Esophageal Cancer, Symptoms, Prognosis And Survival Rate

Esophageal cancer is a malignant tumor of the esophagus or the food pipe that conveys food from the mouth to the stomach. The tumor can affect any part of the esophagus; however, by and large, statistics say, that the cancer predominantly occurs in the lower portion of the esophagus.

When the DNA of the cells gets damaged, the cells lining the esophagus start multiplying out of control, eventually resulting in malignant cancer. Chronic acid reflux, chewing tobacco, smoking, and heavy alcohol intake, cause oxidative damage to the DNA, thus initiating tumor formation.

An Overview of Esophageal Cancer Symptoms

During the early stages of the disease, esophageal cancer symptoms are relatively obscure. The patient is usually asymptomatic, i.e., he may not demonstrate any esophageal cancer symptoms.

With a progression of the disease, the patient experiences dysphagia or difficulty in swallowing. Patients complain of this symptom when the cancer has constricted the tube to half its normal size. Initially, swallowing solids is difficult, but, gradually, it becomes difficult to swallow liquids as well.

Weight loss occurs. Cancer causes muscle wasting and weight loss; because it alters the way in which nutrients are metabolized by the body. Also, dysphagia triggers poor dietary pattern and the consequent weight reduction.

Pain is one of the important esophageal cancer symptoms. Pain occurs in the throat, chest and / or between the shoulder blades.

Food sticking in the throat is a significant symptom.

Heart burn and discomfort in the chest, during swallowing are other esophageal cancer symptoms.

Hoarseness of voice, vomiting of blood, constant hiccups and passing blood in the stool are clinical manifestations that appear when the cancer has reached an advanced stage.

It is advisable that you report even the mildest of symptoms to your doctor. Neglecting them can have grave repercussions. Detecting cancer in the early stages helps manage it better. Furthermore, esophageal cancer tends to spread to the surrounding structures and also via blood and lymph, thus affecting distant organs.

Treatment depends on the type of esophageal cancer, the location and spread, and the stage of cancer. Age and general health are also important determining factors.

Surgical excision of the tumor and a part of the esophagus is usually the treatment strategy. Non invasive techniques such as radiotherapy and chemotherapy are also utilized to bring about complete cure. In general, doctors integrate surgery, radiation therapy and chemotherapy to help manage the case effectively and successfully. Additionally, following an optimal nutritional plan and including certain home remedies in to the daily diet alleviate the symptoms of the cancer and help meet the daily nutritive requirement.

The successful management of esophageal cancer demands satisfactory knowledge about the symptoms of the disease, and an early identification of the condition. Certain symptoms of esophageal cancer are rather prominent, while some are not easy to detect. Early diagnosis and timely management is the only way to curb its progress.

Esophageal Cancer Symptoms
Image source : verywell

Esophageal Cancer

The esophagus or the food pipe is a10 inch long tube that conveys food from the mouth to the stomach. When the DNA of the cells lining the esophagus gets damaged, the cells start multiplying autonomously and uncontrollably, and ultimately results in a mass of malignant cells.

Esophageal Cancer Causes

  • Excessive intake of alcohol: chronic alcoholism is a key factor that causes esophageal cancer.
  • Tobacco: chewing or smoking tobacco significantly increases the risk of esophageal cancer.
  • Acid reflux of long standing: when the LES or the lower esophageal sphincter becomes weak and permits an acid reflux in to the esophagus, the risk of developing carcinoma of the esophagus is very high.
  • Diet: a diet which is lacking in fresh vegetables and fruits, leads to cancer of the esophagus.
  • Obesity: obese individuals are at a high risk of developing esophageal cancer.

Esophageal Cancer Symptoms

By and large, in the initial phase of the disease, the symptoms are slightly obscure, or the patient may even be asymptomatic. However, these are commonly occurring symptoms of esophageal cancer:

  • The chief symptom is a difficulty in swallowing solid foods.
  • Eventually swallowing liquids becomes difficult too.
  • Sudden, excessive weight loss is another important sign of esophageal cancer
  • Pain while swallowing occurs in a large number of patients.
  • Other symptoms to watch out for are: food sticking in the esophagus, passing blood in stools, vomiting blood and chest pain.

Esophageal Cancer Treatment

Management of esophageal cancer largely depends on the stage at which the condition is diagnosed, the location and the extent of spread, the patient’s age, and his overall health.

Generally, surgeons use a combination of surgery, radiation therapy and chemotherapy to manage the case.

  • Surgery: based on the location and type of cancer, a part or the whole esophagus is removed. This is called Esophagectomy. Occasionally, the esophagus along with some portion of the upper stomach needs to be removed. This operation is called Esophago-gastrectomy.
  • Chemotherapy: along with the surgery, certain drugs are administered to destroy the cancer cells.
  • Radiation Therapy: is the principal form of treatment for cancer of the esophagus. It is used to reduce the size of the tumor before the surgical procedure.
  • Photodynamic Therapy: relieves obstruction and pain. A light-sensitive drug that can stay in the cancer cells for a longer period of time than it can stay in the healthy cells is administered. Using an endoscope, a laser light is directed at the esophagus. This triggers the synthesis of an active form of oxygen which destroys the tumor cells, whilst protecting the healthy cells.

Esophageal Cancer Prognosis

Esophageal cancer develops when the DNA of the cells undergo oxidative damage. The cells start multiplying autonomously and uncontrollably, and a tumor mass develops.

The cancer is categorized in to 2 types – squamous cell carcinoma and adenocarcinoma. In squamous cell carcinoma, the upper part of the esophagus near the mouth is affected, whereas, in adenocarcinoma, the lower part of the tube, near the stomach, gets affected.

Understanding Esophageal Cancer Prognosis

  • Esophageal cancer prognosis is largely dependent upon the stage at which the tumor is identified, the location and spread of the cancer, age of the patient and the general health condition.
  • In the preliminary stages of the disease, i.e. stages 0 – 3, the spread of the tumor may be limited, through surgery and chemo-radiotherapy. But stage 4 is irreversible, since metastasis or spread to distant organs has taken place.
  • Early diagnosis of the cancer plays a very crucial role in increasing the chances of survival and determining esophageal cancer prognosis.
  • On the whole, esophageal cancer prognosis is not very good, particularly for stage 4. This is primarily due to the fact that the symptoms of esophageal cancer are somewhat obscure in the beginning, making diagnosis difficult. Diagnosis is often made at an advanced stage, when metastasis has already occurred. By the time the patient complains about dysphasia or difficulty in swallowing, the cancer has progressed considerably.
  • Esophageal cancer stages 0 – 3 are clinically seen as metastasis to the surrounding lymph nodes and adjacent organs. In stage 4, the cancer cells spread throughout the body, even to distant organs. Consequently, stage 4 esophageal cancer prognosis is relatively poor.
  • The survival rate of the patient also depends up the stage of the cancer. The overall survival rate for esophageal cancer is less than 20%.
  • Patients with cancer restricted to the esophageal mucosa have 80% 5 year survival rate, those with spread to adjacent structures have 7% 5 year survival rate, while, the survival rate for the stage 4 is less than 5%.

Once the diagnosis is made, therapy is started promptly. The patient is put on to medications, and an-easy-to swallow-and-digest diet plan, comprising of soups, porridge, juices, yogurt, barley water, and purees. Nutritional supplements are prescribed to maintain the overall health and provide the daily nutritional requirement. The physician decides on the most appropriate line of treatment, which may consist of surgery, chemotherapy and radiation therapy.

Esophageal Cancer Survival Rate

Esophageal cancer is a malignancy of the food pipe, and is characterized by the development of cancerous cells within the esophagus. The prominent causes for esophageal cancer are chewing tobacco, smoking and excessive alcohol consumption. Diagnosis is made on the basis of the symptoms and certain diagnostic procedures like endoscopy, biopsy, and chest X-ray.

Statistics say that males are a lot more susceptible to esophageal cancer than females. The incidence of the cancer increases with age, and is highest amongst people in the age group of 55 – 80 years.

On an average, the esophageal cancer survival rate for all stages, combined, is about 17%.

Understanding Esophageal Cancer Survival Rate

In general, esophageal cancer survival rate is relatively low. The survival rate depends up on the stage at which the cancer is discovered, the age and general health of the patient and the choice of treatment. The survival rate decreases with each passing stage.

Below are mentioned the esophageal cancer survival rate according to the stage of the disease:

  • Stage 0: in this stage, the cancerous cells are limited to the epithelium / the inner most layer of the esophagus. The 5 year survival rate for this stage of esophageal cancer is 70%.
  • Stage 1: in this stage, the cells invade beyond the epithelium in to the sub-mucosa of the esophagus. The 5 year esophageal cancer survival rate is 60%.
  • Stage 2A: in stage 2A, the cancer cells invade the muscle layer of the esophagus. The 5 year survival rate is about 40%.
  • Stage 2B: in this stage, the cells extend beyond the epithelium, but have not yet invaded the adventitia. The 5 year esophageal cancer survival rate is 20%.
  • Stage 3: in stage 3, the cells have extended to the adventitia and spread to the surrounding lymph nodes and / or even to the adjacent organs. The 5 year esophageal cancer survival arte is 15%.
  • Stage 4A: is characterized by the spread of the cancer cells to distant lymph nodes. The survival rate is about 15%.
  • Stage 4B: is characterized by a spread of the cancer cells to the distant lymph nodes and / or other organs. The 5 year survival rate is below 5%.

Thus, early diagnosis of the condition plays a pivotal role in the prognosis and determining the survival rate for esophageal cancer. Doctors may opt for surgical intervention along with radio-chemotherapy to help manage the case effectively.

Symptoms of Esophageal Cancer

Esophageal cancer is a malignant tumor of the cells lining the esophagus. The tumor arises when the DNA of the cells gets impaired and they replicate out of control, autonomously. Smoking, chewing tobacco and consuming excessive amounts of alcohol are common triggers for esophagus cancer.

In general, during the early stages of the disease, the patient is asymptomatic, i.e. he does not experience any symptoms. As the condition progresses, however, the following symptoms of esophageal cancer become evident:

  • Dysphagia or difficulty in swallowing: dysphasia is one of the first symptoms of esophageal cancer to occur; it develops when the tumor cells have occluded half of the esophagus. The patient experiences discomfort and difficulty while swallowing food. Initially, he can not swallow solids, however, as the disease advances, swallowing liquids becomes difficult as well.
  • Weight loss: reduction in weight is another major symptom. The patient’s diet gets affected, he can not eat adequately, and hence considerable weight loss occurs. Also, cancer causes muscle wasting and weight loss, since, the way nutrients are utilized by the body get seriously affected.
  • Pain: pain in the throat, the mid chest or in between the shoulder blades are other accompanying symptoms of esophageal cancer.
  • Patients also complain of hoarseness, heartburn, hiccups, blood in stool and vomiting of blood; these symptoms manifest when the cancer has reached an advanced stage.

Esophagus Cancer Treatment

Diagnosing the symptoms of esophageal cancer early, and promptly deciding on the line of treatment is necessary to manage esophagus cancer.

Treatment for esophageal cancer comprises of surgical procedures, along with radio-chemotherapy.

The surgeon may remove a part / whole of the esophagus (esophagectomy) or remove a part of the esophagus along with the upper portion of the stomach (esophago-gastrectomy). Alongside, the doctor will make use of non invasive techniques like chemotherapy and radiation therapy to fight the cancer effectively.