The esophagus is the tube for people to eat, but it is called as esophagus in medical anatomy; correspondingly, people often say that esophageal cancer should be called as esophageal cancer in medical science.
People’s food is the sky, and the tongue of China fully demonstrates the long history of China’s food culture. However, diseases come from the mouth, so while we pursue delicious food, we should also pay attention to healthy diet to prevent the occurrence of diseases. Unbeknownst to us, some traditional cuisines are also related to the occurrence of esophageal cancer.
So what factors are related to the occurrence of esophageal cancer?
1.Moldy food
Some people don’t want to throw away some moldy foods, but these foods contain a lot of aflatoxin, which has carcinogenic effect, and long-term consumption will obviously increase the incidence of esophageal cancer.
2.Eating style
Many people like to eat some stimulating foods, like spicy hotpot, hot pot, etc. They think these foods are tasty and nutritious. However, long-term consumption of too hot and too spicy food as well as wolf swallowing way of eating can damage esophageal mucosa and induce various esophageal diseases, which is also the cause of esophageal cancer.
3.Epidemic disease
Studies have found that people who consume pickled, smoked and barbecued foods for a long time are more prone to esophageal cancer. Since these foods contain amine nitrite, which is a strong carcinogenic substance, it will lead to cancer over time.
4.Smoking and drinking alcohol
Smoking is not only the culprit of lung cancer, it is also closely related to the occurrence of many malignant tumors such as esophageal cancer, oral cancer and oropharyngeal cancer. It is often said that smoking and alcohol do not separate, and the combined effect of smoking and alcohol will further increase the incidence of malignant tumors. Nowadays, it is not uncommon for esophageal cancer and lung cancer to occur in one person at the same time, which is also related to the smoking and drinking habits of patients.
5.Food safety problems
Food and drug safety problems such as melamine, lean meat extract, dyed steamed buns, poison capsules are heard from time to time, all of which may also be one of the reasons for the high incidence of malignant tumors.
6.Industrialization
The deteriorating environment of human existence is also one of the reasons for the occurrence of various malignant tumors. Therefore, we should also pay great attention to protect the environment and build a better global village together.
7.Malnutrition
The deficiency of certain trace elements, such as molybdenum and selenium, may be related to the occurrence of esophageal cancer. The lack of vitamin intake may also be related to the occurrence of esophageal cancer.
As we can see, to prevent and fight against cancer, we need to match the diet reasonably and supplement protein, vitamins, fat and all kinds of trace elements in appropriate amount, not to eat partially or overeat, and also try to stay away from smoking and alcohol. For the sake of health, we should control our mouth properly.
What are the symptoms of esophageal cancer and how to diagnose it?
Early stage of esophageal cancer can be asymptomatic. Some patients have foreign body sensation in esophagus or choking sensation when swallowing. It may also show as burning, pinching or pulling pain behind the sternum when swallowing. In more advanced cases of esophageal cancer, patients often visit the doctor because of dysphagia, which is often progressively aggravated or even completely unable to eat. Patients with esophageal cancer are often accompanied by vomiting, epigastric pain, weight loss and other symptoms. Long-term lack of food intake may be accompanied by obvious malnutrition, emaciation and cachexia. If the tumor metastasizes, local compression, pain and other symptoms can appear. For example, if the tumor presses the laryngeal nerve, it may cause hoarseness and choking; if the tumor metastasizes to the bone, it may cause pain. When tumor invades trachea and complicates esophagus and tracheal perforation, it can also cause mediastinal abscess and pneumonia, which manifests as continuous fever and chest pain. Patients often feel the lump on the clavicle, which is an enlarged lymph node.
Of course, it does not mean that you have esophageal cancer once you have the above symptoms. Many benign diseases such as gastroesophageal reflux, esophageal cardia failure, esophagitis, benign esophageal stricture, etc. can also show the above symptoms, but if these symptoms appear, it is necessary to go to hospital for examination to exclude the possibility of esophageal cancer.
The diagnosis and staging of esophageal cancer are often determined by the following tests.
1.Esophagogram
Patients only need to simply take a few mouthfuls of barium and take a few X-rays to complete the esophagogram examination. Esophagogram can clarify the length of the esophageal lesion, whether the esophageal dilatation is restricted or not, and whether there is significant esophageal stricture.
2.Esophageal endoscopic ultrasonography
Whether esophageal cancer is early or advanced does not depend on the size of the tumor, unlike the common understanding that a large tumor is advanced, but on the infiltration depth of the esophageal wall. Ultrasound endoscopy can observe the depth of tumor infiltration, therefore, in order to determine the treatment plan, ultrasound endoscopy is a good choice.
3.CT of chest
For whether esophageal cancer has involved mediastinal lymph nodes and the lateral invasion range of tumor, chest CT can provide more information.
4.Gastroscopy
It can directly observe the small lesions, and at the same time, it can easily clamp the lesions for pathological examination, which is a necessary means to confirm the diagnosis of esophageal cancer, because pathology is the gold standard for definite diagnosis.
5.Positron emission tomography (i.e. PET-CT examination)
This method is easier and more convenient to find out whether there is systemic metastasis of esophageal cancer, and it is easy to see where the tumor has metastasized to. However, this test is more expensive and also has certain false positives and false negatives.
Unfortunately, China is a big country of esophageal cancer, and the mortality rate of esophageal cancer in China is the highest in the world. Then how to treat when you have esophageal cancer? Surgery, radiotherapy and chemotherapy are the three conventional means of esophageal cancer treatment. The general treatment principles are: pre-cancerous lesion or early cancer confirmed by gastroscopy can be removed by endoscopic peeling or local surgery; if esophageal cancer is confirmed to be not deeply infiltrated in the esophageal wall, chemotherapy is not needed; however, if esophageal cancer is deeply infiltrated in the esophageal wall or accompanied by lymph node metastasis, combined surgery, radiotherapy and chemotherapy are needed; upper esophageal cancer is close to the pharynx, so surgery is more difficult and radiotherapy is preferred; middle and lower esophageal cancer is generally Of course, radical radiotherapy for middle esophageal cancer can also achieve the same efficacy as surgery; for relatively late localized esophageal cancer, surgery is often difficult to remove, so combined radiotherapy and chemotherapy becomes the main treatment; for patients with distant metastasis, chemotherapy is the main treatment, and local radiotherapy is performed when necessary.
First of all, surgical treatment is one of the oldest and most important means in the treatment of esophageal cancer, and it is also the preferred and most effective treatment method for early and mid-stage lower and middle esophageal cancer. Early esophageal cancer can be treated by surgery alone, and no radiotherapy is needed after surgery. For patients with mediastinal lymph node metastasis, postoperative radiotherapy is an effective means to improve the therapeutic effect.
Radiotherapy also plays an increasingly important role in the treatment of esophageal cancer. Radiotherapy is a modern treatment for malignant tumors using radiation without anesthesia and surgery, and has an important place in the radical treatment of malignant tumors. Radiation therapy is abbreviated as radiotherapy. Except for esophageal perforation forming esophageal fistula and serious diseases of heart, lung, liver and other organs that cannot tolerate radiotherapy, radiotherapy is feasible. For older esophageal cancer patients with other diseases such as cardiopulmonary insufficiency that cannot be treated surgically, radiotherapy is the treatment of choice and patients can still be cured. For upper segment esophageal cancer and cervical segment esophageal cancer, radiotherapy has the most certain efficacy and the least adverse effects, and is the best treatment choice at present. Therefore, do not think that there is no hope if esophageal cancer cannot be operated, in fact, radiotherapy is also a radical treatment for esophageal cancer, and many patients are cured after radiotherapy. Among the patients in our hospital, there are many patients who are over 75 years old and have only undergone radical radiotherapy. In the review of several years, no signs of tumor existed and the patients’ survival quality is also very good. Of course, there are also some patients with very extensive lesions or distant metastases, which have less hope of cure. After radiotherapy, it can relieve the symptoms, reduce the pain and improve the quality of life, and some patients can also survive with tumor for a long time.
Chemotherapy after surgery can improve the efficacy of esophageal cancer, and synchronization of chemotherapy and radiotherapy has become the standard protocol for radical treatment. Recent studies have shown that synchronized radiotherapy and chemotherapy before surgery can improve the cure rate of esophageal cancer. Thus, chemotherapy has become part of the comprehensive treatment of esophageal cancer.
Gene targeted therapy has become a popular treatment in the new century, and targeted therapy for esophageal cancer has also achieved certain efficacy. For example, nitrozumab monoclonal antibody combined with radiotherapy has improved the efficacy of esophageal cancer, and erlotinib and gefitinib have also been effective in treating esophageal cancer. It is believed that with the introduction of new targeted therapeutic drugs and in-depth research on the molecular mechanism of malignant tumors, molecular targeted therapy will play a greater role in the treatment of esophageal cancer.
Post-treatment review
After the treatment of esophageal cancer, regular review is also needed. Generally speaking, in the first two years, it needs to be reviewed once every three months; after two years, it needs to be reviewed once every six months; after five years, it needs to be reviewed once a year.
Return to society
After the end of esophageal cancer treatment, patients should gradually return to the society and can engage in labor within their ability. As long as they recover well and do not feel fatigue, they can still perform light physical labor.