Esophageal Cancer

Overview of Esophageal Cancer

Esophageal cancer is the cancer of the esophagus which if not treated can metastasize. The 5-year survival rate in Pakistan is less than 15 percent.

Signs and Symptoms of Esophageal Cancer

The esophagus is a long muscular, hollow tube that runs from the throat to the stomach. It is approximately 8 inches long. Its main function is to help move the food and fluids from mouth to stomach. Esophageal cancer is the cancer of the lining of the esophagus.
Esophageal cancer (Ghazai Naali ka Cancer / غذائی نالی کا کینسر) occurs when cancer cells are present in the esophagus. The first layer to be affected by the cancer cells is the inner layer of the esophagus.
The cancer cells can metastasize and spread throughout the other layers of the esophagus and other parts of the body.
Esophageal cancer can occur at any part of the esophagus. The prevalence in men is higher than in women. It is the 6th most common cancer that kills people in the world. Genetics play a big role in the manifestation of esophageal cancer.

Occurrence Rate of Esophageal Cancer

The 5-year survival rate of esophageal cancer is approximately 20 percent worldwide. In the case of metastasis, the survival rate is 5 percent.
The prevalence of esophageal cancer in Pakistan is high. In Quetta, it is the 3rd most common cancer in men. It is the 7th most common cancer in men and the 6th most common cancer in women.
In Pakistan, the 5-year survival rate is 10 percent.

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Types of Esophageal Cancer

Cancer is usually discovered at a later stage. Symptoms generally manifest at a progressive stage. As cancer progresses, the following symptoms are frequent:

  • Heartburn
  • Difficulty and pain while swallowing
  • Nausea and vomiting
  • Indigestion
  • Pressure or burning in the chest
  • Chest pain
  • Chronic cough
  • Weight loss (unintentional and unexplainable)
  • Food coming back up the esophagus

Causes of Esophageal Cancer

There are two common types of esophageal cancer depending on location:

  • Squamous Cell Carcinoma

The cancer present in the squamous cells of the esophagus is called squamous cell carcinoma. The upper and middle part of the esophagus is affected by cancer cells.
Squamous cells are flat, thin cells that make up the lining of the esophagus.

  • Adenocarcinoma

Adenocarcinoma is the cancer of the lower part of the esophagus. The cancer cells develop in the glandular cells and tissue of the esophagus.
Glandular cells are responsible for fluid products such as mucus.


Risk Factors of Esophageal Cancer

The exact origin of cancer is still unknown. The most common conclusion is a mutation in the DNA of the esophagus cells. This leads to the rapid multiplication of cells.



Certain factors increase the risk of esophageal cancer. Some of these factors are as follows:

  • Ages between 45 and 70
  • Men are thrice likely to develop esophageal cancer
  • Alcoholism
  • Tobacco
  • Smoking
  • Individuals suffering from GERD (gastroesophageal reflux disease)
  • Barrett's esophagus which develops due to chronic GERD
  • Black people are more prone to developing esophageal cancer
  • Lack of fruits and vegetables in the diet
  • Individuals with achalasia
  • Obesity

Health Complications of Esophageal Cancer

If a person is dealing with esophageal cancer he or she may be prone to the following health complications:

  • Anemia

When a person bleeds too much due to esophageal cancer, he or she might have to deal with anemia. Paleness and tiredness are some of the common symptoms of anemia. Red blood cells transfusions is a famous treatment method for anemia

  • Sudden Weight Loss

When the tumor growth escalates, the food passage can be interrupted. This can cause a person to lose weight.

  • Pneumonia

Esophageal cancer can cause aspiration pneumonia in people. Bacterial infections can cause this severe type of pneumonia.

  • Metastases

When cancer progresses it can metastasize to other areas of the body. Starting with the lymph nodes several other regions are also affected.

  • Tracheo-oesophagal Fistulas

The formation of holes in the windpipes or esophagus leads the food to escape the food pipe and enter into the lungs. This causes choking, gauging or severe coughing.



Given below are some of the preventive measures that can reduce the risk of esophageal cancer:

  1. Quit smoking
  2. Limit your alcohol intake
  3. Engage more in physical activities
  4. Make healthy lifestyle choices
  5. Avoid passive smoking
  6. Consult with your doctor on a regular basis

Treatment of Esophageal Cancer | When to Consult a Doctor

Cancer is a very serious condition. Many tests are done to give a final diagnosis. It is important to find whether cancer has spread to other parts of the body or is localized in a specific region. This tells about the severity of the condition.

A detailed physical examination is done and the following tests are performed to diagnose esophageal cancer:

  • Barium Swallow

The chemical barium is swallowed in liquid form which coats the inner lining of the esophagus. An X-ray is then performed to check for any abnormalities lining the esophagus using the barium as an indicator. This process is also called an esophagram.

  • Endoscopy

The lining of the esophagus is seen by the endoscope. This process is called Upper Endoscopy or Esophagus-Gastric-Duodenoscopy (EGD).

  • Endoscopic Ultrasound

This is usually done alongside upper endoscopy. Ultrasound outlines any tumor growth in the wall of the esophagus and the clinical features of the tumor.

  • Biopsy

During Biopsy, a sample of tissue is taken and is sent to the lab for further tests.

  • Scan

A CT scan, PET scan, or MRI is done to see the spread of cancer to other parts of the body.
All the above mentioned diagnostic tests are done in Pakistan.

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