Esophageal cancer is a common gastrointestinal tumor that kills about 300,000 people worldwide each year. Its incidence and mortality rates vary greatly from country to country. China is one of the regions with high incidence of esophageal cancer in the world, with an average of about 150,000 deaths per year. Among the malignant tumors of digestive system in China, the incidence rate of esophageal cancer ranks the 2nd or 3rd, more men than women, and the age of onset is mostly above 40 years old.
Causes of esophageal cancer
The population distribution of esophageal cancer is related to age, gender, occupation, race, region, living environment, diet and living habits, genetic susceptibility and so on. Investigation data have shown that esophageal cancer may be a disease caused by many factors. The proposed causes are as follows.
1.Chemical etiology: nitrosamines. These compounds and their precursors are widely distributed and can be formed inside and outside the body, and are highly carcinogenic. The nitrite content in the diet, drinking water, sauerkraut, and even saliva of patients in the high incidence area is much higher than that in the low incidence area.
2.Biological etiology: fungi, in some high incidence areas, a variety of fungi can be isolated from food, upper digestive tract of esophageal cancer patients or resected specimens of esophageal cancer, some of which have carcinogenic effects. Some fungi can promote the formation of nitrosamines and their precursors, which can further promote the occurrence of cancer.
3.Lack of certain trace elements: molybdenum, iron, zinc, fluorine, selenium, etc. have low content in food, vegetables and drinking water.
4.Lack of vitamins: lack of vitamin A, vitamin B2, vitamin C and insufficient intake of animal protein, fresh vegetables and fruits is a common feature of high incidence area of esophageal cancer.
5.Factors such as smoking, alcohol, hot food, hot drinks, unclean mouth, etc.: Long-term drinking of strong alcohol, addiction to smoking, food that is too hard, too hot, eating too fast, causing chronic irritation, inflammation, trauma or unclean mouth, dental caries, etc. may be related to the occurrence of esophageal cancer.
6.Esophageal cancer genetic susceptibility factors.
Clinical manifestations of esophageal cancer
1.Early stage: the symptoms are often not obvious, but there may be different degrees of discomfort when swallowing coarse and hard food, including choking sensation of swallowing food, burning, pinching or pulling and rubbing pain behind the sternum. Food passes slowly and there is a sensation of stagnation or foreign body. The choking sensation is often relieved by swallowing water and disappears. The symptoms are mild and sometimes severe, and progress slowly.
2.Middle and late stage: The typical symptom of esophageal cancer is progressive difficulty in swallowing, first it is difficult to swallow dry food, then semi-liquid food, and finally water and saliva cannot be swallowed. Often spit mucus-like sputum, which is the secretion of saliva and esophagus from the lower throat. The patient gradually loses weight, becomes dehydrated and weak. Persistent chest pain or back pain indicates advanced symptoms, and the cancer has invaded the extraesophageal tissues. When the inflammatory edema caused by cancer obstruction temporarily subsides or part of the cancer is detached, the obstructive symptoms can be temporarily reduced, which is often mistaken for improvement of the disease. If the cancer invades the recurrent laryngeal nerve, hoarseness may appear; if it compresses the cervical sympathetic ganglion, Horner’s syndrome may arise; if it invades the trachea and bronchus, esophageal, tracheal or bronchial fistula may be formed, and violent choking and coughing when swallowing water or food, and respiratory system infection may occur. Finally, a cachectic state appears. If there is metastasis to the liver, brain and other organs, jaundice, fluid in the abdominal cavity, coma and other states may occur.
Treatment options
Having cancer is not scary, what is scary is that we do not go for timely treatment when we have the disease. However, when diagnosed, most of them lose the chance of surgical cure, or recur after surgery, radiotherapy and chemotherapy, so endoscopic treatment becomes an important measure to lift obstruction, relieve symptoms, improve survival quality and prolong life of esophageal cancer.
Interventional treatment.
1.Microwave therapy
2.Laser treatment
3.Argon knife treatment
4.Photodynamic therapy (PDT)
5.Electrochemical therapy
6.Local drug injection
7.Internal stent placement, etc.
For advanced esophageal cancer, a combination of two or more methods can be used, such as cryo- or thermal ablation therapy, internal stent placement, local injection of chemotherapy drugs, etc., which usually have obvious curative effect.
How to prevent esophageal cancer in life?
1.Chew slowly and swallow less friction: chewing can make food and saliva fully mixed and form smooth food mass. Slow swallowing can make the food mass get lubricated by the mucus secreted by the esophagus and move to the stomach smoothly, so that the esophagus will not be worn out. If you swallow when eating, then the esophagus will inevitably be damaged.
2.Avoid scalding food to hurt the esophagus: drinking hot coffee and tea with milk, and enjoying hot soup and porridge for a long time will increase the risk of esophageal cancer.
3. Food quality should be taken into consideration: Eating a lot of meat, animal fat and salt will accelerate the risk of esophageal cancer. However, eating a lot of vegetables and fruits, cereals and drinking green tea can reduce the above risks.
4.Maintain balanced nutrition: Poor nutrition is related to esophageal cancer. Lack of protein will lead to mucosal hyperplasia of esophagus, which will easily become malignant; lack of fat will hinder the absorption of essential fatty acids and fat-soluble vitamins, which will affect health and lower immune function. It is necessary to eat more fresh vegetables and fruits, the former cannot replace the latter, because a lot of vitamins and trace elements are often destroyed in cooking.