Facts to know about Esophageal Cancer

Understanding Esophageal Cancer with Dr Mboyi

Dr Ntomboxolo Mboyi has a BSc (UKZN), MBCHB (Medunsa), Fc Rad Onc (SA), and is a Postgraduate in Cancer Biology and Therapeutics: High Impact Cancer Research Program (Harvard Medical School). She is a member of the South African Oncology Consortium (SAOC), South African Society of Clinical and Radiation oncology (SASCRO), American Society of Clinical Oncology (ASCO), and American Brachytherapy Society (ABS) and a Chairperson of the leading body of CanSurvive, a non-benefit association offering support to cancer patients.

What is Esophageal Cancer?

Esophageal cancer is a type of cancer that strikes the esophagus – the long tube that runs from the throat to the stomach, also known as the food pipe. This organ aids digestion by moving food from your throat to your stomach.

The cause of Esophageal Cancer is unknown. We do know that it happens when the cells in the esophagus develop mutations (errors) in their DNA, making the cells grow and divide abnormally. These cells form a tumour in the esophagus and cancer can spread to other places in the body. The disease affects more men than women.

According to the Globocan database, there are 604100 cases globally with a high mortality rate of 544076 cases. Generally, there is a poor survival rate with 50-80% of patients having the incurable disease with a 5-year survival rate of 20%

Different Types

There are two main types of Esophageal Cancer i.e squamous which affects the cells lining the surface of the esophagus and adenocarcinoma which is found in the mucus-secreting glands.

Factors that place you at risk

• Smoking
• Alcohol
• Gastroesophageal reflux disease
• Diet low in fruits and vegetables
• Drinking very hot liquids
• Obesity
• Achalasia
• Barret’s esophagus (precancerous changes in the cells)
• Atrophic gastritis
• Other head and neck cancers
• Age (older patients)
• Ethnicity (African and Asian)

Less common symptoms

• Persistent cough
• Sore throat
• Indigestion

Understanding your diagnosis and symptoms

Early-stage to locally advanced

• Trouble swallowing with transient sticking of solid food
• Retrosternal discomfort or a burning sensation
• Locally advanced-progressive dysphagia
• Weight loss
• Chest pains
• Cough
• Hoarseness of voice
• Gastrointestinal blood loss (melena stools, haematemesis)
• Tracheobronchial fistula
• Lump under the skin

Metastatic

• Depends on the site example lung, liver, bones and adrenal glands.

Preventative measures

• Avoid tobacco and alcohol
• Healthy eating habits more vegetables and fruits
• Increase intake of zinc and folate
• Get treatment for reflux diseases

Treatment plan

• Surgery is performed for superficial and locally advanced cancers.
• Chemotherapy can be given before surgery to shrink the tumour or after surgery if there is any indication it may assist further in the treatment.
• Chemotherapy is also given with radiation therapy in patients who can’t have surgery.
• Radiation therapy for curative and palliative purposes
• Brachytherapy
• Stent insertion for palliation
• Laser therapy