Esophageal cancer

Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia (difficulty swallowing), pain and other symptoms, and is diagnosed with biopsy. Small and localized tumors are treated with surgery, and advanced tumors are treated with chemotherapy, radiotherapy or combinations. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.

Cause and risk factors

There are a number of risk factors for esophageal cancer. Some subtypes of cancer are linked to particular risk factors:

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• Age and sex. Most patients are over 60, and it is more common in men.
• Tobacco smoking and heavy alcohol use increase the risk, and together appear to increase the risk more than these two individually.
• Swallowing lye or other caustic substances
• Particular dietary substances, such as nitrosamine
• A medical history of other head and neck cancers increases the chance of developing a second cancer in the head and neck area, including esophageal cancer.
• Plummer-Vinson syndrome (anemia and esophageal webbing)
• Tylosis and Howel-Evans syndrome (hereditary thickening of the skin of the palms and soles)
• Gastroesophageal reflux disease (GERD) and its resultant Barrett's esophagus increase oesophageal cancer risk due to the chronic irritation of the mucosal lining (adenocarcinoma is more common in this condition), while all other risk factors predispose more for squamous cell carcinoma.

Risk appears to be less in patients using aspirin or related drugs (NSAIDs). Statistically, it appears that Helicobacter pylori, known for increasing risk for gastric cancer, actually decreases the risk of esophageal cancer (O'Connor 1999); the exact mechanism for this phenomenon is unclear.

Related Topics:
Aspirin - NSAID - Helicobacter pylori - Gastric cancer

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