Esophageal cancer, 3D illustration shows malignant tumor in the human esophagus (Source: Shutterstock)
Esophageal cancer (Oesophageal Carcinoma) is a rare malignant disease of the tissue of the oesophagus. There are basically two types of esophageal cancer, the so called adenocarcinoma, and the squamous cell carcinoma. It mostly affects men over 55 years of age.
The so called adenocarcinomas, which are becoming more frequent in the western world, are formed in the lower esophagus as a result of a reflux disorder (acid reflux into the esophagus). Risk factors are high concentrations of long-term alcohol and nicotine consumption. Also particularly hot and spicy foods, as well as certain chemicals, play a role. Common to all risk factors is chronic irritation and damage to the oesophageal lining.
When the first complaints appear, the cancer often has already removed two-thirds of the diameter of the oesophagus. Common symptoms include a burning sensation when swallowing food, and heart palpitations when drinking hot drinks. In the early stages, patients complain only when swallowing solid food. Later they also complain when swallowing soft food and liquid. The result is an insufficient food supply with massive weight loss.
Due to the closure of the esophagus, food flows back into the mouth, and the patient produces foul belches. The spread of cancer into the surrounding areas leads to pain behind the breastbone, hoarseness, loss of voice, coughing and shortness of breath.
Esophageal cancer usually metastasizes first via the lymph into the surroundings (the mediastinum and the cervical lymph nodes), and later through the blood into the liver, lungs and bones.
Esophageal barium swallow (esophagography) examination, and endoscopy with tissue sampling are critical for an accurate diagnosis. Further studies include (endo) ultrasound, chest X-rays and computed tomography.