Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. However, as the cancer grows, symptoms may include painful or difficulty in swallowing, weight loss and coughing up blood. Risk factors for developing esophageal cancer include:
• Squamous Cell Carcinoma : Cancer that forms in squamous cells, the thin, flat cells lining the esophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
• Adenocarcinoma : Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.
• Barium Swallow with X-ray : In a barium swallow, patients swallow a special liquid containing barium that coats the esophagus.
• Upper Endoscopy : In an upper endoscopy, a thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus. The endoscope allows the physician to view the inside of the esophagus, as well as to insert instruments through the scope for the removal of a tissue sample for biopsy.
• Endoscopic Ultrasound (EUS) : EUS is a test that helps physicians determine the extent to which tumors have penetrated the esophagus and nearby lymph nodes.
• CT : A CT scan is a noninvasive imaging test that combines X-rays and computer technology to produce images of the body. In addition to showing tumors of the esophagus, a CT scan can assist doctors in determining if the cancer has spread into other organs, such as the lungs or liver.
• PET : PET is a sophisticated, noninvasive imaging test that measures the metabolic activity of cells. PET aids physicians in finding cancerous tissue that may not show up on X-rays or other tests.
• Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy is usually done during an esophagoscopy. Sometimes a biopsy shows changes in the esophagus that are not cancer but may lead to cancer.
• Laparoscopy and Thoracoscopy : Laparoscopy and Thoracoscopy are surgical procedures that involve the use of special thin instruments equipped with a light and camera that are inserted into the body to look for tumors or gather tissue for biopsy.
• Surgery : Surgery is commonly used to treat esophageal cancer that has not spread beyond the esophagus and its surrounding lymph nodes. The goal of the operation is to remove the cancer and nearby tissue that may be affected. In an esophagectomy, the surgeon removes part of the esophagus, nearby lymph nodes, and possibly part of the stomach. The remaining part of the esophagus is then connected to the stomach.
• Chemotherapy : Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.
• Radiation therapy : The use of high-energy rays to damage cancer cells, stopping them from growing and dividing. Like surgery, radiation therapy is a local treatment that affects cancer cells only in the treated area. Radiation can come from a machine (external radiation) or from a small container of radioactive material implanted directly into or near a tumor (internal radiation).
• Photodynamic Therapy : A form of treatment that uses a photosensitizing agent, administered by mouth or intravenously, which concentrates selectively in certain cells, followed by exposure of the involved tissue to a special light (such as laser or ultraviolet light), in order to destroy as much of the abnormal tissue as possible. For example, photodynamic therapy is used to treat some forms of cancer and psoriasis.
For some early (small) cancers, the esophagus can be removed through several small incisions instead of 1 or 2 large incisions. The surgeon puts a scope (like a tiny telescope) through one of the incisions to see everything during the operation. Then the surgical instruments go in through other small incisions. In order to do this type of procedure well, the surgeon needs to be highly skilled and have a great deal of experience removing the esophagus this way. Because it uses smaller incisions, minimally invasive esophagectomy may allow the patient to leave the hospital sooner and recover faster.
Occasionally, the surgeon is unable to do the procedure laparoscopically and must convert to open surgery in order to make it safer for you. In this case, you will have an incision in the middle of your abdomen and your recovery will be longer. To help prevent blood clots from forming in your legs during and after surgery, sequential compression stockings may be applied.
What is the Benefit of Minimally Invasive Esophageal Cancer Surgery?
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