Esophageal Cancer Awareness Month 2023
April is Esophageal Cancer Awareness Month. Esophageal cancer is a cancer of the tube that transports food from the throat to the stomach. There are multiple layers to the esophagus including the mucous membrane, muscle, and connective tissue. Esophageal cancer starts on the inside and grows outward. It is projected that in 2023, there will be 21,560 new cases of esophageal cancer (17,030 men and 4,530 women) while there will be 16,120 deaths from the cancer (12,920 men and 3,200 women) in the United States. It is more common in men than women and makes up one percent of total cancers in the United States. The five-year survival rate has improved over time. In the 1960s and 1970s, the five-year survival was five percent versus 20 percent today.
There are different signs of esophageal cancer. The largest signs are weight loss and painful or difficulty swallowing. Other signs include pain behind the breastbone, hoarseness and cough, indigestion and heartburn, chest pain, vomiting, bone pain, bleeding in the esophagus, and a lump under the skin. If you have symptoms, there are different ways to diagnose esophageal cancer. One way is through imaging tests. The one most often done first is a barium swallow test. People swallow a thick, chalky liquid called barium to coat the walls of the esophagus and then x-rays are taken. CT scans, which are detailed cross-sectional x-ray images, are also available. They are helpful for determining if cancer has spread. Magnetic resonance imaging (MRI) scans can also be performed. They use radio waves and strong magnets to look at the body. Positron Emission (PET) scans are also available. People are injected with a radioactive form of sugar called FDG that collects in cancer cells. Images of the body are taken, allowing doctors to see if cancer exists. Sometimes PET scans and CT scans are done together.
Endoscopies are also useful. A flexible tube with a camera is inserted down the esophagus, allowing doctors to visually see the esophagus and remove (biopsy) tissue samples to be tested for cancer. An endoscopic ultrasound, similar to an endoscopy, is also helpful. This uses an ultrasound device at the end of a probe to use sound waves to see how big the cancer is and how far it has spread. Bronchoscopies, thoracoscopies, and laparoscopies are also useful. They can test if cancer has spread to the trachea or windpipe (bronchoscopy) and see if cancer has spread to lymph nodes in the chest (thoracoscopy) or abdomen (laparoscopy). Blood tests can also be utilized to check for anemia. Doctors do this because people with esophageal cancer have low red blood cell counts due to tumors bleeding. Liver enzymes can also be checked because esophageal cancer can spread to the liver.
Multiple treatments are available for people with esophageal cancer. The first option is surgery, which can be performed to remove small tumors that are confined to the superficial layers of the esophagus that have not spread. A portion of the esophagus can also be removed, which is called an esophagectomy. The portion of the esophagus containing cancer is removed with a portion of the upper part of the stomach and nearby lymph nodes. The remaining part of the esophagus is reattached. An esophagogastrostomy is also useful. It is like an esophagectomy, but a larger portion of the stomach is removed. If necessary, a part of the colon is used to attach the remaining esophagus and stomach. Other treatments can also be used to help with complications. If there is an obstruction, a metal tube called a stent can be placed to help keep the esophagus open. Feeding tubes might also be necessary if someone is having esophagus surgery or is having trouble swallowing. Chemotherapy, radiation therapy, targeted drug therapy, and immunotherapy are also useful options. Chemotherapy uses cytotoxic (cell killing) drugs before or after surgery or alongside radiation. It can also be used alone to relieve symptoms of the cancer. Radiation uses high energy beams like x-rays or protons to kill cancer cells. It can also be used to relieve symptoms or complications like tumors preventing food from going to the stomach. Targeted drug therapy exploits weaknesses in cancer cells, causing them to die. It is usually combined with chemotherapy for advanced stages of cancer. Finally, immunotherapy can be used for cancer. Immunotherapy helps the immune system fight and kill cancer cells. It does this by helping the immune system recognize harmful cancer cells, allowing them to be killed instead of just passing by undetected.
Esophageal cancer has multiple risk factors. Two unchangeable risk factors for the cancer include age and gender. Less than 15 percent of esophageal cancers are diagnosed in people younger than 55 and men are more likely to develop esophageal cancer than women. People with gastroesophageal reflux disease (GERD), which happens when acid from the stomach escapes to the lower part of the esophagus, are more likely to develop the cancer. GERD can lead to Barrett’s esophagus, another risk factor for esophageal cancer. A consistent reflux of stomach acid in the stomach damages the lining of the esophagus. Squamous cells that normally line the esophagus are replaced with gland cells, which are like stomach and small intestine cells, and are more resistant to stomach acid. Most people with this condition do not get esophageal cancer, but the risk is still increased. Over time, gland cells show dysplasia, which is a precancerous condition. Higher grade of dysplasia leads to a higher risk of cancer. Obesity, diet, and physical inactivity can also lead to esophageal cancer. Obese people are more likely to have gastroesophageal reflux, which then leads to cancer. Diets with high amounts of processed meats can have a higher risk of esophageal cancer while a diet with a lot of fruits and vegetables can have a lower risk. Frequent hot liquid drinking (149 degrees F or 65 degrees C or higher, which is much higher than a normal cup of coffee) can also increase the risk of the squamous cell type of esophageal cancer. It can damage the inside of the esophagus, leading to cell changes and cancer.
Exposure to certain carcinogenic substances like tobacco, alcohol, and asbestos can also lead to esophageal cancer. Tobacco products like cigarettes, cigars, pipes, and chewing tobacco are all major risk factors of the cancer. More frequent use over a longer period creates a higher risk of esophageal cancer. Alcohol, like tobacco, also causes esophageal cancer. Higher alcohol use increases the risk of squamous cell carcinoma. Asbestos, which is a fibrous mineral used for its heat and fire-resistant properties, is also a risk factor. When asbestos fibers are released into the air, they can be inhaled or ingested. They then become lodged in human tissue like the esophagus where they cannot be broken down or removed. Over time, the fibers cause DNA changes in cells, which lead to the cells turning into cancer cells. A combination of these carcinogens creates a higher risk than each carcinogen alone.
Were you exposed to asbestos? You could be entitled to compensation. Asbestos causes cancers like mesothelioma, lung cancer, colorectal cancer, and esophageal cancer. If you have any of these cancers or a different type of cancer and believe you worked with asbestos or another carcinogen, contact us today to see if you could be entitled to compensation. Call 412-471-3980 or fill out our contact form to speak to a member of our team. We will do anything we can to help you win the compensation you deserve.