1.What are the causes of esophageal cancer?
(1) Dietary habits: Prefer to eat hot food, coarse and hard food, and drink alcohol.
(2) Intake of nitrosamine compounds: high content of nitrite salts in sauerkraut.
(3) The carcinogenic effect of mold: the intake of moldy food.
(4) Micronutrient deficiency: molybdenum, zinc, copper, nickel and other deficiencies. Liu Qianwen, Department of Thoracic Surgery, Cancer Hospital of Sun Yat-sen University
(5) Genetic susceptibility: familial aggregation phenomenon.
(6) Precancerous lesions of esophagus: chronic inflammation of esophagus, reflux disease, cardia incontinentia, etc. may lead to cancer.
2.What are the high-risk groups of esophageal cancer?
(1) Middle-aged and elderly people aged 45-65.
(2) People with bad eating habits: those who like to eat hot food, coarse and hard food.
(3) Those who intake carcinogens such as nitrosamines and fungal toxins for a long time.
(4) Smokers and alcoholics.
(5) Those who have family history of tumor.
(6) People with precancerous esophageal lesions and precancerous diseases: precancerous lesions such as esophageal epithelial hyperplasia and severe hyperplasia. Pre-cancerous diseases include chronic inflammation of esophagus, reflux disease, pancreatic dyschondroplasia and chemical burns of esophagus, etc.
3.Can esophageal cancer be hereditary?
Families with high incidence of esophageal cancer can be found in both high and low incidence areas. This indicates that there is an obvious familial gathering phenomenon. However, there is no definite conclusion as to whether this family clustering phenomenon is due to genetic factors or due to family members receiving the same environmental cancer-causing factors over a long period of time.
4.How to prevent esophageal cancer?
(1) Reduce the intake of nitrosamines and fungal toxins by minimizing the consumption of sauerkraut and fish sauce.
(2) Develop good eating habits.
(3) Change the bad lifestyle, such as quit smoking and alcohol.
(4) Timely treatment of precancerous esophageal lesions and precancerous diseases.
(5) Regular cancer prevention checkups for high-risk groups.
5.Can regular physical examination detect esophageal cancer?
Routine physical examination cannot detect esophageal cancer. Early detection of esophageal cancer depends on regular esophagoscopic examination.
6.What are the signs and symptoms of esophageal cancer?
(1) The symptoms of early esophageal cancer are mild, mainly manifested as discomfort behind the sternum, rubbing sensation, slight pain or foreign body retention sensation, which can be easily ignored.
(2) With the increase and infiltration of tumor, there will be difficulty in swallowing and progressive aggravation, and there may be pain and discomfort behind the sternum or under the sternum, vomiting mucus, neck mass, difficulty in breathing and weight loss.
7.What tests should be done when I suspect esophageal cancer?
The physician will usually do physical examination, then blood test, barium swallow, endoscopic ultrasound + biopsy, enhanced CT, etc. will be done to clarify the pathological diagnosis and clinical stage. If surgical treatment is expected, cardiac ultrasound and pulmonary function tests will be done to assess cardiopulmonary function.
8.Do I need to fast for the barium swallow test?
No, it is not necessary.
9.Do I need to fast for CT examination?
No, it is not necessary.
10.Do I need to fast for endoscopic ultrasound?
Yes, patients should fast for at least 6 hours before the examination. If the examination is done in the morning, fasting should be started after 10:00 pm on the night before; if the examination is done in the afternoon, light and semi-liquid food can be eaten for breakfast and fasted at noon.
11.Is there any painless endoscopic ultrasound examination?
Yes, there is. Endoscopic ultrasonography can be done under intravenous general anesthesia.
12.Why do some patients with esophageal cancer need to undergo bronchoscopy?
The upper and middle esophagus are adjacent to trachea and bronchus, so bronchoscopy is needed for esophageal cancer in these areas to understand whether the tumor has infiltrated trachea and bronchus.
13.Do I need to fast for bronchoscopy?
Yes. The day before the examination, you should fast after 10 pm and drink after 12 pm.
14.Can I drink or eat immediately after bronchoscopy or endoscopic ultrasound?
No. After bronchoscopy or endoscopic ultrasound, you need to abstain from food and water for 2 hours to avoid accidental aspiration.
16.Is PET/CT the most accurate test for esophageal cancer?
No, it is not. PET/CT has certain advantages over CT in the diagnosis of esophageal cancer in assessing whether there are metastases in lymph nodes and whether there are distant metastases such as liver and lung metastases. However, it cannot replace endoscopic tissue biopsy to confirm the diagnosis and endoscopic ultrasound to assess the depth of tumor infiltration.
17.Why should pulmonary function and cardiac ultrasound be done before surgery?
It is mainly to assess whether the heart and lung function can tolerate the surgical treatment.
18.Is my condition serious?
The severity of esophageal cancer needs to be evaluated by endoscopic ultrasound + biopsy, CT and other examinations.
19.What are the treatment means of esophageal cancer?
There are surgical treatment, endoscopic treatment, radiotherapy, radiotherapy, chemotherapy
20.How to make the treatment plan?
The severity of tumor and cardiopulmonary function can be understood through barium swallow, endoscopic ultrasound + biopsy, enhanced CT, cardiac ultrasound and pulmonary function. According to the severity of the tumor and combined with the cardiopulmonary function, the treatment plan will be formulated.