Esophageal Cancer

What is Esophagus?

The tube that attaches the throat to the stomach is known as the esophagus. This 10-inch long muscular tube is a part of the digestive tract from where the food travels from the esophagus to the stomach.

The esophagus is comprised of four layers that include –

Outer Layer:

The esophagus is covered by this outer layer.

Inner Layer or Lining:

This layer helps in passing the food to the stomach as this layer is properly moist.

Muscle Layer:

This layer helps in pushing down the food to the stomach.

Submucosa:

Mucus is made by the glands present in this layer. This mucus moisturizes the esophagus.

What is Esophageal Cancer?

The uncontrollable growth of cancer cells in the esophagus causes esophageal cancer. This cancer begins at the inner layer of the esophagus that can spread further to the other layers of the esophagus and also to different body parts. Esophageal cancer has been categorized into two types that include –

Bladder Cancer Rarer Types

Adenocarcinomas and squamous cell cancer are considered as the rarer types of bladder cancer. Both of them are invasive bladder cancer. Adenocarcinomas begin from the glandular cells while squamous cell begins from other type of cell in the lining of the bladder.

Symptoms of Colon Cancer

The early symptoms of colon cancer include –

  • Unexplained weight loss
  • Bleeding from the rectum or blood in the stools
  • Abdominal pain
  • Change in normal bowel habits that continue for more than 3 weeks including

passing of stools more frequently, diarrhea or constipation Sometimes bleeding happens when the colon cancer progresses. Gradually, there will be not enough red blood cells in the body that is called as anemia. Following are some of the symptoms of anemia –

  • Breathlessness
  • Fatigue

The early symptoms of colon cancer include –

  • Vomiting
  • A feeling of bloating, especially near the belly button
  • Constipation
  • Abdominal pain

Stages of Colon Cancer

Stage 1:

In the first stage, cancer has not spread further than the original tumor.

Stage 2:

The second stage is marked by the growth of tumors through the bowel wall that are close to the tissues. However, this growth has not spread to any part of the body.

Stage 3:

In the third stage, there are tumor cells close to the lymph nodes

Stage 4:

The last stage is marked by the spread of the tumor to other parts of the body.

Diagnosis of Colon Cancer

A number of tests are performed for diagnosing colon cancer that include –

  • Carcinoembryonic Antigen (CEA) Assay :
  • CEA levels in the blood are measured in this test. The normal as well as cancer cells release CEA in the bloodstream. When these CEA is found in large amounts then it indicates colon cancer.
  • Proctoscopy:
  • A proctoscope (a thin and tube-like instrument having light and lens for viewing) is inserted into the rectum in this rectum test. Sometimes removal of the tissue is also done by using a tool in order to check the presence of a disease by examining under a microscope.
  • Physical Examination and History:
  • This is done for examining the general signs of health and also for seeing any indications of disease that may include lumps. Proper evaluation of the history of a patient is done that include past illnesses and treatments taken.
  • Colonoscopy:
  • This test is performed for viewing the colon and rectum from within in order to see the presence of cancer, polyps or abnormal areas.
  • Digital Rectal Exam (DRE):
  • This is considered as a test of the rectum. The insertion of the gloved and lubricated finger is done into the lower part of the rectum for viewing the presence of lumps. Vagina is examined in case of women.
  • Biopsy:
  • The signs of cancer are checked by removing tissues or cells that are then examined under a microscope. The removal of tissue at the time of biopsy is helpful in checking the gene mutation in a patient that is responsible for causing HNPCC. The other two tests include –
  • Immunohistochemistry Study :
  • Certain antigens are checked by using some substances such as radioisotope, dye or an antibody and they are then added to a tissue sample.
  • Reverse-Transcription Polymerase Chain Reaction (RT-PCR) Test :
  • Function of genes or the changes in the structure in a tissue sample are examined by using certain types of chemicals.

Certain other tests are also required for finding the cancer cells that have spread inside the rectum and colon or possibly to other body parts that include –

  • Carcinoembryonic Antigen (CEA) Assay
  • Chest x-ray
  • Positron Emission Tomography Scan (PET)
  • CT scan
  • Endoscopic Ultrasound (EUS)
  • Magnetic Resonance Imaging (MRI)

Treatment of Colon Cancer

There are six treatment options for colon cancer that include –

Targeted Therapy :

Certain substances and drugs are used by the targeted therapy in order to target particular cancer cells without causing any harm to nearby normal cells. The two types of targeted therapy include –

  • Angiogenesis Inhibitors:
  • This helps in stopping the growth of new blood vessels which tumors need to grow.
  • Monoclonal AntibodiesAngiogenesis Inhibitors:
  • These antibodies are prepared in the laboratory with the help of a single type of immune system. Certain substances can be identified by these antibodies that are on the cancer cells or it also indentifies certain normal substances that are helping in the growth of cancer cells. These antibodies then attach themselves with the substances for destroying cancer cells and also prevent them from spreading.

Chemotherapy:

Certain types of drugs are used for stopping the growth of cancer cells or for destroying the cancer cells. The injection of these drugs is done into a vein from where they enter the bloodstream and they then travel through the entire body.

Radiation Therapy:

High-energy beams are used for destroying cancer cells. Internal radiation and external radiation are the two types of radiation therapy. A radioactive substance that is sealed in catheters, needles wires or seeds is placed close to the cancer in the case of internal radiation. On the other hand, linear accelerators outside the body are used for sending radiation to the cancer in the case of external radiation. The type of radiation depends on the stage and type of the cancer.

Surgery:

The surgical procedure involves the removal of diseased segment with sufficient margins, surrounding lymph nodes and tissue. Following are some of the types of surgeries performed –

  • Pelvic Exenteration:
  • The removal of lower rectum, bladder and colon are done when the cancer has spread to different organs nearby the rectum. In the case of women, nearby lymph nodes, vagina, ovaries and cervix are removed. The prostate is removed in the case of men. For flowing the urine and stool out of the body, artificial openings are made in order to collect them in a bag.
  • Polypectomy:
  • During a colonoscopy, a polyp is removed if the cancer is found inside a polyp.
  • Resection:
  • The removal of nearby healthy tissue and a section of the rectum having cancer is done when the cancer has spread to the wall of the rectum.
  • Local Excision:
  • A small amount of nearby healthy tissue and the cancer is removed when the cancer has spread to the inside surface of the rectum and also has not spread into the rectum wall.

Sometimes chemotherapy or radiation therapy is provided after surgery in order to shrink the tumor. This makes the removal of the tumor easy while simultaneously lessening the problems associated with bowel control after surgery. Neoadjuvant therapy is the name given to the treatment that is given before the surgery.

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