Esophageal cancer - developing from the epithelial lining of the esophagus cancer.In the structure of morbidity of human malignancies, esophageal cancer ranks eighth.In men, the disease occurs in two - three times more often. About 80% of people with cancer of the esophagus, are in the age group of over sixty years of age (up to thirty years, the disease occurs in a few cases)
The causes of esophageal cancer
development of this tumor, researchers associated with tobacco use, alcohol abuse, and featuresnutrition and smoking and alcohol abuse are among the main precipitating factors in areas with low incidence, and on the other hand, eating habits: eating too hot drinks and food, hard frozen meat and fish melkokostnoy observed in areas with elevated levels of morbidity.In addition, considerable importance is monotonous diet, which provide inadequate intake of fruits and vegetables, which leads to a deficiency of riboflavin and vitamins A and C.
factors for increased ris
Previous cancer diseases
constantly recurring impact of various harmful factors leads to thermal damage or microtraumas esophageal mucosa, which contributes to the emergence and further maintain this diseaseas chronic esophagitis.Also to precancerous diseases include Syndrome Plummer-Vinson (sideropenic dysphagia), scar stricture, papillomavirus and polyps of the esophagus, peptic ulcer of the esophagus
Signs and symptoms of esophageal cancer
Typical early signs of esophageal cancer: increasing weakness, decreased performance, deterioration of generalstate, decreased appetite and weight loss.These symptoms increases gradually, so often the warning signs of the onset of cancer quite a long period of time unnoticed.
One of the early symptoms of esophageal cancer is dysphagia, which manifests itself in violation of the process of swallowing food (found in 75% of patients with this malignancy).Better food to patients unable to swallow if used products result in excessive salivation (herring, fried meat, sausages and so on.).Much worse saliva is released during the use of boiled potatoes, boiled meat, black bread.Originally from this symptom can be eliminated if chew eat or drink it with water, but as the disease progresses, the symptoms become permanent.In some patients with cancer of the esophagus observed this symptom as excessive salivation.Most often begin salivating at the sharp narrowing of the esophagus stages.
20% of patients with one of the symptoms of cancer of the esophagus is a pain in the back, chest, epigastric.Patients report a nagging dull pain in the sternum, sometimes there is a feeling of contraction of the heart muscle, extending to the neck.These pains occur when swallowing, and some time after the passage of food through the esophagus disappear on their own.Infrequently such pain may be ongoing.
Weight loss is also referred to as a sign of cancer of the esophagus.Losing weight the person is directly related to the fact that the body is limited supply of food, so the toxic effects of tumor has spread here at all and.The most significant weight loss observed with extreme degrees of dysphagia which developed when the patient loses any possibility of taking even liquid.In addition to cancer of the esophagus characterized by the following symptoms: bad taste in the mouth, bad breath, regurgitation, coated tongue, coughing and choking
stages and prognosis of esophageal cancer
Stage 1. At this stage of infestation submucosa and mucosa wallesophagus.Swelling of small size does not germinate muscular layer of esophageal metastasis no narrowing of the esophagus have
Step 2. Tumor affects submucosa, mucosa, muscular layer, without departing from the walls of the affected organ.There is a narrowing of the esophagus, in regional lymph node metastases detected unit
Stage 3. At this stage, there is sprouting all layers of the wall of the esophagus is affected circumesophageal tissue and serosa.The lumen of the esophagus narrows in regional lymph nodes there are multiple metastases.Nearby organs are not affected
Stage 4. The tumor affects circumesophageal fiber, serosa, all the layers of the esophageal wall and adjacent organs.Perhaps the formation of esophageal-bronchial or esophageal-tracheal fistula, multiple metastases to distant and regional lymph nodes
If cancerous lesion does not go beyond the esophagus and there is a possibility of complete surgical removal of the tumor, the cure rate of patients is quite high.In patients with inoperable tumors of the most effective treatment is a complex application of radiotherapy and chemotherapy.Complete recovery after the application of this method is observed in a small number of patients.The most favorable results are achieved with the optimum combination of surgery, radiotherapy and chemotherapy
diagnosis of esophageal cancer
main diagnostic method that is used for the diagnosis of this disease is X-ray.With its help it is possible to determine the shape and extent of the tumor, its location and the presence of possible complications.
mandatory method for diagnosing esophageal cancer lesion is esophagoscopy.This method allows you to specify the location of the tumor and set the length of the lesion.Besides esophagoscopy to determine the background state of the mucous membrane of the esophagus and to identify a plurality of mucosal lesions.
Laparoscopic diagnosis of this disease provides evidence (or disproves) metastatic lesions of the liver, peritoneum, lymph nodes.
an ultrasound is indicated for the detection of enlarged lymph nodes, liver metastases, as well as to evaluate the intramural spread of tumor
treatment of esophageal cancer
If you choose this method of treatment is carried out complete or partial removal of the esophagus (It depends on the prevalence of the process).In addition, the areas of metastasis holds the complete removal of the lymph nodes.The mortality rate in the surgical treatment of esophageal cancer about 7 - 10%.Sometimes the transplant except the stomach can be used thick or thin intestine
This method of treatment of cancer of the esophagus is the only way of treatment, which is used for the majority of patients with contraindications to surgery, due to their having any pathology (disorders of the cardio - vascular system, respiratory system, etc.).Thanks to modern methods of exposure in 40% of cases it is possible to achieve the disappearance of severe clinical manifestations of cancer
Complex (combined) treatment
preoperative radiotherapy significantly reduces tumor growth and reduces the number of local recurrence.As a component of the combined treatment, radiotherapy improves radical surgery reduces the incidence of local recurrence, metastasis, and expands the testimony concerning the surgical treatment of esophageal cancer.Traditionally, this type of therapy during complex combination treatment is applied directly before the operation, but long-term clinical practice, there are situations when preoperative radiation therapy for a variety of reasons was not carried out.In such cases, it shows the use of postoperative irradiation
This type of therapy is used if a patient diagnosed with low-grade form of cancer of the esophagus, or there is a small cell cancer of the esophagus.
Five-year survival based on conduct radical surgery is around 56%.The average life expectancy in untreated esophageal cancer is not more than eight months since the discovery of apparent symptoms of the disease.