Esophageal cancer

Esophageal cancer is a malignant tumor arising from the lining of the esophagus, often detected late due to vague symptoms. It’s a serious condition with a generally poor prognosis if not caught early, but outcomes are improving with earlier detection and advances in treatment.

🧬 Types of Esophageal Cancer

1. Adenocarcinoma (AC)

• Arises from glandular cells in the lower esophagus.
• Most common in Western countries.
• Typically develops from Barrett’s esophagus (a complication of GERD).

2. Squamous Cell Carcinoma (SCC)

• Arises from squamous epithelial cells in the upper or middle esophagus.
• More common worldwide, especially in Asia and parts of Africa.
• Associated with smoking, alcohol, and dietary factors.

⚠️ Risk Factors

😖 Symptoms

Usually appear late in disease:

• Dysphagia (trouble swallowing—first solids, then liquids)
• Weight loss
• Chest or back pain
• Regurgitation or vomiting
• Hoarseness (if recurrent laryngeal nerve involved)
• Cough, especially with aspiration
• Hematemesis or melena (rare)

🧪 Diagnosis

1. Upper Endoscopy (EGD) with Biopsy

• First-line test for suspicious symptoms.
• Allows visualization and tissue sampling.

2. Barium Swallow (Esophagram)

• May show a “apple core” or irregular narrowing.

3. CT, PET-CT, Endoscopic Ultrasound (EUS)

• Used to stage the cancer and evaluate spread to lymph nodes or organs.

4. Bronchoscopy

• If tumor is near the trachea, to assess airway invasion.

📊 Staging (TNM System)

💊 Treatment

🩺 Depends on stage, location, and patient condition:

🧠 Prognosis

⏳ Early detection is key to improving survival.

🛡️ Prevention & Surveillance

• Treat and monitor GERD and Barrett’s esophagus
• Stop smoking and alcohol
• Maintain a healthy weight
• Diet rich in fruits and vegetables
• Surveillance endoscopy for high-risk patients (e.g., Barrett’s with dysplasia)

🔄 Barrett’s Esophagus → Adenocarcinoma Sequence

1. GERD
2. → Barrett’s esophagus
3. → Low-grade dysplasia
4. → High-grade dysplasia
5. → Esophageal adenocarcinoma