Oesophageal cancers

Background 

Oesophageal cancers also know as cancers of food pipe are considered to one of the dreaded cancers after pancreatic cancers. The rate of the cancer is variable across different countries and is related to multiple risk factors. These cancers are more common in male population and I also closely to various substance abuse, smoking and obesity related reflux disease. These cancers need multimodal management to tackle the various aspects of complications related to oesophageal cancers.

Common causes and risk factors with oesophageal cancers 

  1. Old age 
  2. Obesity 
  3. Smoking and tobacco chewing products and alcohol consumption 
  4. Reflux disease 
  5. Exposure to environmental hazards

Common symptoms of oesophageal cancers 

  1. progressive inability to intake solids followed by liquids
  2. Nausea and vomiting after food intake 
  3. Rapid weight loss
  4. Tiredness and cancer related fatigue
  5. Chronic cough and hoarseness of voice 
  6. Occasionally blood in vomiting
  7. Symptoms of spread to lungs , liver  and neck 

Diagnosis and investigations 

These symptoms are ignore initially by the patients which lead to rapid progression of the disease.   It is advisable that u should consult ur clinician/ surgeon for assessment and further get investigation for early treatment of this fatal disease. After initial evaluation, patient is advised to undergo blood investigation and upper gastrointestinal endoscopy to assess the exact cause, size of the lesion and take multiple biopsies of the lesions. 

Once the diagnosis is confirmed of oesophageal cancer, patient is advised to undergo Contrast enhanced computerised tomography (CECT) of the chest and abdomain for further evaluation of the disease, site and size of the lesion and spread of the disease. Positron emission tomography (PET) scan be used to asses the multiple involvement of organs as well as response of the treatment, though it remains expensive modality.

Treatment for oesophageal cancers 

Once the diagnosis is confirmed the treatment is planned by cancer specialists and surgeons in best interest of patients. Treatment is multimodal which involves surgery, radiotherapy and chemotherapy. 

Surgery remains the mainstay treatment for removal of tumour and tissues containing cancer. Oesophageal cancer are considered major surgery (Ivor Lewis oesphagectomy/ Mckneown oesophagectomy / Transhital oesophagectomy) are done using minimal access ( Laparoscopic /robotic surgery) or conventional open surgery. Minimal access surgery provides extensive advantages of improvised lung functions and early post recovery since the surgery involves the complete chest area. Occasionally, alternate feeding routes are created to maintain the nutrition of the patient.

Radiotherapy is used before surgery to provide shrinkage of the tumour and control the spread of cancer cells in local area. Chemotherapy is used along with radiotherapy before surgery and after surgery to control the spread of disease in the body. 

Since, these cancers will compromise the nutrition of the patients, it is important to maintain it with various methods suitable according the situation. The hospital stay after surgery is usually 7-10 days depending upon lung functions and recovery of the patient after surgery.

To consult with best team of general, minimal access and cancer surgeons available at  The Surgeons House (SHL) in different global locations, please click this link for more details. 

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