Esophageal Cancer

Esophageal cancer may manifest itself through one or more of the following symptoms:

• The tumor, as it grows, can block the passage to the stomach. Hence patients may have difficulty in swallowing, especially hard foods, and sometimes even liquids
• Choking on food or even liquids
• Pressure or burning sensation in the chest
• Heartburn or indigestion
• Vomiting blood
• Unexplained and sudden weight loss
• Pain in the throat or behind the breastbone
• Frequent coughing or hoarseness of speech
• Due to bleeding, may present as anemia (low hemoglobin) on the blood test

The following are some of the risk factors associated with development of esophageal cancer:

• Gender: Men are more likely to develop (3 times higher risk) compared to women
• Age: The incidence of cancer is seen between 50-70 years of age
• Tobacco: From snuffing tobacco to chewing tobacco to smoking cigarettes and cigars all increase the risk of developing esophageal cancer.
• Alcohol: Heavy drinking over a period of time increases the risk
• Obesity: BMI greater than 25 (Asia) and greater than 30 (rest of the world) increase the risk of developing adenocarcinoma, especially in the lower one third of esophagus
• Familial: Inherited disorders like Tylosis are also linked to developing SCC in esophagus
• Others: Conditions like Plummer-Vinson syndrome, previous caustic injury to esophagus, achalasia and HPV infection are also linked with developing cancer in the esophagus

There are many tests that diagnostic specialists employ. The tests are based on the symptoms, age, general health of the patient and his or her medical history. However, the following two tests are usually the best ways to confirm that a patient is suffering from cancer:

• Endoscopy: An endoscope is a tiny video camera fitted to a slender, flexible tube. The endoscope is inserted into the esophagus via the throat, and the doctor carefully examines the mucosal lining of the esophagus, stomach and the duodenum. The procedure is very safe, and is usually less than 10 minutes. Mostly it is carried out with a throat spray, and the patient can return to normal activities within few hours. If any abnormalities or changes are noted on the examination, the doctor will proceed to take a sample/ biopsy from the concerned area.
• Biopsy: A biopsy is only way to confirm cancer. The tissue is sent to a pathologist, who views it under a microscope and confirms if there are any cancerous cells present in the tissue.