Esophageal cancer, also called esophageal cancer, is a malignant tumor occurring in the epithelial tissue of esophagus, accounting for 2% of all malignant tumors. About 220,000 people die of esophageal cancer worldwide every year, and China is a high incidence area for esophageal cancer, which is the second most common cause of death after gastric cancer, with the age of onset mostly above 40 years old and more men than women, but there is a growing trend of onset below 40 years old in recent years. The occurrence of esophageal cancer is related to the chronic stimulation of nitrosamines, inflammation and trauma, genetic factors, and the content of trace elements in drinking water, food and vegetables.
It is believed that the development of esophageal cancer may be related to the following factors.
1.Eating habits
Long-term smoking and strong alcohol consumption, long-term hot and scalding food, hard food without fine chewing, etc. are related to the occurrence of esophageal cancer.
2.Carcinogenic substances
Nitrosamines: Nitrosamines are a group of very strong carcinogenic substances. Residents in Henan Lin County, a high incidence area of esophageal cancer, like to eat sauerkraut, which contains ammonium nitrite. Practice has proved that the amount of sauerkraut consumption is directly proportional to the incidence of esophageal cancer.
Mold: Some people in China use moldy food to feed rats for a long time and induce esophageal cancer.
3.Genetic factors
The susceptibility of human population is related to genetic and environmental conditions. Esophageal cancer has a remarkable phenomenon of family gathering, and it is not uncommon to see families with three or more consecutive generations of esophageal cancer patients in high incidence areas.
4. Precancerous lesions and other disease factors
Such as chronic esophageal inflammation, esophageal epithelial hyperplasia, esophageal mucosal injury, Plummer-Vinton syndrome, esophageal diverticulum, esophageal ulcer, esophageal white spot, esophageal scar stenosis, hiatal hernia, pancreatic dyscrasia, etc. are considered precancerous lesions or precancerous diseases of esophageal cancer.
5.Nutrition and trace elements
Lack of vitamins, proteins and essential fatty acids in the diet can make the esophageal mucosa proliferate and interstitially change, which can further cause cancer. The lack of trace elements such as iron, molybdenum and zinc is also related to the occurrence of esophageal cancer.
Three levels of prevention of esophageal cancer
Primary prevention.
Etiology prevention: avoid water pollution, reduce nitrosamines and harmful substances in water, adjust dietary habits, do not eat overheated food, do not eat rough and hard food, prevent mold and detoxification; drink less highly listed wine and do not smoke.
Pathogenetic prevention: apply preventive drugs, actively treat esophageal epithelial hyperplasia and deal with precancerous lesions, such as esophagitis, polyps, diverticula, etc.
Secondary prevention.
Early detection, early diagnosis and early treatment. Those who have one of the “four senses” symptoms should be promptly seen by experienced specialists, or regular gastroscopy or radiological examination should be recommended.
Tertiary prevention.
To improve the cure rate, survival rate and quality of life of esophageal cancer patients by all means, focusing on rehabilitation, palliative and pain relief treatment. Provide standardized diagnosis and treatment plan for patients, and provide guidance on physiology, psychology, nutrition and rehabilitation. To do clinical end-transfer and improve the survival quality of advanced patients.
Preventive measures.
Do not eat moldy and spoiled food; do not eat overheated and hot food; drink tea and porridge at 50℃ or below; prevent water pollution and improve water quality; do not smoke and drink strong alcohol; supplement the trace elements required by human body; eat more vegetables and fruits and increase the intake of vitamin C. Surveillance for susceptible people, popularize cancer prevention knowledge and raise cancer prevention awareness.
Esophageal cancer and diet
1.Don’t eat too much meat, because meat has high fat content, you can eat more fish and shrimp to meet the body’s demand for protein.
2.Salted vegetables, salted meat and other foods contain carcinogenic substances such as nitrite, so they should be eaten sparingly.
3, moldy rice, noodles, peanuts and other foods contain carcinogenic aflatoxin, once found, should be abandoned not to eat.
4, do rice, porridge before washing the rice to reduce the damage of mold on the body.
5, often frying food will increase the pollution in the kitchen, making people vulnerable to lung cancer.
6, the water in the tank should be updated every 2 to 3 days, do not always leave the stub, because the bacteria in the sediment at the bottom of the tank can make the nitrate in the water reduced to carcinogenic nitrite.
7, eat more fiber-rich food, such as celery, leeks, fresh dates, sweet potatoes, etc.
8, smoked fish, meat, sausages and other foods contain carcinogenic smoke tar, should be eaten less.
Do not put too much oil when frying, research shows that the occurrence of breast cancer, colon cancer, ovarian cancer are related to too much fat intake.
9. Don’t buy vegetables and fruits that are not fresh or rotten for cheap.
The prominent symptom of esophageal cancer patients is difficulty in swallowing, which is also a serious problem of esophageal cancer patients in terms of diet. Most esophageal cancer patients’ dysphagia occurs gradually and worsens progressively. At the beginning, patients only have choking sensation when eating dry food, but it gradually worsens to the extent that they have difficulty in eating soft food and semi-liquid food, and finally they have complete difficulty in drinking and eating, which makes patients’ nutritional status worse and worse and finally leads to cachexia. Thus, it can be seen that difficulty in eating is a very serious problem for patients with esophageal cancer.
Early and middle stage esophageal cancer patients who have been diagnosed should seize the opportunity to increase nutrition, give them soft food or semi-liquid food with high protein and high vitamin, and make use of the absorption function of their gastrointestinal tract to supplement nutrition as much as possible so that they can have a better physical condition.
In order that chemotherapy can be carried out smoothly, drug therapy should be accompanied by rich nutritious food to improve the body’s tolerance to the toxic side effects of anti-cancer drugs. During chemotherapy, patient’s diet should be mainly high-calorie and high-protein, such as chicken, duck, fish, shrimp, lean meat, eggs, etc., so as to play a supplementary therapeutic role. The diet should be diversified, pay attention to the meal mix, with a view to various nutrients complement each other and improve the immunity of the body. If you have the symptoms of five heartburn and yin deficiency, you should eat silver fungus porridge or use 0.15 grams of American ginseng steeped as tea. If economic conditions allow, stewed turtle soup can be taken. Cooking should pay attention to color, aroma and taste, preferably steaming, boiling and stewing, not eating or less smoking, deep-frying and baking food, less pickled food, no smoking and no drinking, alcohol can activate many carcinogens and reduce immune function. The main food for chemotherapy patients can be buns, dumplings, wontons, noodles, etc. according to their dietary habits and tastes. Patients with poor appetite can eat less and more meals. Prof. Yang especially pointed out that unlike other tumors, esophageal cancer is not poor, but difficult to swallow and unable to eat, causing the consumption of the body, so they should try to eat more diets that can enter the esophagus, such as semi-fluid and full-fluid, pay attention to the quality of semi-fluid and full-fluid, don’t restrict calories, be nutritious, meals are fine and soft, easy to digest and absorb, and if necessary, do homogenized If necessary, we can do homogenized diet, elemental diet and mixed milk diet, etc. The homogenized diet is a normal human diet de-spined and de-boned, stirred into a paste with a high-speed tissue masher, containing nutrients similar to the normal diet, but crushed outside the body, extremely easy to digest and absorb, which can avoid a long-term single diet and prevent constipation.
The caloric and nutritional requirements of the homogenized meal can be formulated according to the condition and personal dietary habits of the individual. You can choose from rice, porridge, noodles, steamed bread, eggs, fish, shrimp, chicken, lean meat, pork liver, cabbage, carrot, rape, white radish, winter melon, potato, as well as appropriate amounts of milk, soy milk, tofu, dried beans and other foods. The method of preparation is also very simple, for example, chicken, lean meat, fish, shrimp, vegetables, etc., must first be washed, boneless, peeled, de-thorned, cut into small pieces cooked or fried, steamed buns to remove the outer skin, eggs cooked and shelled into pieces, all the food needed for each meal mixed, add the appropriate amount of water together with pounding and stirring (available medical tissue pounding machine or food pounding machine pounding), to be all stirred into a grain-free paste and then add Salt 1~2g/meal can be added. Alternatively, stir-fry the vegetables and mix them with crushed steamed buns, then mash them together with a tissue masher, and then take them orally or feed them.
The main attention in the diet of esophageal cancer patients is to avoid.
1.When patients have choking sensation, do not swallow forcibly, otherwise it will stimulate local cancer tissue bleeding, spreading, metastasis and pain. When choking is serious, patient should have liquid food or semi-liquid food.
2.Avoid cold liquid food and cold noodles, milk, egg soup, etc. which are placed for a longer period of time should not be drunk. Because the narrow part of the esophagus to cold food stimulation is very obvious, easy to cause esophageal spasm, nausea and vomiting, pain and swelling and numbness and other feelings. Therefore, it is better to eat warm food.
3, can not eat pungent, spicy, smelly, fishy stimulating food, because these foods can also cause esophageal spasm, making the patient discomfort. For esophageal cancer patients who can not eat at all, they should adopt intravenous high nutrition method to input nutrients to maintain the needs of the patient’s body.
Improved drinking water: Drinking water is one of the main sources of carcinogenic nitrosamines and their precursors (nitrates, nitrites and amines) entering human body. Dry well water and pond water consumed by residents in high incidence areas are more polluted than river and spring water, shallow well water is more serious than deep well water, and filtered and disinfected tap water has better water quality. These precursors can be converted to nitrosamines in vitro and in vivo under appropriate conditions. Should be combined with the basic construction of rural health, and gradually transform drinking water equipment to improve drinking water hygiene. Conditional townships and villages, advocate the construction of various types of tap water. Rural households can also apply activated carbon water purifier. Advocate reasonable fertilization of farmland, formula fertilization, do not use too much nitrate fertilizer.
Mold prevention and detoxification: corn, peanuts, wheat is easy to mold, rice, bean crops less moldy. Grain in the process of harvesting, storage, when the temperature and humidity is suitable for easy mold. So the grain mold prevention first of all, we should choose the best varieties to prevent insects from falling; to fast harvest, fast fight, fast sun, fast into the warehouse; to strengthen the management of grain warehouses, pay attention to ventilation, dry, the temperature should be controlled at 13. C below, the relative humidity is maintained at 70% to 75%. For serious contamination of food should not be eaten, can be used for other purposes. In addition to food, other food mold is also very important, Professor Yang pointed out in particular, such as dried potato chips, dried radish shreds, overnight meals, sauerkraut, pickles are easy to mold. Food in the process of processing, circulation, storage mold problems are more serious and give people harm. Therefore, it is necessary to strengthen food hygiene management, implement national food hygiene regulations, eliminate moldy food from the market, and educate the public not to eat moldy and spoiled food. Balanced nutrition: advocate a wide variety of vegetables, fruits and oil plants in areas with high incidence of esophageal cancer. Local residents can increase the intake of vitamin A, B2, C, E, carotene and selenium from food to supplement the lack of nutrition.
Change bad diet and living habits: Bad diet and living habits are related to the development of esophageal cancer. Among them, factors such as smoking, drinking alcohol, chewing betel nut, eating nas, often eating sauerkraut, yogurt lumps, fish sauce, small fish with spines, moldy food, eating too fast and three meals not on time are positively correlated with esophageal cancer; and negatively correlated with often eating vegetables, fruits and soybean products. Improve cooking methods and storage techniques, and establish good dietary hygiene habits.
Treatment of esophageal epithelial hyperplasia and esophagitis: esophageal epithelial hyperplasia is a precancerous lesion of esophagus, which has the nature of two-way transformation (part of it can be transformed into cancer and part of it can be transformed into normal). Therefore, treatment of esophageal epithelial hyperplasia can promote the transformation to normal and reduce the occurrence of esophageal cancer.
Identify people or individuals with genetic susceptibility to esophageal cancer and focus on prevention. Families with two or more deaths of esophageal cancer in three generations are considered as high-risk families, and members of the family aged 40-69 are considered as high-risk groups, for which initial screening screening, multiple tests and prospective observation are conducted to identify genetically susceptible individuals. He was persuaded to change unhygienic and harmful habits and provided with vitamins and preventive medications. This strategy makes the number of key preventions compressed and targeted, saves a lot of manpower and material resources, and is easily accepted by the public. Precancerous lesions and esophageal cancer detected in high-risk groups by primary screening and screening are treated promptly.