Esophagus is the tube that starts in your throat and goes till stomach. In common language it is called food pipe as it is used to transfer food from mouth to stomach. Cancer of esophagus or esophageal cancer starts in the innner lining of the esophagus. In general it is seen that more men than women get esophagus cancer around the world. In India as well more men than women are seen to have cancer of food pipe. The very common reason being the usage of tobacco and tobacco products in India. Cancer occurs due to chronic irritation of an area over the long period of time. With the usage of tobacco the mucossa get irritated and over the period of time turns into cancer.

The two most common type of cancer of food pipe of esophegus in India are Squamous Cell Carcinoma and Adenocarcinoma. In some cases esophageal tumours are also diagnosed.

Squamous Cell Carcinoma - Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.

Adenocarcinoma - Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus.

Causes

Following are the most common causes for cancer of food pipe or esophagus that are seen in India:

Gastroesophageal disease or acid reflux

Smoking and Tobacco consumption

Alcohol Consumption

Not eating fruits and green vegetables

Habit of drinking very hot tea or coffee

Radiation therapy to upper chest

Any problem in throat whether in swallowing or pain should not be taken lightly and a gastroenterologist should be consulted immediately. Following are the symptoms that can be attributed to chances of having esophageal or cancer of food pipe:

Difficulty or pain in swallowing food or water

Unexplained weight loss

Pain in chest

Coughing

Hoarseness in voice

Problem with digestive system and having acidity

Diagnosis

Like any other diagnosis of cancer cancer of food pipe or esopagus also has two stages. First stage is the phyical consultation and examination by a gastroenterologist or gastro surgeon in India. This is followed by investigations and finally staging for planning the best line of treatment.

After the consultation and examination the gastroenterologist or gastro surgeon may advise following investigations:

An endoscopy to see through the food pipe or esophagus

Biopsy of the tissue from esophagus which can be taken at the time of biopsy

CECT or contrast CT scan of the abdomen is a very important test

MRI with contrast is almost conclusive test as it shows the nature of the growth

PET CT for staging of the cancer. Many people think that PET CT is a cancer diagnosing tool, which is absolutely wrong. PET CT is a staging tool which gives you staging of the cancer by screening the whole body to check for the spread of cancer to any other organ.

Endoscopic Ultrasound

Bronchoscopy

The planning for the treatment of the esophageal cancer or cancer of food pipe starts from the PET CT and biopsy reports. Whereas the biopsy tells the type of esophageal cancer on the other hand PET CT gives the stage for cancer of food pipe for the gastro surgeon in India. After the analysis of the reports the gastro surgeon in India will opt for any of the following or combination of treatment option for the patient keeping in mind the best quality of life:

Surgery - Surgery for cancer fo food pipe can be done for mainly three purpose.

Endoscopic Surgery - If the cancer is found to be at a very early stage and also confined to very small part of the food pipe of esophagus then the surgery is done through endoscopic method and is called minimally invasive or endoscopic surgery for cancer of food pipe or esophagus.

Esophagectomy - Esophagectomy is the surgery for removing a part of the esophagus or the food pipe along with small upper part of stomach along with the lymph nodes are removed. Stomach is then pulled and connected back to remaining esophagus or food pipe.

Esophagogastarectomy - In this surgery part of the affected esophagus or food pipe, surrounding lymph nodes and large part of your stomach. Afterwards the stomach is pulled up and connected to the esophagus.

Chemotherapy - Chemotherapy as a part of the esophageal cancer treatment is given either as pre surgery treatment or in case of advanced stage cancer of food pipe.

Radiation Therapy - Radiation therapy is mostly given along with the chemotherapy as a part of pre surgery planning or after the surgery to relieve the complication in advanced cancers.

Immunotherapy - Immunotherapy helps strengthen body's immune system to fight the cancer. In India it is mostly used in cases of advanced stage esophageal or food pipe cancer.

Cost - Cost of treatment of esophageal or food pipe cancer in India is approximately between INR 3,00,000 to 5,00,000.

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