the esophagus).
2. Esophageal adenocarcinoma (develops from the glands of the esophagus that produce mucus).

The prevalence of esophageal cancer.

Among oncological diseases, esophageal cancer is the eighth most common.

Esophageal cancer is most common in Asian countries. The high level of morbidity is largely due to the peculiarities of nutrition.

Every year, more than 410 thousand new cases and approximately 340 thousand deaths from this type of cancer are diagnosed.

Men are more likely to get sick than women in a ratio of 5-10:1.

The peak incidence occurs at the age of 50-60 years.

In Russia, the incidence is 6.8 per 100 thousand people.

Risk factors.

For squamous cell carcinoma.

1. Frequent alcohol intake.
2. Smoking and chewing tobacco.
3. A small amount of fresh vegetables and fruits in the diet.
4. Reception of hot drinks.
5. Hereditary factor.

For esophageal adenocarcinoma.

1. Baret's esophagus (a complication of gastroesophageal reflux disease).

Symptoms.

1. Difficulty passing food (in the early stages of the tumor-a feeling of discomfort when eating).
2. With an increase in the size of the tumor, it is impossible to take solid and soft food, liquid.
3. Pain in the center of the chest.
4. Vomiting.
5. Pain when swallowing.
6. Hoarseness of the voice and persistent cough (it happens if the tumor spreads to the trachea and larynx).
7. Weight loss.
8. Signs of gastrointestinal bleeding: vomiting of blood or a mass resembling coffee grounds.
9. Black feces (melena).

Diagnostics.

1. X-ray examination with a contrast agent.
2. EGDS + taking a biopsy.
3. Endoscopic ultrasound examination of the esophagus (EUS).
4. Computed tomography (CT) of the chest, abdomen and neck with intravenous contrast.
5. Ultrasound of the left neck.
6. Histological examination of the biopsy material.
7. PET-CT.
8. Diagnosis of concomitant diseases.

Treatment.

The use of a number of diagnostic measures allows specialists to identify the extent of the spread of the disease and begin comprehensive treatment.

1. Surgical treatment.
2. Chemotherapeutic treatment.
3. Radiation therapy.

Surgical treatment.

With the preservation of the esophagus.

Endoscopic removal of the tumor (in the earliest stages of esophageal cancer, when the tumor is located only in the surface layer of the esophagus).

With the removal of the esophagus.

The operation involves removing most of the esophagus with the tumor and connecting the remaining part to the stomach (radical surgery).  

Employees of the Department of High-tech Surgery of the Loginov Moscow State Medical Center perform these operations using low-traumatic methods (laparoscopic and thoracoscopic access).

The postoperative period is on average 7-12 days.

The rehabilitation period is individual, on average, from 2 to 4 weeks.