Esophageal cancer overview: Difference between revisions
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{{Esophageal cancer}} | {{Esophageal cancer}} | ||
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==Overview== | ==Overview== | ||
'''Esophageal cancer''' is [[cancer|malignancy]] of the [[esophagus]]. There are various subtypes. Esophageal tumors usually lead to [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]] and are diagnosed | '''Esophageal cancer''' is [[cancer|malignancy]] of the [[esophagus]]. There are various subtypes. Esophageal tumors usually lead to [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]] and are diagnosed by carrying out a [[biopsy]]. Esophageal cancer must be differentiated from [[gastroesophageal reflux disease]] (GERD), [[Barrett's esophagus]], [[esophageal achalasia]], [[gastritis]], [[gastric ulcer]], and [[stomach cancer]]. Common risk factors in the development of esophageal cancer are [[tobacco smoking]], [[alcohol]], [[gastroesophageal reflux disease]], and [[barrett's esophagus]]. Small and localized tumors are treated with [[surgery]], and advanced tumors are treated with [[chemotherapy]], [[radiation therapy|radiotherapy]] or a combination of both. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor. | ||
==Classification== | ==Classification== | ||
Esophageal cancer may be classified into [[squamous cell carcinoma]] or [[adenocarcinoma]] based on [[histology]]. | Esophageal cancer may be classified into [[squamous cell carcinoma]] or [[adenocarcinoma]] based on [[histology]]. | ||
== | ==Pathophysiology== | ||
The pathophysiology of esophageal cancer depends on the histological subtype. | The pathophysiology of esophageal cancer depends on the histological subtype whether squamous cell carcinoma or adenocarcinoma. | ||
==Differential diagnosis== | ==Differential diagnosis== | ||
Esophageal cancer must be differentiated from [[gastroesophageal reflux disease]] (GERD), [[Barrett's esophagus]], [[esophageal achalasia]], [[gastritis]], [[gastric ulcer]], and [[stomach cancer]]. | Esophageal cancer must be differentiated from [[gastroesophageal reflux disease]] (GERD), [[Barrett's esophagus]], [[esophageal achalasia]], [[gastritis]], [[gastric ulcer]], and [[stomach cancer]]. | ||
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Esophageal cancer is associated with a 5 year survival rate of 20%. | Esophageal cancer is associated with a 5 year survival rate of 20%. | ||
==Staging== | ==Staging== | ||
According to the American Joint Committee on Cancer, there are 4 stages of esophageal cancer based on the tumor spread. | According to the American Joint Committee on Cancer, there are 4 stages of esophageal cancer based on the different degrees of tumor spread. | ||
==History and Symptoms== | ==History and Symptoms== | ||
Symptoms of esophageal cancer include [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]]. | Symptoms of esophageal cancer include [[dysphagia]], [[odynophagia]], [[weight loss]], and [[hematemesis]]. | ||
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==Primary Prevention== | ==Primary Prevention== | ||
Effective measures for the primary prevention of esophageal cancer include the treatment of [[gastroesophageal reflux disease]] and [[Barrett's esophagus]], [[weight loss]], avoidance of tobacco and [[alcohol]], and a diet rich in fruits and vegetables. | Effective measures for the primary prevention of esophageal cancer include the treatment of [[gastroesophageal reflux disease]] and [[Barrett's esophagus]], [[weight loss]], avoidance of tobacco and [[alcohol]], and a diet rich in fruits and vegetables. | ||
==Secondary Prevention== | |||
High risk populations, such as those in Hishun village, China, who had evidence of dysplasia on cytology were treated with monoclonal antibodies. The incidence of esophageal cancer was decreased by 53%. | |||
==References== | ==References== | ||
Revision as of 14:04, 11 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Esophageal cancer is malignancy of the esophagus. There are various subtypes. Esophageal tumors usually lead to dysphagia, odynophagia, weight loss, and hematemesis and are diagnosed by carrying out a biopsy. Esophageal cancer must be differentiated from gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal achalasia, gastritis, gastric ulcer, and stomach cancer. Common risk factors in the development of esophageal cancer are tobacco smoking, alcohol, gastroesophageal reflux disease, and barrett's esophagus. Small and localized tumors are treated with surgery, and advanced tumors are treated with chemotherapy, radiotherapy or a combination of both. Prognosis depends on the extent of the disease and other medical problems, but is fairly poor.
Classification
Esophageal cancer may be classified into squamous cell carcinoma or adenocarcinoma based on histology.
Pathophysiology
The pathophysiology of esophageal cancer depends on the histological subtype whether squamous cell carcinoma or adenocarcinoma.
Differential diagnosis
Esophageal cancer must be differentiated from gastroesophageal reflux disease (GERD), Barrett's esophagus, esophageal achalasia, gastritis, gastric ulcer, and stomach cancer.
Epidemiology and Demographics
The majority of esophageal cancer cases are reported in the “Asian belt” area which includes China, Japan, India, Iran, Turkey, among other Middle Eastern countries.
Risk Factors
Common risk factors in the development of esophageal cancer are tobacco smoking, alcohol, gastroesophageal reflux disease, and Barrett's esophagus.
Prognosis
Esophageal cancer is associated with a 5 year survival rate of 20%.
Staging
According to the American Joint Committee on Cancer, there are 4 stages of esophageal cancer based on the different degrees of tumor spread.
History and Symptoms
Symptoms of esophageal cancer include dysphagia, odynophagia, weight loss, and hematemesis.
Physical examination
Physical examination of patients with esophageal cancer is usually unremarkable.
Laboratory Findings
There are no diagnostic lab findings associated with esophageal cancer.
CT
CT scan may be diagnostic of esophageal cancer. Findings on CT scan suggestive of esophageal cancer include either eccentric or circumferential wall thickening or peri-esophageal soft tissue and fat stranding.
MRI
There are no MRI scan findings associated with esophageal cancer.
Other Imaging Findings
Other imaging studies for esophageal cancer include barium swallow. Findings on barium swallow suggestive of esophageal cancer include irregular strictures, pre-stricture dilatation with 'hold up', and shouldering of the strictures.
Other Diagnostic Studies
Other diagnostic studies for esophageal cancer include FDG-PET (positron emission tomography) scan and endoscopic ultrasound (EUS).
Medical Therapy
The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy and radiation may be required. Drugs approved for the treatment of esophageal cancer include Ramucirumab, Docetaxel, Trastuzumab, and Ramucirumab.
Surgery
The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy and radiation may be required.
Primary Prevention
Effective measures for the primary prevention of esophageal cancer include the treatment of gastroesophageal reflux disease and Barrett's esophagus, weight loss, avoidance of tobacco and alcohol, and a diet rich in fruits and vegetables.
Secondary Prevention
High risk populations, such as those in Hishun village, China, who had evidence of dysplasia on cytology were treated with monoclonal antibodies. The incidence of esophageal cancer was decreased by 53%.