GERD / Esophageal Cancer Surgery

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 difficult swallowing, weight loss and coughing up blood.

Risk factors for developing esophageal cancer include:

  • Smoking
  • Heavy drinking
  • Damage from acid reflux

Treatments include surgery, radiation, and chemotherapy. You might also need nutritional support, since the cancer or treatment may make it hard to swallow.

Esophageal cancer is not very common in the United States. It occurs most often in men over 50 years old.

Two main types of esophageal cancer exist: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope.

Squamous cell esophageal cancer is linked to smoking and alcohol consumption.

Barrett’s esophagus, a complication of gastroesophageal reflux disease (GERD), increases the risk for adenocarcinoma of the esophagus. This is the more common type of esophageal cancer. Other risk factors for adenocarcinoma of the esophagus include:

  • Male gender
  • Obesity
  • Smoking

Symptoms:

  • Backwards movement of food through the esophagus and possibly mouth (regurgitation)
  • Chest pain unrelated to eating
  • Difficulty swallowing solids or liquids
  • Heartburn
  • Vomiting blood
  • Weight loss

Exams and Tests

Tests used to help diagnose esophageal cancer may include:

  • Barium swallow
  • Chest MRI or thoracic CT (usually used to help determine the stage of the disease)
  • Endoscopic ultrasound (also sometimes used to determine the stage of disease)
  • Esophagogastroduodenoscopy (EGD) and biopsy
  • PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible)

Treatment

When esophageal cancer is only in the esophagus and has not spread, surgery is the treatment of choice. The goal of surgery is to remove the cancer.

Sometimes chemotherapy, radiation, or a combination of the two may be used instead of surgery, or to make surgery easier to perform.

If the patient is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable.

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