Oesophageal Cancer Explained: Types, Risk Factors, and Treatment

Oesophagal cancer is a tumour that arises from the oesophagus, which is the long, hollow tube connecting the throat to the stomach. This vital structure plays a critical role in transferring swallowed food and liquids from the mouth into the stomach for digestion.

Oesophageal cancer may arise anywhere along the length of the oesophagus and is generally divided into two major types, depending on the cell type involved: adenocarcinoma and squamous cell carcinoma. This type of cancer is strikingly more common in men and clearly linked to lifestyle factors such as smoking and excessive intake of alcohol.

Anatomy of the Oesophagus

The oesophagus consists of several layers, and each layer has a specific function. The inner lining is called the mucosa, which is the most common place for oesophagal cancer to start. The length of the oesophagus is approximately 10 to 13 inches, with its purpose being designed to connect the throat to the stomach through the process of swallowing food by means of muscular contractions called peristalsis.

Symptoms of Oesophageal Cancer

It may not present with symptoms one would easily notice in the initial stages; hence early detection may not be possible. Patients develop a variety of symptoms in the advanced stages of the disease, including:

• Difficulty Swallowing - Dysphagia: It is one of the common symptoms during early diagnosis and may advance to feelings of food sticking to the throat or chest.
• Chest Pain: It may present as discomfort, pressure, and burning sensations.
• Persistent Cough or Hoarseness: Hoarseness of the voice or chronic cough that will not go away. Such changes may result in chronic hoarseness of the voice, which could be present prior to other symptoms.
• Unexplained Weight Loss: Loss of weight without trying might point to an underlying health problem.
• Worsening Indigestion or Heartburn: Frequent digestive discomfort which worsens over time.

Seek medical attention if you encounter these symptoms.

Causes of Oesophageal Cancer

The development of oesophagal cancer is brought about by genetic alterations in the DNA of cells lining the oesophagus. Because of the genetic alteration, the cells grow abnormally and an excess number of cells may build up and accumulate enough to form a tumor. The tumour can invade healthy tissue, and the cancerous cells have the capability to break away from the original tumour, travel through the bloodstream or lymphatic system, and settle in other parts of the body, which is called metastasis.

Partly, the risk of developing oesophagal cancer depends on several variables, including:

• Chronic Irritation: Diseases like GERD can cause constant irritation to the lining of the oesophagus. This would include Barrett's oesophagus, which is a precancerous condition in response to chronic acid exposure and increases the risk for oesophagal cancer.
• Tobacco and Alcohol Use: Tobacco use (smoking) and heavy alcohol consumption are major risk factors.
• Diet: A diet low in fruits and vegetables may increase risk.
• Obesity: Greater body weight has been associated with an increased risk for a number of cancers, including oesophagal cancer.
• Radiation Therapy: Previous radiation to the chest or upper abdomen adds to the risk.
• Hot Liquids: Ingestion of very hot liquids for a long time leads to scalding of the oesophagus lining.

Types of Oesophageal Cancer

Determining the type of oesophagal cancer becomes relevant for choosing the type of treatment. Two significant types of oesophagal cancer include:

• Adenocarcinoma: It tends to begin within the glandular cells of the lower oesophagus. Currently, this is the most common type of oesophagal cancer in the United States and primarily occurs in white males.

• Squamous Cell Carcinoma: A tumour arising in these thin, flat cells which essentially line the interior of the upper and middle portions of the oesophagus comprises this category of oesophagal cancer. This represents the most common type of oesophagal cancer found throughout much of the world.

Other infrequent types of oesophagal cancers are small-cell carcinoma, lymphoma, sarcoma, melanoma, and choriocarcinoma.

Risk Factors

The determination of risk factors for developing oesophagal cancer is important for its prevention and early treatment. The main risk factors are:

• Tobacco and Alcohol Consumption: These are related to excessive smoking and consumption of alcohol.
• Chronic Acid Reflux: The presence of GERD can lead to Barrett's esophagus, a premalignant condition.
• Dietary Habits: Low consumption of fruits and vegetables and excessive intake of processed foods may enhance the risk.
• Obesity: An overweight condition enhances the chance of this cancer.
• Radiation Exposure: Previous radiation therapy in the chest region will increase the risk for cancer.
• Age and Gender: Males above 55 years have more chances of acquiring this cancer.
• Family History: A family medical history of oesophagal or any other cancer increases vulnerability.

Complications of Oesophageal Cancer

As the stages of oesophagal cancer advance, a number of complications arise, including the following:

• Oesophageal Obstruction: The presence of cancer can cause obstructive damage and later contribute to poor passage of both solids and liquids through the oesophagus.
• Bleeding: Esophageal cancer may cause internal bleeding—an event that might be gradual or rapid.
• Pain Issues: Advanced stages of cancer may lead to chronic pain, which needs to be well managed.

Prevention

Preventing Esophageal Cancer: There is no sure way to prevent oesophagal cancer, but you may be able to lower your risk by taking some of the following steps below.

1. Regular Screenings: People with Barrett's esophagus should consider regular screening to find precancerous cell changes.

2. Limit Alcohol: If you drink, limit yourself to no more than one drink a day for women and two drinks a day for men.

3. Diet: Consume a variety of foods. Fruits and vegetables should be included in the diet. Whole foods rich in vitamins and minerals are better than supplements because they have a tendency, in very large doses, to be harmful to health.

4. Exercise: The use of some time in aerobic physical activity on most days for at least 30 minutes. Consult a medical professional before starting new exercise routines.

5. Maintain a Healthy Weight: If overweight, work toward a healthy weight through balanced eating and regular physical activity.

6. Quit Smoking: Seek support and resources to help quit smoking. Professional counselling, medicines, and organized support groups are proven to help many smokers quit for good. If you don't smoke, don't start.

Conclusion

It is a form of cancer that significantly influences health and quality of life, given the symptom complex that it comprises, which may rapidly deteriorate. Symptoms causes, and risk factors for the forms of oesophageal cancer are characteristics of the disease that may be known. If concerned about any of these symptoms, seek medical evaluation by a healthcare professional.