The oesophagus is a hollow muscular tube that is a passage way for food and liquid from the throat to the stomach. Oesophageal cancer starts in the inner lining of the oesophagus which is made up of several layers; a mucous membrane, muscle and connective tissue. As the cancer grows, it spreads to the outer layers. The most common types of oesophageal cancer are squamous cell carcinoma and adenocarcinoma.
Even though the exact cause of this cancer is not known, tobacco use and excessive alcohol intake are common risk factors for oesophageal cancer. Symptoms may include coughing, difficulty swallowing and unexplained weight loss. Biopsy, endoscopy and other imaging tests like positron emission tomography (PET) and computerised tomography (CT) scans. Treatments of this cancer include surgery, chemotherapy and radiation therapy, among other options depending on the stage of the cancer and other factors like the patient’s preference.
Oesophageal Cancer Staging
Doctors or specialists use the TNM system to categorise the cancer according to stages. This system determines;
- Tumour (T): Checking how far the tumour has grown into the oesophagus wall and surrounding tissue,
- Nodes (N): Whether the tumour has spread to the nearby lymph nodes, and
- Metastasis (M); Whether the cancer has spread to other parts of the body.
- Stage 0; The cancer is only in the top lining of the oesophagus
- Stage I: The cancer is found only in the top layers of the oesophagus.
- Stage II: The cancer is in the top layers of the oesophagus but the tumour cells are differentiated or in the third layer of the oesophagus, but has not spread to the lymph nodes or to any other body parts.
- Stage III: In this stage, the cancer has spread beyond the oesophagus and nearby lymph nodes to surrounding tissues. However, it has not spread to other organs.
- Stage IV: The cancer in this stage, is said to have metastasized; that is, it has spread not just to surrounding tissue but also to other parts of the body.
International Medical Treatment Ltd (IMT) partners with some of the leading hospitals in the world which provide advanced cancer treatments using the latest state-of-the-art technology. Treatments for oesophageal cancer include:
- Surgery: It is usually the first treatment and the most common for oesophageal cancer, offered to remove tumour or the affected part of the oesophagus (esophagectomy). In other cases, esophagogastrostomy can be done to remove part of the oesophagus and a portion of the stomach. However, it is mostly done for patients who have early-stage oesophageal cancer. In esophagectomy, the remaining healthy part of the oesophagus is connected to the stomach to enable normal swallowing to continue even after surgery.
- Radiotherapy: Use of high energy beams to destroy cancer cells and keep them from growing and spreading further.
- Chemotherapy: This common cancer treatment option is done using anti-cancer drugs to kill cancer cells and just like in radiation, with the aim of stopping the growth and spread of cancer cells.
Other therapies that use medication:
- Targeted therapy: This is basically a more specific type of chemotherapy which targets the specific proteins, genes and other factors that enable the growth of cancer cells. By blocking these factors, the growth and spread of cancer cells is controlled while the damage to normal healthy cells is limited.
- Immunotherapy: Once cancer begins to grow in the body, the immune system may not detect them. Through immunotherapy, which uses materials produced by the body or manufactured in a laboratory, the body’s immune system, responsible for fighting infections, is boosted. This improves or restores the immune system’s function prompting it to fight cancer cells in the body.
What makes our partner hospitals preferable in getting the accurate diagnosis and treatment of oesophageal cancer and other types of cancers, is the equipment used such as:
- Computerised tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans are advanced diagnostic methods used in producing detailed images of internal parts of the body which help the doctor or specialist have a clear representation of what is going on inside the body. Through these images, treatment can be more specific and therefore, precise.
- The da Vinci Robotics surgical system which can be used to perform surgery to treat oesophageal cancer. This system makes the procedure more precise and allows for faster recovery, hence, shorter hospital stays due to the fact that small incisions are made during the surgery unlike in traditional surgery. This system also allows for the surgeon to operate on even the difficult-to-reach parts.
- The Volumetric Modulated arc Therapy (VMAT) also known as the intensity modulated radiation therapy (IMRT) is a more advanced therapy for cancer which enables the radiation to be administered 360 degrees around the patient. This therapy makes it possible to control the speed, rotation and amount of radiation to reduce exposure of radiation to the normal tissue.
It refers to care offered to patients who have metastatic oesophageal cancer; meaning, cancer that has spread to other parts of the body. The purpose of palliative or supportive care is to help relieve symptoms and side effects of cancer, thereby, improving quality of life for the patient. Some of the treatments that can be done for patients with metastatic oesophageal cancer are:
- Surgery is done to help the patient eat and relieve symptoms caused by the cancer. The two ways this can be done are by:
1. Putting a feeding tube also known as a percutaneous gastrostomy or jejunostomy to receive food directly into the stomach.
2. Creating a bypass to the stomach in cases where, the tumour is blocking the oesophagus but surgery is not possible.
- Endoscopic Therapy: An endoscope can be used to manage side effects caused by the tumour. These treatments include:
1. Endoscopy with stent placement: A stent is inserted into the oesophagus which is expanded to keep the oesophagus open.
2. Endoscopy and dilation: This procedure also expands the oesophagus and can be repeated if the tumour grows.
3. Cryotherapy: A probe is attached to an endoscope which is then used to freeze or remove the tumour tissue and that can reduce the size of the tumour enabling the patient to swallow better.
4. Electrocoagulation: Uses electric current to kill the cancer cells, thereby, relieving symptoms as it removes the blockage caused by the tumour.