Matters Concerning Esophageal Cancer

Matters Concerning Esophageal Cancer

Esophageal cancer is one of the common malignant tumors of the digestive system globally, with relatively high incidence rates especially in Asia and Africa. Currently, esophageal cancer has become the sixth most frequently occurring cancer in the world, and its mortality rate ranks fourth. In China, the incidence of esophageal cancer accounts for as high as 50% of the global total. This means that half of the world's esophageal cancer cases are in China! Two-thirds of these cases occur in the Taihang Mountain region spanning Henan, Shanxi, and Hebei provinces.

Esophageal cancer is generally divided into two types: squamous cell carcinoma and adenocarcinoma. In China, squamous cell carcinoma accounts for over 90% of esophageal cancer cases. It often occurs in the middle and lower segments of the esophagus and is mainly associated with smoking, alcohol consumption, and poor dietary habits. Adenocarcinoma, on the other hand, is usually related to gastroesophageal reflux disease and Barrett's esophagus.

I. How to Prevent Esophageal Cancer?

Although the exact cause of esophageal cancer has not been fully elucidated, modifying lifestyle habits can effectively reduce the risk of its occurrence:

1.Avoiding smoking and excessive alcohol consumption is crucial for preventing esophageal cancer.

2.Maintain a balanced diet. Consume more fresh fruits and vegetables, and reduce the intake of pickled, grilled, and overly hot foods.

3.For individuals with high-risk factors, such as those who eat too fast or too hot, smoke and are exposed to irritants for a long time, regularly consume pickled or moldy foods, and neglect oral hygiene, regular gastroscopy is recommended to detect potential lesions at an early stage.

4.Actively treat diseases such as gastroesophageal reflux disease (GERD) and esophagitis.

5.Getting sufficient sleep, engaging in moderate exercise, avoiding overwork and emotional stress, etc., help enhance the body's immunity and reduce the risk of esophageal cancer.

II. What Symptoms Warrant Caution for Esophageal Cancer?

The early symptoms of esophageal cancer are often not obvious, and most people do not pay attention to the occasional symptoms. As a result, many patients are already in the middle or late stages when diagnosed.
Common symptoms include:

1.Dysphagia, which is particularly prominent when eating relatively hard foods.

2.Weight loss, due to reduced food intake caused by dysphagia or loss of appetite, as well as the consumption of nutrients by the tumor.

3.Chest pain or discomfort, which is especially noticeable during eating or when lying down.

4.Nausea and vomiting, caused by the blockage of the esophageal passage by the tumor.

5.Hoarseness or persistent cough, when the tumor invades the trachea or nerves.
If the above symptoms occur, seek medical attention at the hospital in a timely manner.

III. Who Needs Early Screening for Esophageal Cancer?

1.Individuals aged 40 years and older should pay special attention to esophageal cancer screening. As people age, various functions of the body gradually decline, and immunity also decreases, making middle-aged and elderly people more vulnerable to malignant tumors such as esophageal cancer.

2.Due to geographical, environmental, and dietary habits, people from high-incidence areas of esophageal cancer have a relatively high incidence rate and should also undergo early screening.

3.People with upper gastrointestinal symptoms should also be vigilant. The early symptoms of esophageal cancer may not be obvious, but some patients may experience upper gastrointestinal symptoms such as pharyngeal discomfort, dysphagia, and retrosternal pain.

4.People with a family history of esophageal cancer also need to pay attention. Genetic factors play a certain role in the development of esophageal cancer. If there are esophageal cancer patients in your family, your risk of getting the disease may be relatively high.

5.People with precancerous lesions or diseases of the esophagus are the key targets of esophageal cancer screening. Precancerous lesions and precancerous diseases of the esophagus include esophageal mucosal leukoplakia, esophageal squamous epithelial hyperplasia, esophageal ulcers, etc., which may increase the risk of esophageal cancer.

In addition to the above-mentioned groups of people, those who drink alcohol heavily, smoke, or have a history of head-neck or lung squamous cell carcinoma should also undergo esophageal cancer screening. The incidence of esophageal cancer in Wuwei is also relatively high. Our hospital conducts free general surveys for esophageal cancer every year. You can find the information about the general survey on our hospital's website. Welcome everyone to come for the general survey.

IV. What Examinations May Be Done at the Hospital?

1.Gastroscopy: It can directly observe the lesions in the esophagus.

2.Biopsy: When an esophageal lesion is suspected, a biopsy is taken through gastroscopy for further pathological examination to clarify the diagnosis.

3.Imaging examinations: CT scans, angiography, PET-CT, etc. can help assess the size, location, and metastasis of the tumor.

4.Endoscopic ultrasound: It is used to evaluate the depth of tumor invasion and lymph node metastasis.

Based on the above examinations, an accurate staging of the tumor can be made, that is, what we usually call early, middle, and late stages.

V. What Are the Treatment Methods for Esophageal Cancer?

The treatment method for esophageal cancer is determined according to factors such as the tumor stage and the patient's physical condition, mainly including:

1.Surgical treatment, which is applicable to localized tumors.

2.Radiotherapy and chemotherapy. For patients with esophageal cancer who are unwilling or unable to undergo surgery, radiotherapy and chemotherapy can further shrink the tumor, relieve symptoms, and prolong survival.

3.Targeted therapy and immunotherapy have brought new hope to advanced-stage patients.

4.Provide sufficient nutritional support to enhance the body's immune function.

5.Carry out symptomatic treatment to relieve dysphagia and pain.

According to different stages, the standardized combination of the above methods can achieve the best treatment effect.

VI. What is Radiotherapy for Esophageal Cancer?

1.Radiotherapy plays an important role in the comprehensive treatment of esophageal cancer. For resectable esophageal cancer, surgery after neoadjuvant chemoradiotherapy is the standard treatment regimen; for unresectable esophageal cancer, radical chemoradiotherapy is the only radical treatment regimen; postoperative adjuvant radiotherapy can improve local control rate and survival rate for selected cases.

2.Radiotherapy uses various rays to kill tumors. It has the advantages of precise treatment, non-invasive, organ-protecting, and low side - effects.

3.Heavy-ion radiotherapy, as a high-tech radiotherapy technology, can precisely treat tumors by using its unique "Bragg peak". It causes little damage to surrounding organs, can break the DNA double-strands of tumor cells, making the tumor lose its ability to further proliferate and thus eliminate the tumor. It has a stronger tumor-killing effect and fewer side-effects.

4.The forms of radiotherapy for esophageal cancer are:

★ Pre-operative radiotherapy: It can shrink tumors that are difficult to resect, making it easier for surgical resection.

★ Post-operative radiotherapy: It can kill unresected or residual lesions and prevent local recurrence.

★ Radical radiotherapy: The aim is to maximize the killing of tumor cells and improve the long - term survival rate and quality of life of patients.

★ Palliative radiotherapy: The main purpose is to relieve symptoms, reduce pain, and prolong life.

VII. What Precautions Should Be Taken for Radiotherapy of Esophageal Cancer?

1.Eat regularly and in moderation, eat small and frequent meals, and eat with ease. Eat 5 - 6 times a day. Do not eat too hastily or quickly, and chew food thoroughly.

2.Patients should pay attention to the temperature of food when eating. Wait for the food to cool down before eating. An appropriate temperature can better promote the relaxation and expansion of the smooth muscles of the esophagus, thus reducing the resistance to eating for patients and preventing dietary obstruction.

3.The protein consumption of patients with esophageal cancer is much higher than that of ordinary people. Patients should eat more fresh fruits and vegetables, dairy products, lean meat, eggs, and other high-protein foods. They also need to pay attention to the cooking methods, mainly steaming, boiling, stewing, and mixing. Avoid greasy, highly irritating, and pickled foods, such as fatty meat, chili peppers, pickles, etc. Drink plenty of water to ensure sufficient daily water intake.

4.When patients have difficulty eating, oral nutritional supplements are the first choice. When the body's needs cannot be met, consider enteral nutrition through nasogastric tubes or gastric/jejunal fistulas to increase the patient's nutritional intake.

5.After radiotherapy, the effect of radiotherapy still exists for a certain period of time. Pay attention to preventing colds, supplementing nutrition, and accelerating the recovery of radiotherapy side-effects. Protect the skin in the irradiated area, do a good job in sun protection, and avoid sun exposure and scratching of the skin in the irradiated field. Maintain an optimistic attitude and actively cooperate with the treatment!