Esophageal Cancer

Although a cure is possible, treatment for esophageal cancer takes place over an extended period of time, which infringes on quality of life. The treatment options include esophagectomy, a procedure to remove all or part of the esophagus. This method carries a high rate of mortality. Nonsurgical treatment includes radiation and chemotherapy, either alone or concurrently.

Esophageal Cancer is Subdivided into Two Categories

  • Adenocarcinoma, which makes up 50 percent of all new cases. It is linked to the development of a condition called gastroesophageal reflux disease (GERD). This occurs when the amount of stomach acid that flows backwards into the esophagus is greater than the normal limit. This backwards flow, or reflux, can lead to Barrett’s esophagus, in which the lining of the esophagus becomes damaged, and normal mature cells are replaced with immature abnormal ones.
  • Squamous cell carcinoma, which is linked to smoking and alcohol consumption.

Patients with Early Stage Disease are Asymptomatic

Patients do not initially present with symptoms; however as the disease progresses, the following symptoms may appear:

  • Difficulty swallowing
  • Weight loss
  • Chest pain or pressure
  • Fatigue
  • Frequent choking during meals
  • Indigestion or heartburn
  • Persistent coughing or hoarseness

Other Causes of Esophageal Cancer

  • Vitamin and nutritional deficiencies, especially riboflavin (Vitamin B2)
  • Human papillomavirus (HPV) infection
  • Tylosis palmaris et plantaris, a genetic disorder in which there is thickening of the palms and soles and white patches in the mouth

Asbestos Exposure Linked to Esophageal Cancer

In 2005, the Institute of Medicine, which is a division of the National Academies, published a report titled “Asbestos: Selected Cancers” that investigated the relationship between asbestos and certain cancers. Here is what it said about esophageal cancer:

“Because of the relative rarity of esophageal cancer, few cohort studies presented data explicitly on this endpoint; and when they did, the statistical precision was routinely low. The results of the 20 citations that presented information on esophageal cancer in 25 cohort populations were mixed. Berry et al. (2000) and Selikoff and Seidman (1991) saw strong evidence of increased risk with any exposure, while Meurman et al. (1994) and Peto et al. (1985) found some evidence of a dose-response relationship (the greater the exposure, the higher the risk). Findings from the remaining studies either were close to null (insignificant), presented mixed or inconsistent results, or indicated lower than expected risks.”

A later study than those mentioned in the above citation titled “Occupational Exposures and Risk of Oesophageal Cancer by Histological Type: a Case-Control Study in Eastern Spain”, published November 2008 in Occupational and Environmental Medicine found that asbestos exposure increased the overall risk for esophageal cancer.

The researchers collected data from 185 newly diagnosed male esophageal cancer patients and 285 healthy individuals from several hospitals in two Mediterranean provinces of Spain. Their observations led them to discover that a three-fold increase in risk for esophageal cancer was associated with asbestos exposure.

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