Definition
Esophageal cancer is a malignant tumor that develops in the esophageal wall. There are two main types: squamous cell carcinoma, commonly found in the middle and upper esophagus, and adenocarcinoma, mostly affecting the lower esophagus.
Pathogenesis
Cancer development is associated with risk factors:
- Squamous cell carcinoma: Smoking, excessive alcohol consumption, hot beverages, and chronic irritation.
- Adenocarcinoma: Gastroesophageal reflux disease (GERD), obesity, and Barrett’s esophagus linked to chronic reflux.
Chronic inflammation and cellular mutations play a key role in carcinogenesis.
Diagnosis
Diagnosis involves:
- Endoscopy: Allows direct visualization of the tumor and biopsy for histological confirmation.
- Imaging studies: CT, MRI, PET-CT, and endoscopic ultrasound for staging.
Treatment
Treatment depends on the cancer stage and type:
- Surgical intervention: Esophagectomy is the main treatment for localized disease.
- Chemotherapy and radiotherapy: Used pre-surgery (neoadjuvant) or for unresectable cases.
- Immunotherapy: Administered in advanced or resistant stages, particularly in patients with specific biomarkers.
- Supportive care: Endoscopic interventions or stent placement may be required to improve swallowing and nutrition.
Prevention
Prevention includes:
- Quitting smoking and reducing alcohol consumption.
- Managing obesity and GERD.
- Regular monitoring for Barrett’s esophagus.
Early diagnosis and comprehensive treatment approaches are critical for improving prognosis and patient quality of life.