Signs of esophageal cancer you can't miss... Esophageal cancer early symptoms and signs

Esophageal cancer is a malignant tumor that develops as a result of degeneration and accelerated division of cells in the epithelial layer of the organ. The histological basis of the tumor is squamous epithelium (with or without keratinization).

Basal cell, colloid and glandular tumors develop much less frequently - with abdominal localization of the process. The process is most often localized in the middle third of the organ. Clinically, the tumor is manifested by increasing symptoms of dysphagia and, as a consequence, the development of cachexia - an extreme degree of exhaustion.

ICD-10 code: C 15 Malignant neoplasm of the esophagus.

Reasons that can cause the development of an oncological process

The following reasons are identified for the development of esophageal cancer:

lifestyle features (consumption of hot food, water with a high content of salt and minerals, smoking, alcohol);
developmental abnormalities - tylosis (a rare genetically determined disease manifested by impaired development of squamous epithelium), sideropenic syndrome.
– chronic esophagitis, esophageal ulcers, polyps, (a disease characterized by replacement squamous epithelium to glandular, characteristic of the stomach).

What are the morphological forms of esophageal carcinoma?

The danger of any tumor is determined by how differentiated its constituent cells are.

For esophageal cancer, there are two main forms of pathology:

The non-keratinizing form is the uncontrolled proliferation of undifferentiated cells. These forms are different high malignancy. They grow quickly and metastasize early. Non-corrosive forms squamous cell carcinoma are considered the most malignant tumors.
Keratinizing cancer is an accumulation of highly differentiated and moderately differentiated cells, therefore the malignancy of this form of cancer is lower.

Stages of the cancer process in the esophagus

There are V degrees of cancer process.

Grade 0 is the emergence of a cancer cell; it is impossible to clinically identify this stage (the words “grade” and “stage” in oncology are now used as synonyms).

Table 1. Characteristics of stages of development of esophageal cancer

Process characteristics	Stage I	Stage II	Stage III	IV stage
Histological characteristics of the stage	The tumor grows deep into the mucous membrane, but does not affect the muscular layer	The mucous and muscular lining of the esophagus is affected. There is a narrowing of the lumen	Swallowing problems, weight loss, and other signs of cancer are prominent. The tumor has grown through all layers of the esophagus	The tumor grows into all membranes of the organ
Metastases to regional lymph nodes	No	Single metastases may occur*	Multiple metastases	Multiple metastases
Metastases to distant lymph nodes	No			Eat
Damage to anatomically close organs (trachea, bronchi, nervus vagus, heart)	Does not affect	Does not affect	The tumor grows into nearby organs
Damage to anatomically distant organs (kidneys, liver)	Does not affect			Metastases to distant organs

*For stage 2 esophageal cancer, there are 2 substages:

II A – no metastases;
II B – there are metastases in the nearest lymph nodes.

How do symptoms of esophageal cancer manifest in women?

The earliest symptoms of esophageal cancer are: weakness, loss of appetite. But patients usually do not go to the doctor with these complaints.

The first symptom of concern is increasing dysphagia (impaired swallowing of food). There are several degrees of dysphagia:

the patient has difficulty swallowing solid food;
difficulties arise when swallowing food diluted with liquids;
difficulty swallowing liquid food;
the patient cannot swallow anything.

Dysphagia is accompanied by increased salivation.

As the tumor enlarges and goes beyond the anatomical limits of the organ, the following, already late, signs appear.

By the later clinical manifestations relate:

pain first appears when eating, and then becomes constant, the nature of the pain is different, localized in the front, in the upper part of the sternum, or behind, in the interscapular region;
patients complain of a “lump” behind the sternum;
when moving to the stomach - constant belching followed by regurgitation mixed with blood, nausea, vomiting;
with tumor invasion into the trachea – change in voice timbre;
when a neoplastic formation grows into the bronchi, they often develop aspiration pneumonia, a sharp hacking cough appears;
Growth into the mediastinum is characterized by the phenomenon of mediastinitis (inflammation of the mediastinal tissue.

IN terminal stage joins the clinic affected by metastasis of organs (liver, bones, lungs).

How does esophageal cancer spread?

Tumor cells are able to move throughout the body, thereby affecting nearby organs, lymph nodes and distant organs.

Distribution routes cancer cells in the human body:

Local spread is the growth of a cancer tumor into organs located in anatomical proximity (heart, trachea, recurrent nerve, bronchi).
Hematogenous spread (through the blood) - cancer cells enter the bloodstream and attach to other organs (the kidneys and liver are most often affected).
Lymphogenic type of spread is the most important route of metastasis, occurring through the lymphatic vessels. Metastases (secondary tumors) in the lymph nodes closest to the organ are detected already when the tumor has invaded the submucosal layer. In many ways, the localization of metastasis depends on the location of the tumor.

If the tumor is located above the bifurcation (branching) of the trachea, metastasis occurs in the supraclavicular lymph nodes and mediastinal lymph nodes. With distal localization (below the branching) of esophageal cancer, metastasis occurs in the lymphatic collectors of the peritoneum.

But due to the peculiarities lymphatic system esophagus and the presence of retrograde lymphatic flow, metastases at any location of the cancer process can be detected in various lymph nodes.

Measures for early detection of esophageal tumors

The most effective are considered preventive examinations, periodically carried out among patients at risk. Not only are they examined by a physician, but they also undergo an esophagoscopy and, if necessary, a biopsy is taken.

Patients at risk include:

with a genetic predisposition;
with Barrett's disease and other precancerous pathologies;
with long-term non-healing ulcers of the esophagus of various etiologies.

Diagnosis of esophageal cancer

The diagnosis of esophageal cancer is considered established if cancer cells are found in a biopsy taken from the patient's esophagus. All other examination methods are aimed at clarifying the localization and prevalence of the process. This is necessary for drawing up a patient management plan and choosing a rational method of treatment.

An X-ray examination is performed for all patients with diseases of the esophagus:

The x-ray clearly shows narrowing of the esophagus; the presence of ulcers and fistulas characteristic of a cancerous process is determined;
X-rays can be used to determine the position of the cancerous defect relative to other structures and organs;
the study allows you to assess the patency of the esophagus and its propulsive function (ability for peristaltic movements);
determine the presence of other diseases of the esophagus.

Esophagoscopy allows not only to take a targeted biopsy of the mucosa for histological examination, but also to examine the affected area in detail, identifying areas of necrosis, ulceration, and bleeding.

Oncology in the esophagus most often occurs in older people. Among young people, the problem is caused by cell mutation. Statistically, men are more often affected. Symptoms of esophageal cancer become noticeable early, allowing treatment to begin sooner.

Cancer concept, statistical data

Tumors appear due to an abnormality occurring in a specific group of cells. In most cases, the middle and lower thirds of the organ are affected. A malignant neoplasm affects the patient’s ability to swallow: the larger the tumor, the less dense food can enter the stomach.

The initial development of oncology is detected by endoscopy, ultrasound radiation or computed tomography. Diagnosis involves analysis of tumor tissue. Not every neoplasm is malignant.

Severe stages of the disease this moment incurable. Tumor in severe cases spreads to neighboring organs, depriving the patient of a chance for recovery.

Classification

Oncologists divide pathology into several groups in two ways. According to growth, oncology is:

Exophytic, that is, growing only along the organ above the mucosa.
Endophytic - formed in the tumor tissue, or under the mucous membrane .
Mixed, affecting both parts of the esophagus.

According to the type of structure, cancer can be squamous cell or adenocarcinoma:

In the first case, the tumor is formed only from epithelial tissue.
In the second - from gland cells that secrete mucus. Adenocarcinoma of the esophagus is much less common, the pathology is more difficult to tolerate and more difficult to treat. Occurs exclusively at the transition of the esophagus to the stomach.

There are also four more types of cancer tumor structure, which are extremely rare. These are sarcoma, malanoma, lymphoma and chorionic carcinoma.

Squamous cell tumor

The most common type of cancer. Divided into two categories:

Superficial is considered favorable for the prognosis. Most malignant tumors of this type detected in time are successfully treated. It looks like a plaque or erosive damage to the wall of the esophagus.
Deeply invasive it affects the inner part of the tissues, its manifestation is similar to a fungus or ulcer. Such cancer often spreads to neighboring organs.

Visually, squamous cell carcinoma resembles a polyp or ring-shaped neoplasm surrounding the esophagus. A growing tumor narrows the inside of the organ, reducing the availability of food in the stomach. In women, esophageal cancer has hallmark: a neoplasm arises at the bottom of the organ, gradually spreading upward. The main sign of esophageal cancer in a man is a formation that occurs at the junction with the stomach.

There is also a second type of division of squamous cell carcinoma - based on keratinization:

Non-keratinizing is caused by narrowing. Main symptom esophageal cancer - regurgitation after swallowing saliva.
The keratinizing agent provokes disturbances in the mucous membrane. The secretion stops being released, so the cancer begins to grow, killing tissue. This process is caused by lack of nutrition and leads to necrosis.

The survival prognosis for squamous cell carcinoma of the esophagus is comforting. As a rule, in the early and progressive stages the disease is successfully treated. Severe cases depend on the specific category of disease. Oncology at an early stage is cured in 80% of cases.

Causes

Cancer occurs due to several reasons that appear in a short period of time. A greater number of causes increase the chance of pathology occurring. Cancer is caused by:

Long-term smoking. Harmful substances entering the body through smoking lead to mutations of epithelial cells in the esophagus. According to statistics, cancer occurs 3-4 times more often in smokers. Similar to smoking, cancer is caused by alcohol. Chronic alcohol abuse increases the risk of cancer by 12 times.
The development of oncology can be facilitated by the consumption of excessively hot or spicy foods and pickled foods. Similar Negative influence also provoked by the consumption of moldy vegetables and fruits. Such food is typical for the inhabitants of the Asian continent.
Cancerous tumors can arise from burns of any type of esophagus.
Oncology is associated with a lack of vitamins A and E in the body. Long-term vitamin deficiency - common reason cancer.

Among more rare causes highlight:

Heredity. A mutation in one of the genes can be passed on to the child.
Papilloma - viral disease, which can cause cancer.
Oncology can occur after Barrett's esophagus. Esophagitis causes the release of hydrochloric acid into the esophagus, causing an artificial burn. This pathology occurs due to problems with the gastrointestinal tract. “Barrett's esophagus” leading to cancer is a consequence of esophagitis .

Symptoms

Manifestations of esophageal cancer - following symptoms:

Difficulty swallowing - dysphagia.
Swallowing accompanied by regurgitation.
General weakness of the body caused by lack of nutrients. Symptoms of esophageal cancer develop when the stomach or intestines are malfunctioning .
Losing weight.

First sign , dysphagia, manifested when swallowing solid food. Liquid helps reduce the impact of pathology on the food consumed. In order not to limit yourself in food, it is enough to wash it down. Gradually the patient switches to soups and cereals. In severe cases, the esophagus does not allow food into the stomach at all.

Other signs of esophageal cancer:

Pain behind the sternum. As the tumor grows, the cancer presses on the nerves, causing pain.
Regurgitation occurs due to narrowing of the lumen.
Stagnation of food in the esophagus leads to unpleasant smell from mouth.
Severe stages of the disease are characterized by a coating on the tongue.
The patient's constant hunger. Nausea when eating food.
Increased salivation.
In rare cases, hoarseness occurs.
The transfer of metastases to neighboring organs causes shortness of breath, cough, and pain near the lungs.
Toxification of the body can lead to lethargy, sleep problems, and fever. Liquid food provokes anemia.

Stages

Oncologists divide cancer into 4 stages:

The first is a neoplasm in the mucosa that has not affected the muscles.
The second is spread to muscle tissue with an initial narrowing of the esophagus.
The third is complete tissue damage. Oncology does not penetrate neighboring organs, but affects the lymph nodes.
The fourth is the transition of metastases to neighboring organs.

Complications

Severe cases of oncology lead to complications:

Obstruction. Complete blockage occurs in the most severe stages.
Bleeding that increases as the disease progresses.
Weight loss caused by inability to eat due to problems swallowing.
Cough , caused by food intake. This complication occurs when the trachea is damaged.

Metastasis

With esophageal cancer, metastases can spread to other organs through the lymph nodes or blood. Oncology affects the liver, bone and brain, and lungs. These complications do not aggravate the patient’s condition, since they appear in the later stages.

Diagnostics

If oncology is suspected, the doctor prescribes an examination to clarify the diagnosis. Commonly used:

X-ray to see physical changes in the esophagus.
Esophagoscopy is an examination by swallowing a camera. Shows the causes of swallowing problems.
Bronchoscopy allows you to see metastases in the lungs or trachea.
CT accurately diagnoses the stage of the pathological process.
Ultrasound is prescribed for suspected spread of metastases to other organs.
Tumor markers are a way to determine a malignant tumor of the oncological type. Not the most accurate test, since markers may be present in the body of a healthy person or someone cured of cancer.

Treatment

The specific treatment method depends on the characteristics of the body and the stage of the disease. Chemotherapy and radiation are helpers that prepare or support after surgery. Conservative treatment is also possible . In most cases, a combined method is used .

Surgery

Oncology is operable. The most commonly used methods are:

Osawa-Garloka. An incision is made from the navel to the 7th rib. After spreading the tissues, the stomach is removed into the pleural cavity, and the esophagus is operated on. As a rule, the tumor is excised along with part of the organ to avoid recurrence. Then the stomach is returned to its place.
Toreka. An incision is made along the sixth intercostal space. The esophagus is exposed and a suture is placed on it. The patient is then turned onto his back. From pleural cavity the esophagus is also isolated. Then the tumor is removed, and the incisions are sutured one by one.
Lewis. The operation is two-stage. At the first stage, abdominal access to the abdomen is made with revision. On the second - thoracotomy on the right side of the body. The tumor is excised along with the organ, the lymph nodes are punctured, and the cavity is examined for the presence of internal hemorrhages. After the drainage tubes are installed, the patient is sutured. This operation is performed more often than others, but is contraindicated in case of metastasis.

Conservative method

The basis of therapy is diet. Oncologists prescribe products based on the patient's condition. Typically the diet consists of:

Ground food.
Food without lumps that could close the esophagus.
Calorie content per day, as well as the weight of food and the volume of liquid, are strictly defined. Accordingly, no more than 3 kilos and 1200 ml.
Food is divided into 6 meals.
The food temperature should not exceed 40-45 degrees or be colder than 15-20.

Most patients have difficulty eating, which indicates the need to follow a diet. Food is also supplemented with vitamins, the use of which must be strictly controlled.

Chance of cure

Stages one and two of esophageal cancer can be cured in most cases. Advanced cases are incurable, since even doctors do not know everything about esophageal cancer. Typically, a patient can be kept alive for no more than 8-9 months.

Forecast

For squamous cell carcinoma, patient survival after treatment depends on the stage of the disease. According to statistics, respectively: above 90, about 50, less than 10 percent. At the fourth stage, the disease is curable in exceptionally successful cases.

In eighth place according to statistics among oncological diseases, there is esophageal cancer. The development of tumor pathology begins with the epithelial cells of the organ mucosa. The affected esophagus narrows, causing discomfort when swallowing food - these are the primary signs of the disease. People suffer from cancer regardless of age (young people, older people). However, bad habits (in particular smoking, alcohol abuse) increase the risk of developing a tumor.

The most common localization of tumor formation is the middle and bottom of the esophagus. Most often, specialists diagnose tumors that develop from squamous epithelial cells. But an oncological tumor can also develop from glandular cells and is defined as adenocarcinoma (diagnosed extremely rarely, not exceeding 10% of cases). The danger of this pathology is that it can develop into cancer of the pharynx, lips, and tonsils.

Data. Scientists have found that Asians suffer from esophageal cancer several times more often. This is explained by the regular consumption of spicy foods, as well as citrus fruits. Statistics also confirm that dark-skinned people are seven times less susceptible to esophageal cancer.

Causes of cancer development

The causes of damage to the esophagus by cancer cells, as well as other organs, are not reliably known. An important factor predisposing to the development of cancer is an irritant to the mucous membrane. For development inflammatory process the mucous membrane is affected by thermal, chemical or mechanical effects. Further, inflammation leads to the so-called cell dysplasia, the process of transformation of healthy cells into pathological ones begins.

If a patient has chronic esophagitis, there is a high risk of developing cancer. Experts define this condition as precancerous.

Attention! When diagnosed with Barrett's esophagus, a factor in the development of oncology is allowed.

Organ cancer damage digestive system scientists associate it with the p53 gene (an increase occurs in an abnormal protein that is unable to protect the body from destructive cancer cells). It is possible that HPV can also predispose to cancer. The danger of this virus is that it cannot be completely cured. Only by strengthening immune system the virus is suppressed but remains in the body.

Factors predisposing to cancer

Many factors can provoke the development of a tumor, for example:

human papillomavirus;
hereditary factor;
damage to the esophagus when swallowing;
thermal effects on the esophagus;
poor nutrition, including a large number of spicy food, deficiency of fruits and vegetables;
lack of tocopherol and retinol, B vitamins in the body. As the body weakens, the process of cellular degeneration may begin;
regular consumption alcoholic drinks. As a result of frequent burning effects on the esophagus, its walls become thin, and the mucous membrane is prone to cancerous tumors (therefore, alcohol-dependent people are 10 times more likely to suffer from esophageal cancer);
smoking. One of the destructive factors for the digestive system. Since inhaled smoke is saturated with carcinogens, epithelial cells are exposed to negative processes.

It is important! Smokers should note that regular smoking over several years increases the risk of developing cancer by five times.

Primary signs

The danger of the oncological process is that the first stage occurs almost in asymptomatic form. The first warning signs are difficulty swallowing followed by movement of food. This symptom often develops against the background of a blocked lumen, as a result of which the cancerous pathology begins to germinate.

Main features:

a neoplasm in the esophagus causes a spasmodic state, and a feeling of severe tickling occurs. As the tumor grows, the lumen closes more and more and it becomes difficult for the patient to consume food. As a result, the body begins to deplete;
vomiting and frequent belching. Such symptoms are provoked by the process of food retention above the esophagus;
a painful sensation behind the sternum that radiates between the shoulder blades. This symptom is characteristic of the development of esophagitis. This means the process of tumor growth into neighboring organs;
difficulty breathing. Diagnosed with the progression of oncology and damage not only to the digestive system, but also to the respiratory system;
unpleasant odor from the mouth, difficulty swallowing, belching - all these are signs of tumor formation in the cardia area;
the voice hoarses, Horner's syndrome occurs (in case of damage to the nerve trunks localized near the walls of the esophagus);
high degree of pain in the esophagus and neighboring organs. This is a sign of the last stage of oncology.

Clinical symptoms

With the development of the cancer process, dysphagia is observed first. This is difficulty swallowing food. The patient feels that it is difficult for food to pass through the esophagus, a large amount of water is required, and from time to time the patient begins to drink food.

Difficulty passing food when swallowing - dysphagia

To the extent that it is difficult to consume food, the patient begins to quickly lose weight. Then symptoms arise gastrointestinal bleeding, they manifest themselves in the form of vomiting mixed with blood. There are no problems with defecation, but you need to pay attention to the peculiarity of feces - melena. Thus, with esophageal cancer, the patient will have black stools.

Attention! If cancer is diagnosed in a timely manner (at the dysphagia stage), the prognosis will be quite favorable. The therapy process will be lengthy and difficult, but there is a chance to save life.

Degrees of cancer

IN medical practice There are several degrees of progression of esophageal cancer. Each of them has characteristic symptoms.

Stage	a brief description of
0	Oncological formation affects only the surface of the mucosa, without affecting the deep layer. If the disease is detected at this stage, the prognosis is completely favorable.
I	The spread of cancer cells occurs in the middle of the mucosa, but the muscle layer remains unharmed. At this stage of development of the disease, there are no metastases. When diagnosed by endoscopy, a tumor is detected.
II	Difficulty swallowing may occur. But despite this, other obvious symptoms are completely absent. In this case, it is appropriate to distinguish two substages: A. Cancer cells grow in connective tissues and muscle layer, there is no metastasis, neighboring organs are not affected. B. The tumor completely affects the mucosa, metastases are observed in the lymph nodes.
III	A severe stage of the disease, which is characterized by serious problems with swallowing. The patient loses body weight. Metastases in neighboring organs and nearby lymph nodes. Despite intensive treatment, the prognosis may be poor in most cases.
IV	Last stage. Characterized by severe, almost constant pain, complete loss of appetite, dysfunction internal organs. Metastases affect distant lymph nodes, the prognosis is unfavorable.

Forecasts

The first favorable point is that this type Cancer can be cured and life saved. It all depends on the speed of diagnosis - the sooner the patient contacts specialists, the faster the treatment process will be. In this way, relapses can be prevented. It should be noted that esophageal cancer is one of the slowest representatives of oncology, with a characteristic average degree malignancy.

Most often, when a patient comes for diagnostics, an already advanced stage of oncology is detected, since at first there are no obvious symptoms. With metastasis surgical treatment excluded. Radiation therapy is used. According to statistics, after radiation exposure in almost 10% of all cases, the patient’s life is extended by another year. With a complex effect on the tumor, experts predict more than 5 years of life.

If active treatment is started:

at the first stage – more than 91% of cases of cure;
at the second stage – in no less than half of all cases it is possible to save the patient’s life;
at the third stage - only 10% of patients survive.

How successful the treatment is depends on the speed of organ damage, the stage at which therapy was started, the presence of metastasis of neighboring organs and the patient’s condition as a whole.

Video - Esophageal cancer: symptoms, signs

Malignant tissue damage to the esophagus (cancer) is a widespread disease in older people.

Among the oncologist's patients with this diagnosis, there are more men; up to the age of thirty, only isolated cases of atypical degeneration of esophageal cells into cancerous ones occur.

Concept and statistics

Malignant neoplasm occurs due to abnormal degeneration of normal cells. Most often the lower and middle part organ.

The disease manifests itself as an increasing disturbance in the swallowing process, which ultimately leads to the patient being unable to swallow even the softest food. The consequence of this is severe weight loss.

At the initial stages of tumor development, it can be detected only by one of instrumental methods, that is, ultrasound diagnostics, CT, endoscopy. In the final stages, it is not yet possible to completely defeat cancer.

The diagnosis is made only after histological analysis of biomaterial taken from the tumor. A neoplasm in the esophagus can also be benign, so do not panic until the diagnosis is confirmed.

Esophageal cancer, like any malignant degeneration, in its final stages grows into adjacent organs - the trachea, bronchi, and blood vessels. Metastases can appear both within the sternum and in distant organs.

Classification

Oncologists use several classifications of esophageal cancer; division into types is necessary to choose the most effective treatment tactics.

Based on the growth characteristics of the tumor, cancer affecting the esophagus is divided into:

Exophytic. The tumor in this type of cancer grows only in the lumen of the organ and rises above the mucous layer.
Endophytic. The tumor forms in the thickness of the tissue or in the submucosal layer.
Mixed tumors affect all layers of the walls, are characterized by the appearance of ulcerations and rapid disintegration.

Based on their structure, esophageal cancer is usually divided into:

– atypical cells are formed from squamous epithelial cells.
. Rarely seen. The tumor begins to form from gland cells that secrete mucus. This form of cancer is more difficult to tolerate compared to squamous cell cancer. Adenocarcinoma in most patients is found in the lower esophagus adjacent to the stomach.

In relatively rare cases, other types of cancer of the esophagus also occur. These include sarcoma, melanoma, chorionic carcinoma, lymphoma.

Squamous cell carcinoma is divided into two types:

Surface– one of the most favorable forms of esophageal cancer in terms of prognosis. A malignant lesion appears as a plaque or erosion growing on the wall of the esophagus. Large sizes such pathological change does not reach.
Deeply invasive. Captures tissue located deep in the esophagus. Looks like a deep ulcer or mushroom. With this type of lesion, metastases quickly appear in the bronchi, trachea and heart muscle.

Upon visual examination, squamous cell carcinoma in the esophagus resembles a growth that surrounds the organ from the inside in the form of a ring. As the tumor grows into the lumen of the organ, its diameter narrows, which leads to the appearance of the main clinical picture of the disease.

The photo shows pictures of squamous cell carcinoma of the esophagus with endophytic growth

Sometimes squamous cell carcinoma forms as a polyp.

Conducted studies have established that squamous cell carcinoma in women usually begins in the lower parts of the organ and moves to the upper parts. In men, cancer primarily forms where the esophagus meets the stomach.

Squamous cell cancer of the esophagus is also usually divided into keratinizing and non-keratinizing cancer.

Non-keratinizing cancer disrupts the functioning of the organ due to a pronounced narrowing of the lumen. This form is manifested by disturbances when swallowing food and saliva, and periodic regurgitation.
Keratinizing form a cancerous tumor leads to changes in the surface of the mucous layer. The cells become keratinized and this makes the walls of the esophagus dry, which greatly aggravates all manifestations of the disease. The tumor grows quickly, but does not receive proper nutrition due to the delayed formation of blood vessels in it. The consequence of this process is the appearance of zones of necrosis, which during endoscopy are determined as areas with ulcerative lesions.

The prognosis for survival of patients with cancer in the esophagus depends on the stage of the pathology.

In the first stages, the oncologist can give a great chance of a favorable outcome of the disease after complex treatment. The five-year survival rate of patients reaches 80%. Patients are allowed to continue working if their profession does not involve heavy physical work.

In advanced cases, that is, when distant metastases are already detected, esophageal cancer is difficult to treat even modern methods treatment.

Causes

It is impossible to single out one main reason leading to the formation of cancer cells in the walls of the esophagus.

The disease can occur under the influence of many provoking factors, and the risk of its development increases many times over if the human body is simultaneously affected by a whole group of negative conditions.

Most often, esophageal cancer is diagnosed:

In people whose smoking experience amounts to tens of years. contains carcinogenic substances that settle on the walls of the esophagus and lead to abnormal changes in epithelial cells. It has been established that in people who smoke, malignant neoplasms of the esophagus develop 4 times more often.
With alcohol abuse. Drinks containing burn the esophagus, and this leads to an atypical proliferation of squamous epithelium. In chronic alcoholics, esophageal cancer is detected 12 times more often.
With improper and irrational nutrition. The development of esophageal cancer is influenced by constant consumption of pickled, too spicy and hot foods. Eating foods containing mold and lack of fresh plant foods in the diet has an adverse effect. The listed nutritional features are typical for residents Central Asia, Japan, China, and some regions of Siberia, so in these areas the number of patients with esophageal cancer is tens and hundreds of times greater.
After thermal and chemical burns of esophageal tissue. A burn can also be a consequence of constantly eating too hot food. If concentrated alkalis are accidentally ingested, a cancerous tumor may be detected several years later.
In people with vitamin deficiencies. The mucous layer of the esophagus needs sufficient quantity Vitamins such as A and E, they are involved in creating the natural protective barrier of the organ. If vitamin deficiency is observed for a long time, then the cells of the organ cease to perform their function and degenerate.

There is also a hereditary predisposition to the development of cancer in the esophagus. Scientists were able to isolate a mutation in the p53 gene, which leads to the production of an abnormal protein. This protein disrupts the natural defenses of esophageal tissue against cancer cells.

In the blood of many patients with malignant tumors of the esophagus, it is detected, so it can be suggested that this microorganism can give impetus to the degeneration of cells.

The development of cancerous lesions can be preceded by esophagitis and a condition such as. Esophagitis is characterized by the constant reflux of hydrochloric acid into the esophagus, which irritates the walls of the organ.

Stomach diseases and obesity lead to esophagitis. Barrett's esophagus is a complication of esophagitis and is manifested by replacement stratified epithelium to cylindrical.

Symptoms

The formation of a cancerous tumor in the esophagus is indicated by such signs as difficulty swallowing food and saliva, gradual weight loss up to cachexia, and increasing weakness.

Early metastasis is detected with a malignant neoplasm of the esophagus in the mediastinum, in some areas of the neck, and in the supraclavicular region. The appearance of metastases does not affect life expectancy in esophageal cancer, since rapid and earlier exhaustion is more to blame for the significant deterioration of the patient’s condition.

Diagnostic measures

If a cancerous lesion of the esophagus is suspected, the oncologist prescribes a series of examinations, on the basis of which the final diagnosis is determined.

With contrast agent. This examination allows you to detect narrowing of the esophagus, the location of the tumor, its size, and thinning of the walls.
. Using an endoscope, the doctor examines the entire esophagus, all data is displayed on a computer screen, which allows you to determine the cause of impaired swallowing or other manifestations of the disease. During endoscopy, if necessary, a tissue sample is taken for histology.
Bronchoscopy is necessary to identify metastases in the bronchi, trachea, and vocal cords.
one of the most accurate diagnostic methods. A layer-by-layer examination of the walls of the esophagus makes it possible to determine to what depth the tumor has grown and whether there are metastases in nearby tissues.
Ultrasound is prescribed to detect metastases in internal organs.
– special proteins, the level of which increases during the development of cancer cells. Tumor markers are divided into groups, each of which indicates certain type cancer. A cancerous tumor of the esophagus is characterized by the presence in the blood of tumor markers such as CA 19-9, Tumor marker 2, and squamous cell carcinoma antigen.

It must be remembered that tumor markers in certain situations can also appear in healthy body, therefore, their definition does not provide a reason to accurately diagnose cancer.

How to treat esophageal cancer?

The doctor selects treatment methods for esophageal cancer for his patient, guided by the stage of the pathology, the size of the tumor, and the patient’s age. Apply surgical methods, chemotherapy, radiation exposure. Radiation sessions and chemotherapy may be prescribed before and after surgery.

Surgery involves removing part of the esophagus or the entire organ with tumor-altered tissue. If necessary, part of the stomach is also removed. The esophagus is replaced with part of the intestine or a gastrostomy is formed. There are several types of surgeries performed on patients with esophageal cancer.

Operation

More often used for esophageal cancer the following types operations:

Operation Osawa Garlock. During the operation, an incision is first made in the abdominal cavity and passed along the midline. Usually the beginning of the incision is the navel, and the end is the 7th rib or the angle of the scapula from the side of the sternum. The tissue is dissected and the esophagus is isolated, cutting the pleura. During the operation, the stomach is removed into the pleural cavity. The detected tumor is examined, removed from it by about 8 cm and removed along with the esophagus using a Fedorov clamp. The stomach is fixed in the diaphragm, its food opening.
Torek's operation. From the lateral approach, an incision is made on the right, the skin and tissue are dissected along the sixth intercostal space. First, the organ is isolated, then the cardia is expanded by widening the hole. A suture is placed at the end of the isolated esophagus, catgut and silk threads are used. At the second stage, the patient’s position is changed and he is placed on his back. The neck and area from the collarbone to the deltoid muscle are treated with iodine. From the side of the pleural cavity, the esophagus is isolated. The tumor is cut off along with part of the esophagus. Wounds on the neck and area chest sewn up in layers.
Lewis operation. Resection is carried out in two stages. First, an abdominal approach is made through the midline of the abdomen, after which a revision is performed. A right thoracotomy is then performed with the patient in the left lateral position. The detected tumor is removed along with the esophagus, all lymph nodes must be punctured and the abdominal cavity must be examined for bleeding. It is necessary to install drainage tubes in the pleural cavity and only after this the suturing is performed. The Lewis operation is the most commonly used procedure for esophageal cancer because it is performed in one go. With this type of surgery, it is possible to perform plastic surgery of a partially removed esophagus. Lewis operation is prescribed if there are no metastases.

Diet

Proper nutrition is important during the recovery period for esophageal cancer.

It is necessary to select dishes in such a way that they fully provide the body with everything necessary for normal functioning internal organs components. In this case, you should avoid eating rough food.

Eating pureed food. This facilitates its passage through the esophagus and increases the absorption of nutrients.
Dishes should not contain particles that could block the narrowed lumen.
The total weight of food consumed per day should not exceed 3 kg.
The amount of liquid is limited to 6 glasses, and the liquid included in soups is also taken into account.
The number of meals should be at least 6. In this case, the portions should be small.
The temperature of the food should be medium. Excessively hot and cold foods increase discomfort.

Almost all patients with esophageal cancer experience nutritional deficiencies, which negatively affects the functioning of internal organs and their mental state.

Therefore, it is necessary to adhere to the proposed nutritional principles constantly. The doctor may also recommend a course of use of vitamin-mineral complexes, which will have a positive effect on overall well-being and reduce the likelihood of developing anemia and hypovitaminosis.

Is it possible to cure the pathology?

Esophageal cancer detected at an early stage of development can be cured with combination treatment. In advanced cases from the moment of appearance obvious signs No more than 8 months pass before illness and death. The patient’s life at this time is supported by sessions radiation therapy.

How long do patients live and survival prognosis?

The survival rate of patients with a cancerous tumor in the esophagus after surgery, courses of radiation therapy and chemotherapy is:

At the first stage of cancer, about 90%.
At the second stage – 50%.
On the third – no more than 10%.

The most favorable prognosis is when superficial squamous cell carcinoma is detected. An unfavorable course is observed if cancer forms in the middle section. This is due to the fact that such a tumor quickly grows into the trachea and lungs.

Prevention

WITH for preventive purposes to prevent esophageal cancer, it is necessary to abandon all bad habits and always stick to proper nutrition.

Food must be fortified, plant foods must be present in the diet, spicy and pickled dishes must be limited.

Needs to be addressed in time precancerous conditions esophagus and pass full examination when even the slightest symptoms appear, indicating changes in the functioning of the organ.

Those people whose relatives have a history of cancer of the esophagus should pay special attention to their health.

The following video will tell you about the prevalence, diagnosis and treatment of esophageal cancer:

Video about surgery to remove esophageal cancer using a new technique: