Esophageal cancer

Esophageal cancer
Other namesOesophageal cancer
Endoscopic image of an esophageal adenocarcinoma
SpecialtyGastroenterology General surgery oncology
SymptomsDifficulty swallowing, weight loss, hoarse voice, enlarged lymph nodes around the collarbone, vomiting blood,[1] blood in the stool
TypesEsophageal squamous-cell carcinoma, esophageal adenocarcinoma[2]
Risk factorsSmoking tobacco, alcohol, very hot drinks, chewing betel nut, obesity, acid reflux[3][4]
Diagnostic methodTissue biopsy[5]
TreatmentSurgery, chemotherapy, radiation therapy[5]
PrognosisFive-year survival rates ~15%[1][6]
Frequency746,000 affected as of 2015[7]
Deaths509,000 (2018)[8]

Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.[2] Symptoms often include difficulty in swallowing and weight loss.[1] Other symptoms may include pain when swallowing, a hoarse voice, enlarged lymph nodes ("glands") around the collarbone, a dry cough, and possibly coughing up or vomiting blood.[1]

The two main sub-types of the disease are esophageal squamous-cell carcinoma (often abbreviated to ESCC),[9] which is more common in the developing world, and esophageal adenocarcinoma (EAC), which is more common in the developed world.[2] A number of less common types also occur.[2] Squamous-cell carcinoma arises from the epithelial cells that line the esophagus.[10] Adenocarcinoma arises from glandular cells present in the lower third of the esophagus, often where they have already transformed to intestinal cell type (a condition known as Barrett's esophagus).[2][11]

Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing betel nut.[3][4] The most common causes of the adenocarcinoma type are smoking tobacco, obesity, and acid reflux.[3]

The disease is diagnosed by biopsy done by an endoscope (a fiberoptic camera).[5] Prevention includes stopping smoking and eating a healthy diet.[1][2] Treatment is based on the cancer's stage and location, together with the person's general condition and individual preferences.[5] Small localized squamous-cell cancers may be treated with surgery alone with the hope of a cure.[5] In most other cases, chemotherapy with or without radiation therapy is used along with surgery.[5] Larger tumors may have their growth slowed with chemotherapy and radiation therapy.[2] In the presence of extensive disease or if the affected person is not fit enough to undergo surgery, palliative care is often recommended.[5]

As of 2018, esophageal cancer was the eighth-most common cancer globally with 572,000 new cases during the year. It caused about 509,000 deaths that year, up from 345,000 in 1990.[8][12] Rates vary widely among countries, with about half of all cases occurring in China.[2] It is around three times more common in men than in women.[2] Outcomes are related to the extent of the disease and other medical conditions, but generally tend to be fairly poor, as diagnosis is often late.[2][13] Five-year survival rates are around 13% to 18%.[1][6]

  1. ^ a b c d e f Ferri FF, ed. (2012). "Tumors". Ferri's clinical advisor 2013. Philadelphia, PA: Mosby (Elsevier). pp. 389–391. ISBN 978-0-323-08373-7. Archived from the original on 2015-09-19.
  2. ^ a b c d e f g h i j Montgomery EA, Basman FT, Brennan P, Malekzadeh R (2014). "Oesophageal Cancer". In Stewart BW, Wild CP (eds.). World Cancer Report 2014. World Health Organization. pp. 528–543. ISBN 978-92-832-0429-9.
  3. ^ a b c Zhang HZ, Jin GF, Shen HB (June 2012). "Epidemiologic differences in esophageal cancer between Asian and Western populations". Chinese Journal of Cancer. 31 (6): 281–286. doi:10.5732/cjc.011.10390. PMC 3777490. PMID 22507220.
  4. ^ a b Cite error: The named reference Akhtar-2013 was invoked but never defined (see the help page).
  5. ^ a b c d e f g Stahl M, Mariette C, Haustermans K, Cervantes A, Arnold D (October 2013). "Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Annals of Oncology. 24 (Suppl 6): vi51–vi56. doi:10.1093/annonc/mdt342. PMID 24078662.
  6. ^ a b "SEER Stat Fact Sheets: Esophageal Cancer". National Cancer Institute. Archived from the original on 6 July 2014. Retrieved 18 June 2014.
  7. ^ Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  8. ^ a b "Esophageal Cancer Factsheet" (PDF). Global Cancer Observatory. Retrieved 8 November 2019.
  9. ^ Even by those using the British English spelling "oesophagus"
  10. ^ Kelsen D (2007). Gastrointestinal oncology: principles and practices (2nd ed.). Philadelphia, Pa.: Lippincott Williams & Wilkins. p. 4. ISBN 978-0-7817-7617-2. Archived from the original on 2015-09-25.
  11. ^ Schottenfeld D, Fraumeni J, eds. (2006). Cancer epidemiology and prevention (3rd ed.). Oxford: Oxford University Press. p. 697. ISBN 978-0-19-974797-9. Archived from the original on 2015-10-31.
  12. ^ Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–2128. doi:10.1016/S0140-6736(12)61728-0. hdl:10536/DRO/DU:30050819. PMC 10790329. PMID 23245604. S2CID 1541253.
  13. ^ Enzinger PC, Mayer RJ (December 2003). "Esophageal cancer" (PDF). The New England Journal of Medicine. 349 (23): 2241–2252. doi:10.1056/NEJMra035010. PMID 14657432. Archived from the original (PDF) on 2014-07-14.