Esophageal cancer, or carcinoma, is a malignant tumor which occurs in the esophagus. The esophagus is a hollow long muscular tube that carries food from your mouth and throat to your stomach. Malignancies, or cancers, of the esophagus can occur in the upper portion, midportion, or lower portion.
Causes, Risk Factors, and Occurrence
- Two main types of esophageal cancer
- Squamous Cell Esophageal Cancer
- Related to alcohol use and tobacco use
- Occurs more commonly in the upper and middle thirds of the esophagus
- Most prevalent esophageal cancer worldwide
- Adenocarcinoma Esophageal Cancer
- Related to a complication of gastroesophageal reflux disease (Barrett's esophagus)
- Currently the most common form of esophageal cancer in the United States
- Most commonly seen in the lower third of the esophagus
- Seen more commonly in men over 50 years of age
- Rare forms of esophageal cancer
- Small cell carcinoma
- Additional risk factors
- Alcohol use
- Drinking hot liquids
- Low fruit or vegetable diet
- Radiation treatments to the chest or upper abdomen
- Congenital abnormalities of the esophagus
- Chewing tobacco
- Trauma to the lining of the esophagus
- Dysphagia (difficulty in swallowing solids or liquids)
- Regurgitation (movement of food up the esophagus which may then enter the lungs)
- Chest burning, pressure, or pain
- Vomiting, occasionally vomiting blood
- Unintentional weight loss
Available treatments for esophageal carcinoma depend on the extent and stage of the cancer, your preferences for treatment, and your overall medical condition.
Surgery can be performed to remove your cancer. It can be used alone or in conjunction with other modalities such as chemotherapy and/or radiation therapy.
Esophagectomy is the removal of all or most of your esophagus. In this surgery, incisions are made in either your abdomen and chest, abdomen and neck, or abdomen, chest, and neck.
- Minimally Invasive Esophagectomy: in this procedure small incisions are made in your abdomen and chest which allow the introduction of instruments and video cameras which are then used to perform the dissection. Your surgeon will decide if you are an appropriate candidate for this procedure.
- Transhiatal Esophagectomy: in this procedure an incision is made in your abdomen and a second incision is made in the neck which allows the removal of the esophagus.
- Transthoracic Esophagectomy: involves incisions made in the chest to remove the esophagus
- Esophagogastrectomy: if the esophageal malignancy extends down onto the surface of the stomach, that portion of the stomach needs to be removed with the esophagus to completely remove the cancer. The remainder of the stomach is used to create a tube which is pulled up into the chest or neck and reattached to the remaining portion of the esophagus. If there is insufficient stomach and occasionally a portion of the large intestine is used.
- Non-surgical treatment
- Endoscopic Dilatation: if there is significant narrowing in the esophagus which is interfering with the ability to swallow, then this can be dilated by the passage of a scope. Through the scope balloons can be inflated to open up the esophagus. The care usually a stent will then be placed.
- Laser therapy
At White Plains Hospital we have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, pulmonologists, and critical care intensivists. We have a staff of highly trained nurses, respiratory therapists, nutritionists, physical therapists, case managers, and social workers that work in sync with your surgeon to provide great care for you when you are recovering from your surgery.
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