Is dysphagia always a symptom of esophageal cancer? Esophageal cancer - signs, symptoms, stages, treatment and prognosis. Measures for the early detection of tumors of the esophagus

Esophageal cancer is a malignant tumor that develops from the tissues of the esophagus. This oncological disease is detected quite often - in 6% of cases of all cancerous tumors. Usually, cancerous tumors of the esophagus begin their growth in the lower or middle section of this organ. In this article, we will introduce you to the causes, classification, first manifestations, symptoms, and methods for diagnosing and treating esophageal cancer. This information will help to suspect the possible development of this dangerous disease in time and take measures to combat the tumor.

As a rule, esophageal cancer develops more often in older people. Mostly this malignant tumor is formed in men. This fact is explained by the fact that they are more addicted to smoking and drinking alcohol, which increase the risk of developing a malignant neoplasm.

In addition, there are regions on the planet in which the likelihood of developing such a cancerous tumor is very high. They are found in Asia and have been called the "esophageal cancer belt". These include the following countries and regions: Iran, the northern parts of Japan and China, the republics of Central Asia and some regions of Siberia. In these regions traditional cuisine provides for the intake of a large number of pickled dishes and a small amount of fresh fruits, such a feature of the diet contributes to the development of such an oncological process. And people of the Negroid race, unlike Europeans, suffer from this cancer 6 times less often.

Causes

Scientists believe that a gene mutation plays a leading role in the development of esophageal cancer.

So far, the exact causes of the development of a malignant tumor from the tissues of the esophagus are unknown. There are suggestions that mutations in the p53 gene can cause their growth, which provoke an increased synthesis of the abnormal p53 protein, which is unable to perform its direct functions, which consist in protecting tissues from cancerous transformations.

In addition, scientists suggest that the growth of a malignant neoplasm from the tissues of the esophagus can cause HPV (). Such assumptions are due to the fact that in the course of studies conducted in China, this virus was detected in a large number of patients with this disease.

All experts believe that the following factors can contribute to the development of esophageal cancer:

heredity;
frequent injuries of the esophagus with foreign bodies or hard food;
thermal or chemical burns of the esophagus;
smoking;
intake of alcoholic beverages;
chewing tobacco;
irrational nutrition: a large number of pickled dishes, the intake of mold fungi and products with nitrates, an insufficient amount of fresh vegetables and fruits;
hypo- and beriberi (A, E, B);
leading to food with hydrochloric acid from the stomach.

In most cases, esophageal cancer develops against the background of inflammatory processes in the tissues of this organ - esophagitis, which, with a long course, lead to dysplasia. In addition, background precancerous diseases can become:

stricture of the esophagus;
Barrett's esophagus;
achalasia cardia.

Types of esophageal cancer

According to the histological type, a cancerous tumor of the esophagus can be:

squamous - grows from squamous epithelium and can be superficial (i.e., in the form of erosion or plaque on the walls of the esophagus) or deeply invasive (i.e., in the form of a deep ulcer or mushroom-like formation growing into the deep layers of the esophagus);
adenocarcinoma - a tumor formed from glandular cells.

In 97% of cases, squamous cell tumors are observed. In very rare cases, rare types of esophageal cancer are detected: small cell carcinoma, spindle cell carcinoma, carcinosarcoma, etc.

According to the nature of the growth of the neoplasm, a cancerous tumor of the esophagus can be:

exophytic - rises above the mucous membrane and grows into the lumen of the esophagus;
endophytic - grows in the submucosal layer and grows into the walls of the esophagus;
mixed - combines signs of exo- and endophytic tumors, prone to rapid decay and ulceration.

By area of localization:

cancer of the lower esophagus - 55%;
cancer of the middle part of the esophagus - 35%;
cancer of the upper esophagus - 10%.

Stages of esophageal cancer

I stage

A malignant neoplasm spreads only in the mucous or submucosal layer and does not narrow the lumen of the esophagus.

II stage

A malignant neoplasm extends to the muscle and / or connective tissue layer and narrows the lumen of the esophagus. In stage IIA, the tumor does not affect the surrounding organs and does not metastasize. In stage IIB, there are single metastases in nearby lymph nodes.

III stage

A malignant neoplasm affects all layers, but does not spread to other surrounding tissues and organs. There are multiple metastases in the regional lymph nodes.

IV stage

A malignant neoplasm extends beyond the esophagus, and metastases are detected in both regional and distant lymph nodes. Tumor foci in other organs are possible.

First signs

The first signs of esophageal cancer are the feeling of a foreign body in it and slight pain when swallowing.

In the earliest stages of the development of a cancerous tumor, the patient does not feel any signs of the disease. Dysphagia is usually the first sign of esophageal cancer. The following discomfort may precede its appearance:

scratching in the chest;
sensations of the presence of a foreign body in the esophagus;
slight pain when swallowing.

Somewhat later, the patient has difficulty swallowing poorly chewed food. They are expressed in the feeling of food bolus retention in some part of the esophagus or food sticking to its walls. The resulting discomfort is easily eliminated by drinking water.

After some time, the same sensations arise already when swallowing well-chewed food, and the patient develops the habit of consuming only liquid or semi-liquid dishes. In some cases, dysphagia temporarily disappears. This sign may indicate the beginning of the disintegration of the neoplasm.

Symptoms

Over time, the feeling of difficulty swallowing food is aggravated. In addition, the patient has painful sensations behind the sternum in the form of squeezing or burning, dull and pulling pains. The appearance of this symptom often indicates the spread of the tumor outside the organ and compression of nerve endings by its tissues. Pain in process of growth of a neoplasm gradually amplifies.

The growth of a cancerous tumor constantly narrows the lumen of the esophagus, and the patient is forced to refuse any rough food. He begins to include in his diet semi-liquid cereals, kissels, mashed soups, broths, etc.

Over time, the retention of the food bolus causes esophageal vomiting and regurgitation of mucus and saliva. The constant stagnation of food debris leads to the appearance of bad breath, nausea and furry tongue. These symptoms are especially pronounced in the morning.

In the later stages of esophageal cancer, a person has to almost completely refuse food. This malnutrition leads to a sharp depletion of the whole organism and the development of anemia. The patient feels severe weakness, significantly loses weight, constantly feels hungry. Besides, general state such patients are aggravated by the syndrome of general intoxication, suggesting a breakdown, a slight increase in temperature, apathy, irritability, etc.

Sometimes the collapse of a malignant neoplasm leads to damage to the integrity of large blood vessels. In such cases, patients develop bleeding from the esophagus.

Tumor growth outside the esophagus leads to damage to other organs:

with damage to the vocal cords or recurrent nerve, the patient's voice becomes hoarse;
when the trachea and bronchi are affected, esophageal-tracheal or esophageal-bronchial fistulas are formed, causing coughing when drinking, development, abscesses or gangrene of the lung;
when the lungs are affected, there are chest pains, coughing, shortness of breath and swelling of the subclavian fossa;
with damage to the mediastinum, the patient may develop mediastinitis and;
when the nodes of the sympathetic nerve are affected, the Bernard-Horner syndrome develops, which consists in a narrowing of the pupil, a violation of the reaction of the pupils to light, drooping of the upper eyelid, retraction of the eyeball, dilation of the vessels of the conjunctiva, reddening of the face and impaired sweating in this area.

Which doctor to contact

If you experience discomfort during swallowing, you should contact a gastroenterologist or oncologist. To make a diagnosis, the doctor will prescribe an x-ray with barium, esophagoscopy, histological analysis of biopsy tissues, CT, ultrasound and other studies.

Diagnostics

To confirm the diagnosis of esophageal cancer, the following studies may be prescribed:

X-ray with contrast. The contrast agent (barium) makes the tumor visible on the image. The study reveals the narrowing of the lumen, thinning and thickening of the walls of the esophagus, the presence of ulcers.
Esophagoscopy. The study is performed using an endoscope. The doctor can see the tissues of the esophagus on the monitor, identify suspicious areas and perform a biopsy for histological analysis of the obtained tissues.
Bronchoscopy. The study is performed using a bronchoscope, which allows to detect metastases in organs respiratory system. During bronchoscopy, suspicious areas may be biopsied.
Endoscopic ultrasound. Allows you to detect a tumor in the esophagus.
ultrasound. The study is performed to detect metastases in organs and lymph nodes.
CT scan. This research method allows you to determine the size of the neoplasm, its spread to the surrounding tissues and identify metastases in other organs and lymph nodes.

A blood test for tumor markers in esophageal cancer is not always carried out, because this study has not yet been fully developed. Existing tests can detect only neoplasms at stage III-IV and only in 40% of patients.

In addition to these diagnostic procedures, the patient is prescribed general clinical studies: ECG, blood and urine tests, etc.

Treatment

The choice of treatment for esophageal cancer is completely determined by the stage of the tumor process and the type of neoplasm. As a rule, a comprehensive plan for getting rid of the tumor is drawn up, which may include:

surgery;
radiotherapy;
chemotherapy;
targeted therapy.

Surgery

To remove the tumor, endoscopic techniques or direct surgical intervention are used.

The volume of surgery for esophageal cancer is determined by the stage of the tumor process.

On early stages endoscopic techniques can be used to remove the neoplasm:

endoscopic resection of the mucosa;
radiofrequency ablation;
photodynamic non-thermal destruction.

Surgical interventions to remove the neoplasm and small area adjacent tissues are carried out with a small tumor size (up to 3 cm), the cells of which have not spread to the underlying tissues. In other cases, the following is performed:

esophagectomy - the part of the esophagus affected by the tumor process is removed, and a section of the large intestine or stomach tissue stands in its place;
esophagogastrectomy - a part of the esophagus, the upper part of the stomach and regional lymph nodes are removed, and the removed areas, if necessary, are restored by the tissues of the colon.

Some clinics use CyberKnife stereotaxic radiosurgery to remove tumors of the esophagus, which is combined with radiation treatment using the Elekta Synergy linear accelerator.

In some cases, esophageal cancer requires palliative surgery. If a large tumor is detected in the last stages, endoscopic interventions can be performed to restore the lumen of the esophagus. To do this, a stent is implanted into it, supporting the walls of the esophagus and expanding its lumen. Similar interventions can be performed in traditional ways.

If the entire esophagus needs to be removed to allow eating, gastrostomy surgery may be performed. Usually it is established temporarily: before the healing of postoperative wounds, during chemotherapy or radiation. During this operation, a tube is inserted into the stomach to introduce food. This is followed by reconstructive surgery.

Chemotherapy

The appointment of cytostatics, drugs for the destruction of cancer cells, can be carried out before and/or after surgery or if it is impossible to remove the tumor at advanced stages. For the treatment of esophageal cancer, a combination of the following cytostatics is prescribed:

Cisplatin;
5-fluorouracil;
Mitomycin;
Vindesine;
Bleomycin;
Farmorubicin, etc.

The combination of chemotherapy with radiation increases the effectiveness of treatment up to 45% for advanced tumors and up to 70% for locally advanced ones.

radiotherapy

In operable cases of esophageal cancer, radiation courses are prescribed before and after surgery. Prior to the intervention, radiotherapy is recommended for infiltrative or undifferentiated forms of the tumor and for the localization of the cancer process in a place that is difficult to access for surgery - in the middle third of the esophagus. After the operation, irradiation is recommended to prevent recurrence or in cases where radical removal of the tumor was not possible. In combination with chemotherapy, radiotherapy is prescribed in inoperable cases at advanced stages.

Oncological diseases are diagnosed more and more often in recent years. Cancer affects various organs, including the esophagus. What provokes the development of a cancerous tumor in the esophagus, how to recognize the disease and is it possible to cure it?

What is esophageal cancer

Esophageal cancer is a malignant tumor that is formed as a result of the growth of atypical cells in the tissues of this organ. First of all, patients are concerned about discomfort and pain when eating solid food.

This disease is more often diagnosed among men over 50 years old, women suffer from it several times less often.

As a rule, esophageal cancer mainly develops after injuries of the esophagus, as well as in people who are prone to eating spicy foods, alcohol, and smoking. But there are other reasons for its occurrence.

Causes

A number of factors can provoke the growth of a malignant tumor of the esophagus:

Heredity. According to statistics, people with relatives who have also been diagnosed with this disease are more likely to suffer from esophageal cancer. Recent studies have shown that the risk of developing the disease appears as a result of the mutation of certain genes responsible for protecting the digestive organs from adverse influences.
Bad habits. When drinking alcohol and smoking, cancer develops more often, since a huge amount of carcinogens enters the body.
Lack of vitamins A, B, E. It is these substances that protect cells from negative impact harmful substances.
Foreign bodies entering the esophageal cavity, frequent injuries. If the integrity of the tissues is violated, the cells undergo degeneration, which can lead to the development of cancer.
Chemical, thermal burns of the esophagus. The defeat occurs when eating too hot or spicy food, as well as as a result of exposure to aggressive liquid substances or poisons.
Improper nutrition. The risk of developing esophageal cancer increases significantly if a person's diet is dominated by spicy, pickled, overly spicy foods and there is an insufficient intake of vegetables and fruits, including fresh ones.
Obesity. With excess body weight, an increase in intra-abdominal pressure occurs, which causes the reflux of hydrochloric acid from the stomach into the esophagus. As a result, there is a burn of tissues with their subsequent degeneration.

In addition to external stimuli, the occurrence of a tumor can cause precancerous conditions, which include:

strictures of the esophagus - constant spasms of smooth muscles, as a result of which the lumen of the organ becomes smaller;
gastroesophageal reflux - reflux of the contents of the stomach into the esophagus with functional insufficiency of the muscular valve separating them;
achalasia of the cardia - a violation of the swallowing reflex;
hernia of the esophagus;
polyps are small formations in the tissues of this organ.

Classification

With an oncological disease, the doctor must determine the type of cancer (that is, from what type of cells the tumor originated), since the further treatment plan depends on this.

Esophageal cancer is divided into the following types:

Carcinoma. most often diagnosed. Abnormal cells develop as a result of degeneration of the squamous epithelium lining the esophageal cavity.
Adenocarcinoma. A malignant tumor develops from glandular cells located in the cavity of the esophagus, localized mainly in the lower part of the organ.
Nonkeratinizing squamous cell carcinoma. It is characterized by the growth of abnormal cells along the esophagus, sometimes along its entire length.

These types of tumors are diagnosed in more than 90% of cases.. However, there are also rare types of esophageal cancer:

melanoma;
choriocarcinoma;
lymphoma;
sarcoma.

Depending on the nature of the growth of a malignant tumor, it can be:

Symptoms and development of the disease

Unfortunately, often the first symptoms begin to disturb patients only when the tumor reaches a significant size. First of all, patients complain of dysphagia - discomfort and pain during swallowing. Actually, with this problem and go to the doctor.

As the disease progresses, the following symptoms are noted:

chest pain, burning sensation;
regurgitation that occurs as a result of partial overlap of the esophagus;
bad breath due to the accumulation of food debris in the area of tumor localization;
heartburn.

With advanced cancer, the esophagus is blocked by a tumor by more than half. This greatly complicates the process of eating, especially solid. In such cases, patients begin to eat only liquid and pureed meals. Due to lack nutrients in the body there is a rapid decrease in body weight. Symptoms of general intoxication also increase:

headache;
weakness;
increased fatigue;
nausea, vomiting.

If a malignant neoplasm metastasizes, functional disorders of all organs affected by metastases develop. When the vocal cords are involved in the pathological process, the following are noted:

voice change;
hoarseness that does not respond to treatment.

Often metastases penetrate the lungs, causing:

chest pain;
increasing shortness of breath;
labored breathing;
cough.

There may also be swelling in the area of the supraclavicular fossa.

Depending on the prevalence of atypical cells, esophageal cancer is divided into several stages (degrees of development).

Table: stages (degrees of development) of esophageal cancer, their signs and prognosis of recovery

Stage	Clinical picture	Symptoms	Forecast
Initial	Atypical cells are just beginning to grow and affect the surface epithelium.	There are no symptoms.	A full recovery is possible, but it is almost impossible to identify the disease at this stage.
First	The size of the tumor does not exceed 30 mm. It affects the mucous layer of the esophagus, metastases are absent.	The patient does not feel any pathological symptoms. It is possible to determine the presence of the disease only during an endoscopic examination.	The prognosis is favorable. With the right treatment, you can completely overcome the disease. 90% of patients after therapy live for more than 5 years.
Second	The second stage of esophageal cancer is divided into two degrees: IA - the tumor penetrates into the muscular layer of the esophagus, there are no metastases. IIB - the tumor spreads to regional lymph nodes.	Symptoms in most cases are absent, only a small part of patients feel discomfort when swallowing.	The prognosis is less favorable. With timely treatment, it is possible to overcome the disease, but the probability of survival exceeding 5 years is reduced to 50%.
Third	A malignant neoplasm covers part of the lumen of the esophagus. Cancer cells affect all layers of the esophagus, as well as nearby organs and lymph nodes.	Difficulty swallowing pain, weight loss, signs of general intoxication.	The prognosis is unfavorable. After treatment, only 10% of patients can live more than 5 years.
4th	The tumor reaches its maximum size, gives metastases to distant lymph nodes and internal organs.	Dysfunction of all affected organs, decomposition of the tissues of the esophagus.	The prognosis is poor, rapid death is likely. The average life expectancy after diagnosis is 8 months to 1 year.

Timely detection of esophageal cancer is very difficult, since it has a pronounced tendency to be asymptomatic in the early stages. Therefore, doctors strongly recommend not to disregard any alarming signs.

Possible Complications

In the absence of treatment, as well as with advanced cancer, severe symptoms such as:

bleeding from the vessels of the esophagus;
obstruction of the esophagus - the inability to pass food, liquid;
cachexia - significant depletion of the body and severe weight loss;
tracheoesophageal fistula - an opening between the trachea and the esophagus, when food or liquid gets into it, the patient begins to cough.

Diagnostics of the tumor and metastases

Timely diagnosis of cancer in many cases means saving the patient's life. To determine the presence of a malignant tumor of the esophagus, the patient is assigned a number of medical studies:

Also, the patient needs to donate blood for the determination of tumor markers.

Differential Diagnosis

Esophageal cancer has similar symptoms to other diseases of this organ. Therefore, the oncologist must evaluate the results of the entire complex of necessary diagnostic procedures and laboratory tests in order to confirm the diagnosis. The oncological process can be confused with diseases such as:

Achalasia cardia, or cardiospasm. It is characterized by spasm of the tissues of the esophagus during mental stress, while the symptom is well stopped by antispasmodics. More common in young people.
Diverticula of the esophagus. These are saccular protrusions of the walls of the esophagus. They usually occur in people over 50 years of age, but can also be congenital.
Esophageal scars. Scars are formed more often as a consequence of injuries, they disrupt the contractility of the muscles of this organ and the narrowing of its lumen.
Polyps. Small outgrowths on the mucous membrane resulting from an inflammatory process in the esophagus. Polyps are considered a precancerous pathology. A biopsy is required to exclude the presence of a malignant tumor.
Esophagitis. This is an inflammation of the mucous membrane of the esophagus, during acute manifestations of which patients experience difficulty and pain when swallowing. In this case, endoscopic examination is performed to rule out cancer.

Treatment

The treatment regimen depends on the characteristics of the course of the disease, its stage and type of tumor. The following methods apply:

surgical intervention;
chemotherapy;
radiation therapy;
photodynamic therapy.

Each of them has its pros and cons. Which of them is necessary in each case, only a specialist can determine, based on their clinic and the stage of development of the disease.

Often, combined treatment is prescribed to eliminate esophageal cancer, that is, several methods are used simultaneously.

Surgical treatment (surgical removal of the tumor)

In the surgical treatment of esophageal cancer, the tumor, the affected area of the esophagus and adjacent tissues, and lymph nodes are completely removed. The extent of intervention depends on the degree of neglect of the disease. With a significant lesion, the esophagus is completely removed and a new one is formed from part of the stomach or small intestine.

If the malignant tumor has spread to the stomach, then it is also removed, partially or completely.

Surgical removal of the tumor is carried out at stages 1, 2 and 3 of development in patients under the age of 70. A prerequisite is the absence of metastases in the lymph nodes and distant organs.

To reduce the load on the digestive canal in the postoperative period, a feeding tube is inserted into the stomach or intestines, which will ensure the supply of the required amount useful substances into the body. Also, food can be given with a probe or droppers.

The length of stay in the hospital after removal of the tumor depends on the extent of the operation and on the condition of the patient. As a rule, this period exceeds 7 days.

Chemotherapy

Chemotherapy is often given in the early stages of cancer and in addition to surgery. It involves the administration of drugs to the patient that stop the growth of the tumor and contribute to the death of its cells. It is carried out in courses, their number depends on the stage of development of the disease and the condition of the patient.

The following drugs are usually prescribed:

Photo gallery: chemotherapy drugs for esophageal cancer

During the use of these drugs, a decrease in immunity is observed, so patients are more susceptible to the development of infectious diseases. The following side effects may also occur during chemotherapy:

skin rash;
numbness of the limbs;
arthralgia (pain in the joints);
changes in indicators in the blood test, in particular, a decrease in the number of platelets;
swelling of the hands and feet;
disruption of the digestive system;
hair loss, change in their color.

In case of severe tolerability of the drug, the doctor may decide to replace it with another drug.

Radiation therapy

This method is widely used in the treatment of cancer, as it gives a good result. In the initial stages of cancer, it can be used alone, and when the oncological process is running, it is combined with surgery and chemotherapy.

The essence of the treatment is ionizing radiation of the affected area of the esophagus, as a result of which the tumor decreases in size and its cells are destroyed. It is carried out in two ways:

external therapy. The patient receives gamma radiation from the outside, which is directed directly to the affected area.
Brachytherapy (internal). The patient's throat is treated with an anesthetic and a special tube is inserted into the esophagus cavity, with the help of which irradiation is carried out.

Side effects after radiation therapy are rare and most often temporary. It can be pain in the abdomen, throat, upset stool, nausea.

Photodynamic therapy

This method of cancer treatment is considered new, as it has been used relatively recently, but it has already shown very good results. The essence of photodynamic therapy is the introduction into the body of a photosensitizer (a substance that increases the sensitivity of tissues to light), intravenously or directly into the affected area. After that, the patient's body is exposed to light waves.

As a result, a photochemical reaction occurs, in which the tumor is destroyed due to the cessation of nutrition of its cells.

This method of cancer treatment has a number of advantages over others, as it is rarely accompanied by adverse reactions. Only in some cases, the occurrence of photodermatosis (rashes and areas of inflammation on the skin) is noted.

Palliative care

If stage 4 cancer is detected, then therapeutic measures are no longer aimed at treatment, but at improving the quality of life of the patient and alleviating his condition. Be sure to adjust the diet. In most cases, patients are given parenteral nutrition or a gastrostomy (a tube through which food enters the stomach) is installed. This approach helps prevent obstruction of the affected esophagus.

In the last stage of cancer, patients experience very severe pain, for their relief, narcotic analgesics are used.

Features of nutrition for the period of treatment and rehabilitation

Proper nutrition in esophageal cancer is an essential component of successful treatment. It is necessary to ensure that the patient's body receives all the necessary nutrients.

You need to eat fractionally: in small portions, but often, 8-10 times a day. All dishes should be liquid and pureed until smooth.

There are special dry powder mixtures intended for feeding patients.

It is necessary to completely exclude fatty, fried, spicy, smoked, marinades, alcohol, confectionery . Spices are kept to a minimum.

You should also avoid or drastically limit your intake of milk.

Diet for esophageal cancer includes:

vegetable soups;
lean meat, fish;
butter;
kissels, compotes.

The amount of liquid should not exceed 1.5 liters per day.

The consistency of the dishes should not be very thick, so that the patient can comfortably swallow. To facilitate the passage of food, it should be consumed warm.

Photo gallery: the right diet for a tumor of the esophagus

vegetable soups compotes Cereal dishes Kiseli Butter Dairy products Lean fish dishes Eggs lean meat Fruits, especially in the form of jelly and puree

Alternative treatment

In the treatment of esophageal cancer, folk remedies can also be used, but they should be used only after the permission of a specialist and in combination with the main methods. Consider the most popular recipes.

medicinal plants

hemlock

Hemlock is often used to speed up recovery.

To prepare the medicine, chop the plant finely and fill it with 1/3 three-liter jar. Then completely fill the container with vodka and infuse in a cool dark place for 14-21 days. Use the remedy once a day, gradually increasing and then decreasing its amount. Start with 1 drop diluted in 200 ml of water. Increase daily dose by 1 drop, bringing up to 40 drops per glass of water, and in the following days reduce by 1 drop per day.

It is worth using a hemlock-based remedy with caution and in strict observance of the dosage and regimen, otherwise it can cause poisoning.

burdock

To prepare a medicine from burdock, you can use dried or fresh root plants. It must be crushed with a meat grinder, mixed with the same amount of honey and ethyl alcohol, and then placed in a tightly closed container and left for a week to infuse. Take 2 tablespoons half an hour before meals. The course is 90 days.

Herbal infusions

It is believed that herbal decoctions and infusions also promote healing from cancer.

Take 1 glass of coltsfoot, pour 1 liter of boiling water and let it brew for about 2 hours, then strain the infusion and drink 1 glass 3 times a day. In the same way, you should prepare and take infusions from the herb of celandine, calendula.

Photo Gallery: Herbal Remedies for Cancer Treatment

An infusion of coltsfoot is taken three times a day Calendula has many healing properties An infusion is prepared from the herb of celandine for oral use. Burdock root insist on alcohol with honey Hemlock is poisonous and can poison the body

Mushrooms

Vesyolka

This tool is often used to combat cancer. Take 50 g fresh mushrooms, pour 200 ml of alcohol or vodka and insist for 14 days in a dark place. It is recommended to use 1 teaspoon twice a day. In the last stages, the dose can be increased to 4 tablespoons. The course of treatment is about 3 months.

Shiitake

Shiitake mushrooms are also actively used in the fight against cancer. Take a handful of chopped raw materials, pour 1 liter of water, bring to a boil and simmer for about 15–20 minutes. Use the finished medicine 100 ml 3 times a day.

Chaga (black birch mushroom)

This fungus grows on split or broken birch trees. To prepare the medicine, rinse the chaga well and grate it. Next, mix the chopped mushroom with chilled boiled water in a ratio of 1:5 and leave for 24 hours. Strain the medicine and take 100 ml three times a day half an hour before meals.

It is believed that this chaga slows down tumor metastasis, improves immunity, and replenishes the lack of nutrients in the body.

Photo gallery: mushrooms that help fight cancer

Chaga grows on damaged birch trunks Homeland of shiitake mushrooms - Japan Mushroom vesyolka can have a size from 0 to 30 cm

It is worth remembering that folk remedies are not the main, but only additional means in the treatment of cancer, which should not be used on their own.

How long do patients live after a course of treatment

The life expectancy of patients after surgery depends on the degree of neglect of the disease. At 1-2 stages of cancer, it is possible to completely cope with the disease. If surgery was performed at grade 3, then only 1 patient out of 10 manages to live more than 5 years. Advanced cancer cannot be treated, from the appearance of the first signs to death during palliative therapy, 8–12 months pass.

If esophageal cancer is not treated, then from the moment of contacting a doctor and making a diagnosis, the patient can live no more than 6 years. In the later stages, in the absence of any therapy, this period is from 5 to 8 months.

Prevention

If you are at risk for esophageal cancer, then to prevent the development of a malignant tumor, be sure to follow a number of simple rules:

Give up bad habits.
Eat right.
Treat other diseases and injuries of the esophagus in a timely manner.
Undergo ultrasound of the esophagus, especially with a burdened family history.
Prevent the development of obesity.
Do not abuse too cold or hot food, as well as spicy and spicy dishes.

Video: development and treatment of esophageal cancer

Cancer of the esophagus is one of the complex oncological diseases; unfortunately, it is possible to cure it only in the early stages. Therefore, it is necessary to know about the factors that provoke the development of this disease and measures to prevent it, as well as carefully monitor your health so as not to miss the first signs of a malignant neoplasm.

The danger lies in the depletion of the body due to the progression of intoxication and impaired digestive function. The disease takes 6-8th place in the structure of general oncology. Men and women suffer from the problem equally often.

Causes

The pathogenetic basis for the development of esophageal cancer is the uncontrolled cell division of the organ. The result is the formation of a tumor, which leads to a metabolic disorder in the body with the subsequent development of characteristic symptoms.

It was not possible to establish the only reason for the corresponding violation at this stage in the development of science and medicine. However, there are pathological conditions and individual situations that increase the chance of a problem.

Risk factors:

hereditary predisposition. Failure in the functioning of the genetic material increases the likelihood of transmission of a predisposition to the formation of tumors from parents to children.
Constant consumption of hot food. The situation is aggravated by poor chewing and chronic mechanical damage to the mucous membrane.
Alcohol and smoking. Bad habits depress the patient's immunity, which creates favorable conditions for the progression of the oncological process.
Chronic or acute esophagitis. Inflammatory diseases of the esophagus without appropriate treatment lead to the transformation of epithelial cells, which in the long term accelerates the growth of tumors.
Diverticulitis. Disease of the esophagus, accompanied by the formation of protrusions in the wall of the organ.
Burns with scarring. The altered tissue can transform into a malignant tumor.

Minimizing exposure to these risk factors reduces the chance of developing esophageal cancer.

Classification

Oncological pathology provides a clear classification. Correct verification of the type of tumor and its stage directly affects the choice of treatment for esophageal cancer and the effectiveness of appropriate measures.

Depending on the nature of the damage to the structures of the organ, the following types of pathology are distinguished:

Squamous cell carcinoma of the esophagus. The primary source of the tumor is the epithelial cells inside the organ.
Adenocarcinoma of the esophagus. The source is the mucous glands of the organ or the epithelium changed according to the intestinal type (Barrett's esophagus). Such tumors occur in the lower parts of the organ during the transition to.

Adenocarcinoma of the esophagus occurs in 65-75% of clinical cases. Other variants of pathology in practice are not widely spread.

Squamous cell carcinoma of the esophagus can occur with or without keratinization. Separately, in the conditions of a histological laboratory, the degree of differentiation of neoplasm cells is established. The less specific they are, the worse it is for the patient.

The traditional oncological classification TNM is used for all types of malignancies. In the case of esophageal cancer, the division into groups is as follows:

T is the size and spread of the primary tumor (T 0 -T 4).
N - damage to the surrounding lymph nodes (N 0 -N 1).
M - the presence of distant metastases (M 0 -M 1).

In practice, the domestic classification is additionally used.

Stages of esophageal cancer:

A small tumor affects exclusively the mucous and submucosal membranes of the organ, without narrowing the lumen and disrupting the passage of food. There is no metastasis and retraction of lymph nodes into the process.
The tumor grows into the muscles of the esophagus. The lumen of the organ gradually narrows with a violation of the passage of solid food. A malignant neoplasm does not grow into neighboring organs, but single lesions of nearby lymph nodes can be detected.
The tumor grows into all the walls of the esophagus. Neighboring organs remain unaffected, but numerous lesions of nearby lymph nodes are found.
The tumor grows into neighboring organs. Cancer of the 4th degree is accompanied by the formation of distant metastases in tissues and lymph nodes.

First signs

The first symptoms of esophageal cancer occur with a fairly strong growth of the primary tumor. Because of this, the diagnosis is established already at the stage of the second, third or fourth stage of the disease.

The first signs of esophageal cancer, allowing to suspect the progression of the pathology, are:

Discomfort behind the sternum when eating. The patient complains of a sensation of a lump.
Weakness that does not correlate with the degree of activity of a person throughout the day.
Weight loss.
Paleness of the skin, violation of the structure of nails, hair.
Bad dream.

These symptoms are too non-specific and in 80% of cases are ignored by a sick person. Timely detection of signs of esophageal cancer at an early stage with further specific examination and the appointment of adequate therapy dramatically increases the chance for a complete recovery of the patient.

Symptoms

The clinical picture of the corresponding disease depends on the stage, size of the tumor, localization within the organ. All symptoms are divided into three large groups:

Primary. The occurrence of signs is due directly to the growth of the tumor with a violation of the function of the organ.
Secondary. Symptoms are associated with a parallel dysfunction of nearby structures.
Are common. The clinic is due to intoxication, which accompanies the development of a tumor in the body.

Primary signs of esophageal cancer:

Swallowing disorder. At first, the patient has difficulty eating solid food. Over time, due to an increase in the neoplasm, the patient stops eating cereals, and then liquid food.
Pain behind the sternum.
Increased salivation.
Frequent vomiting of undigested food.

Secondary symptoms depend on the violation of neighboring organs. Digestion in the stomach suffers more often, pain may occur along the course of the intercostal nerves. General symptoms are characteristic of all oncological diseases and are manifested by weakness, exhaustion of the body, discoloration of the skin, and a slight increase in body temperature.

Symptoms of cancer before the death of the patient are complemented by signs of heart or kidney failure.

Which doctor treats esophageal cancer?

An oncologist treats esophageal cancer. The patient's initial visit to a general practitioner or due to digestive disorders should be the reason for a thorough diagnosis with the identification of a tumor and referral of the patient to the appropriate specialist.

Diagnostics

Diagnosis of esophageal cancer is based on the analysis of the patient's complaints with the collection of anamnesis and the use of specialized instrumental methods. To verify the root cause of digestive disorders, the following procedures are used:

Radiography chest.
Ultrasound of the abdominal organs.
Computer or esophagus.
Contrast radiography of the esophagus with barium.
Esophagogastroduodenoscopy.
Biopsy.
A complex of laboratory tests of blood, urine.

Diagnosis of esophageal cancer is aimed at the timely establishment of the stage of the disease with the selection of effective therapy.

Treatment

Treatment of the disease depends on the timeliness of the visit to the doctor. With an early start of therapy, a complete recovery is possible through the use of the following methods:

Radiation therapy.
Surgical excision of the tumor.
The use of chemotherapy drugs.

Radiation therapy for esophageal cancer in combination with the use of specific medications contributes to the complete removal of the tumor, provided early diagnosis and small sizes neoplasms. With the ineffectiveness of these methods, an additional operation is performed.

A late visit to a doctor with a pronounced progression of the disease is accompanied by the use of maintenance therapy aimed at alleviating the patient's condition and eliminating stenosis of the esophagus. In practice it is used:

Painkillers.
Esophageal stenting is the installation of a frame inside the organ to prevent its narrowing.
Bougienage is a mechanical expansion of the lumen of the esophagus.
Radiation therapy to reduce the size of the neoplasm.

folk therapy

Esophageal cancer treatment folk remedies is an ineffective method of normalizing the patient's condition. The use of non-traditional drugs leads to the loss of precious time and the progression of the disease.

Folk remedies used without adequate medical or surgical therapy significantly reduce survival in esophageal cancer. It is allowed to use non-traditional methods only against the background of the main treatment and after consulting a doctor.

Patients use decoctions of Siberian prince, burdock root. Sea buckthorn oil is used. The purpose of appropriate therapy is to reduce the activity of the local inflammatory process, and partially reduce the pain syndrome.

life forecast

The prognosis for esophageal cancer depends on the timeliness of contacting a doctor. Early visits to the doctor in 85-90% guarantee a complete recovery of the patient. In the later stages, the chance for a successful outcome of treatment progressively decreases.

Prevention

There is no specific prevention for esophageal cancer. To prevent the onset of the disease, it is necessary to exclude exposure to risk factors, consult a doctor when the first incomprehensible symptoms appear.

Esophageal cancer is a formidable disease that can be managed. The main thing is not to miss the moment when the problem appears. Early referral to specialists guarantees normalization Everyday life patient with complete recovery.

Useful video about esophageal cancer

The esophagus is about 10 cm long and is located in the chest. This organ is part of the digestive tract. Food moves from oral cavity through the esophagus to the stomach. Esophageal cancer forms in the tissues that line the esophagus.

Esophageal carcinoma is an oncological disease in which a malignant tumor appears on the wall of the esophagus. The disease is quite widespread and ranks sixth among cancerous tumors.

Esophageal cancer is more common in older people. There are more men among the patients. This is due to the fact that smoking and the use of strong alcoholic beverages contribute to the appearance of the tumor. Such bad habits increase the risk of developing the disease tenfold.

Cancers most commonly occur in the middle and lower esophagus. The most common form of esophageal cancer develops from squamous epithelial cells. In second place is adenocarcinoma, which is formed from glandular cells. In 10% of cases, this form of cancer is accompanied by a tumor in the oral cavity: cancer of the lips, palate, tonsils, larynx.

There are areas on the planet where the likelihood of developing a tumor is very high - this is the "belt of esophageal cancer", which is located in Asia. This includes Iran, the republics of Central Asia, some regions of Siberia, the northern regions of China and Japan. This feature is associated with the fact that in this area they traditionally eat a lot of pickled dishes, and much less fresh vegetables and fruits. But representatives of the Negroid race get sick 6 times less often than Europeans.

How long do people live with esophageal cancer

A malignant tumor of the esophagus can be completely cured if the disease is detected at an early stage, but most often the symptoms occur on later dates, which significantly reduces the effectiveness of treatment. If therapy was not carried out, then the patient's life expectancy is from 6 to 8 months. Five-year survival depends on the stage of the disease. At the first stage, it is 90%, at the second - 50%, at the third - 10%. If the patient underwent radiation therapy in addition to surgery, then this significantly increases the survival rate.

In the case when the disease is detected at a later stage and there are already metastases, the use of radiation therapy can extend the patient's life up to 12 months in 10% of cases.

The prognosis is most favorable for superficial squamous cell carcinoma. If the tumor is located in the middle section, then the risk of rapid development of complications and metastases is high, since the neoplasm quickly begins to grow into the trachea and bronchi.

Symptoms of esophageal cancer

Cancer of the early stages of the esophagus most often does not manifest itself clinically, the symptoms begin to appear in the presence of a rather large tumor that interferes with the movement of food.

The most common symptom of esophageal cancer is swallowing disorder - dysphagia. Patients tend to take liquid food, more solid gets stuck in the esophagus, creating a feeling of "lump" behind the sternum.

With the progression of the tumor, there may be pain behind the sternum, in the pharynx. The pain may radiate to the upper back.

Reduced patency of the esophagus contributes to the occurrence of vomiting. As a rule, prolonged lack of nutrition (associated with difficult food intake) leads to general dystrophy: weight loss, disorder of organs and systems.

Gradually, the tumor increases in size and narrows the lumen of the esophagus. Man experiencing discomfort while eating, he is forced to give up coarse food: meat, apples, bread. The patient begins to use semi-liquid ground dishes: cereals, puree soups. But due to the fact that the lumen of the esophagus is gradually narrowing, it remains possible to swallow only liquid: broth, milk, jelly. A person almost completely refuses food and this causes severe exhaustion. The body does not receive enough food, strong weight loss begins. The patient feels constant hunger and severe weakness.
Esophageal vomiting or regurgitation occurs as a result of blockage of the esophagus, and the food returns back.
Stagnation of food debris in the esophagus causes bad breath which is especially noticeable in the morning. The tongue is coated, the patient complains of nausea.

If the tumor has spread to other organs of the chest cavity, then characteristic symptoms occur. If metastases (secondary cancerous tumors) have arisen in the lungs, then blunt chest pain, shortness of breath, cough, supraclavicular fossa swelling.
If the tumor has grown into the recurrent nerve or metastases have spread to the vocal cords, then there is hoarseness. As a result of the general reaction of the body to a cancerous tumor, the temperature slightly rises to 37.5. Patients have loss of strength and apathy, fatigue.

Often, cancer of the esophagus is accompanied by a constant dry cough (occurs reflexively as a result of irritation of the trachea), hoarseness (chronic laryngitis). In the terminal stages of tumor development, blood can be detected in vomiting and coughing. All clinical manifestations of esophageal cancer are nonspecific, but require immediate medical attention. Patients suffering from Barrett's disease require regular dispensary observation by a gastroenterologist, as persons with high risk development of esophageal cancer.

Causes of esophageal cancer

The occurrence of esophageal cancer can be triggered by many factors:

hereditary predisposition. Scientists have identified a link between esophageal cancer and a mutation in the p53 gene. At the same time, an abnormal protein begins to be produced in the body, which does not fulfill its function of protecting the tissues of the esophagus and intestines from malignant tumors.
Injuries to the esophagus caused by foreign bodies or ingestion of hard food contribute to the degeneration of epithelial cells.
Burns of the esophagus. It can be an addiction to too hot food, and the accidental use of caustic liquids that cause a chemical burn of the esophagus. Most often, these are alkalis, the consequences of swallowing which can appear after many years.
Wrong nutrition. A diet rich in spicy pickled foods, molds, and nitrates. The lack of fresh vegetables and fruits, as well as selenium and other substances, has a bad effect on the digestive system.
Avitaminosis. The lack of vitamins A, B, E leads to the fact that the skin and mucous membranes lose natural protection. Their cells cease to perform their functions and begin to regenerate
Alcohol use is one of the main risk factors. Alcoholics are 12 times more likely to develop esophageal cancer. Strong alcoholic drinks burn the mucous membrane and thin it, destroying the top layer of cells.
Smoking recognized cause different forms cancer. Tobacco smoke contains carcinogens that cause changes in epithelial cells. Smokers are 4 times more likely to develop a tumor of the esophagus.
Obesity. Excess weight increases pressure in the abdominal cavity and provokes reflux - the reflux of food from the stomach into the esophagus. This causes cells to burn with hydrochloric acid contained in gastric juice.

Esophageal cancer classification

Esophageal cancer is classified according to the international TNM nomenclature for malignant neoplasms:

by stage (T0 - precancer, carcinoma, non-invasive epithelial tumor, T1 - cancer affects the mucosa, T2 - the tumor grows into the submucosal layer, T3 - layers up to the muscle are affected, T4 - tumor penetration through all layers of the esophageal wall into the surrounding tissues);
by the spread of metastases in regional lymph nodes (N0 - no metastases, N1 - there are metastases)
on the spread of metastases in distant organs (M1 - yes, M0 - no metastases).

Also, cancer can be classified into stages from the first to the fourth, depending on the extent of the tumor in the wall and its metastasis.

According to the shape of the tumor

Exophytic tumors growing in the lumen of the esophagus and rising above the mucous membrane.
Endophytic tumors growing in the submucosal layer, in the thickness of the wall of the esophagus.
Mixed tumors are prone to rapid decay and the appearance of ulcers in their place.

According to the morphology (structure) of the tumor

Squamous cell carcinoma The tumor develops from squamous epithelial cells.
Varieties:

surface, in the form of erosion or plaque on the walls of the esophagus. Differs in a lighter flow, does not reach large sizes.
deeply invasive affecting the deep layers of the esophagus. It may be in the form of a fungus or an ulcer. Prone to the formation of metastases in the trachea, bronchi and heart.

Adenocarcinoma- a tumor that develops from glands that produce mucus. A relatively rare form that is somewhat more severe than squamous cell carcinoma. It is usually located in the lower esophagus near the stomach. Its occurrence is facilitated by a condition in which the flat cells of the mucosa are replaced by cells similar to those that line the small intestine - Barrett's esophagus.

According to the location of the tumor

Cancer of the upper esophagus - 10%
Cancer of the middle part of the esophagus - 35%
Cancer of the lower esophagus - 55%

Stages of esophageal cancer

0 stage. Cancer cells lie on the surface of the esophagus and do not penetrate deep into its walls.
I stage. The tumor grows deep into the mucous layer, but does not affect the muscle. Metastases are absent. The patient does not feel any signs of the disease, but the tumor is clearly visible during endoscopy.
II stage.In some cases, swallowing may be impaired, but more often the disease is asymptomatic.

Substage IIA. The tumor had grown into the muscular and connective tissue layer of the esophagus, but did not affect the surrounding organs and did not form metastases.
Substage IIB. The tumor had grown into the muscular membrane of the esophagus, but did not affect the outer layer, but metastases formed in the nearest lymph nodes.

III stage. Swallowing disorders, weight loss and other signs of cancer are pronounced. The tumor has grown through all layers of the esophagus. She started metastases in the surrounding organs and nearby lymph nodes.
IV stage. If metastases are found in distant lymph nodes and organs, regardless of tumor size, stage IV is diagnosed. At this stage, treatment is difficult and the prognosis is poor.

Diagnostic Measures

If a cancerous lesion of the esophagus is suspected, the oncologist prescribes a series of examinations, on the basis of which the final diagnosis is already determined.

Radiography with contrast agent. This examination allows you to detect narrowing of the esophagus, localization of the tumor, its size, thinning of the walls.
Esophagoscopy. With the help of an endoscope, the doctor examines the entire esophagus, all data is displayed on the computer screen, which allows you to determine the cause of impaired swallowing or other manifestations of the disease. During endoscopy, if necessary, a tissue sample is taken for histology.
Bronchoscopy is necessary to detect metastases in the bronchi, trachea, and vocal cords.
Computed tomography is one of the most accurate diagnostic methods. Layer-by-layer examination of the walls of the esophagus allows you to determine how deep the tumor has grown, whether there are metastases in adjacent tissues.
Ultrasound is prescribed to detect metastases in the internal organs.
Determination of tumor markers - special proteins, the level of which increases
during the development of cancer cells. Tumor markers are divided into groups, each of which indicates a specific type of cancer. A cancerous tumor of the esophagus is characterized by the presence in the blood of such oncomarkers as CA 19-9, Tumor marker 2, antigen of squamous cell carcinoma.

It must be remembered that tumor markers in certain situations can also appear in a healthy body, so their determination does not give rise to an accurate diagnosis of cancer.

Methods for the treatment of esophageal cancer are selected by the doctor for his patient, guided by the stage of the pathology, the size of the tumor, and the age of the patient. Surgical methods, chemotherapy, radiation exposure are used. Radiation sessions and chemotherapy may be given before and after surgery.

Surgical intervention involves the removal of part of the esophagus or the entire organ with tumor-altered tissues. If necessary, part of the stomach is also removed. The esophagus is replaced with part of the intestine or a gastrostomy is formed. There are several types of surgeries performed on patients with esophageal cancer.

For esophageal cancer, the following types of operations are most often used:

Operation Osawa-Gurlock. During the operation, an incision is first made in the abdominal cavity, it is carried out along the midline. Usually the beginning of the incision is the navel, and the end is the 7th rib or the angle of the scapula from the side of the sternum. The tissues dissect and release the esophagus, cutting the pleura. During the operation, the stomach is removed into the pleural cavity. The detected tumor is examined, receded from it by about 8 cm and removed along with the esophagus using a Fedorov clamp. The stomach is fixed in the diaphragm, its food opening.
Operation Torek. From the lateral access, an incision is made on the right, the skin and tissues are dissected along the sixth intercostal space. First, an organ is isolated, then, by expanding the hole, the cardia. A suture is applied to the end of the isolated esophagus, catgut and silk threads are used. At the second stage, the patient's position is changed, he is laid on his back. The neck and the area from the collarbone to the deltoid muscle are treated with iodine. From the side of the pleural cavity, the esophagus is isolated. The tumor is cut off along with part of the esophagus. Wounds on the neck and in the chest area are sutured in layers.
Lewis operation. The resection is carried out in two stages. First, an abdominal access is made through the midline of the abdomen, after which a revision is performed. Then a right-sided thoracotomy is performed with the patient on the left side. The detected tumor is removed along with the esophagus, all lymph nodes must be punctured and the abdominal cavity must be examined, revealing bleeding. In the pleural cavity, it is necessary to install drainage tubes and only after that suturing is performed. The Lewis operation is most commonly used for esophageal cancer, as it is performed in one operation. With this type of surgical intervention, plastic surgery of a partial removed esophagus can be performed. Lewis operation is indicated if there are no metastases

Endoscopic operations.

This type of surgical treatment is less traumatic. It is used in the earlier stages of tumor development. There are several options for this procedure. The endoscope is inserted into the esophagus through the mouth. A camera for video monitoring of the operation, a surgical loop or a laser is attached to its end. To expand the lumen of the esophagus, bougienage is performed using special flexible cylindrical instruments. With the right treatment, 70% of patients regain the ability to eat solid food.

Radiation therapy

In a certain group of patients with esophageal cancer, remote gamma therapy gives good results. It can be used alone or in courses before and after surgery. Irradiation of the tumor with ionizing radiation leads to the suspension of growth and division of cancer cells. The cancer gradually decreases in size.
The radiation breaks bonds in DNA molecules, which are responsible for the transfer of genetic information to daughter cells. Radiation therapy is not as dangerous to surrounding healthy tissue due to the fact that it acts primarily on cancer cells that are actively dividing.
The combination of radiation therapy with chemotherapy has proven itself well. Tumors are significantly reduced in size, the likelihood of metastases is reduced. This method is used to treat patients who cannot be operated on.

Chemotherapy

Chemotherapy is the effect of toxins and poisons on cancer cells. They lead to a halt in the growth of the neoplasm and the death of its cells. Separate use of chemotherapy drugs was not effective enough. Chemotherapy drugs: Vindesine, Farmorubicin, Mitomycin, Bleomycin, 5-fluorouracil improve the patient's condition and life expectancy by 15-20%. While in combination with radiation therapy, the effectiveness of treatment reaches 45%.

Chemotherapy uses anti-cancer drugs (cytostatics) in the fight against oncology.

Chemotherapy drugs that are commonly used in the treatment of esophageal cancer in Israel:

fluorouracil (5-FU);
cisplatin (or sometimes carboplatin);
epirubicin;
capecitabine (Xeloda®);
oxaliplatin (eloxatin ®).

As a rule, therapy involves a combination of two or more medications. For the treatment of adenocarcinoma of the esophagus, the ECF regimen is most often used - epirubicin, cisplatin and 5-FU.

Capecitabine is a tablet form of 5-FU. If capecitabine is used, the regimen is called ECX.

Another combination of chemotherapy drugs - EOX (another name for EEX) - includes epirubicin, oxaliplatin and capecitabine.

Squamous cell carcinoma of the esophagus is usually treated with a combination of cisplatin and 5-FU.

Indications for chemotherapy in esophageal cancer

Cytostatics are given before surgery to reduce the malignancy and make it easier to remove. If there is a possibility that the cancer cells are in other parts of the body, giving chemotherapy earlier will increase the chances of controlling the disease.

Treatment with chemotherapy drugs is also performed after surgery in order to reduce the likelihood of a return of the disease. Cytostatics destroy any tumor cells that have survived after surgery.

Chemotherapy is treated when the tumor process has spread to other parts of the body. The task is to reduce the cancerous growth, alleviate the manifestations of the disease and improve the quality of life of the patient. In some cases, these goals are achieved. However, sometimes under the influence of cytostatic agents, the tumor does not shrink, and the side effects outweigh the benefits of therapy.

Chemotherapy with radiotherapy

Chemotherapy drugs with radiation can be prescribed at the same time. This treatment of esophageal cancer in Israel is called chemoradiotherapy. Some cytostatics, such as 5-FU, can increase the effectiveness of radiotherapy.

Chemoradiation therapy is mainly performed for squamous cell carcinoma of the esophagus, but sometimes for adenocarcinoma.

This type of treatment can be the main one if there are contraindications to surgery. It is also used before surgery to reduce the size of the tumor. As a new type of treatment, chemoradiotherapy may be given as part of a clinical trial.

Simultaneous use of cytostatics and radiation increases the risk side effects. This treatment of esophageal cancer in Israel is not suitable for people who have other health problems.

If chemoradiotherapy is an option, doctors discuss it with the patient. Talk about the benefits and side effects of treatment for a particular situation.

Chemotherapy for esophageal cancer

Chemotherapy drugs can be administered intravenously, by injection. Also apply central catheter or PICC line system when the controlled quantity medicinal product enters the bloodstream for a certain period of time, does not require hospitalization.

Sometimes cytostatics are taken in tablets.

Usually given treatment esophageal cancer in Israel is carried out on an outpatient basis, in the form of a session. The course is repeated every 3-4 weeks.

The therapy is followed by a rest period of several weeks while the body recovers from undesirable consequences treatment. Collectively, this period is called a cycle, their number depends on the body's response to therapy.

Combined method

A course of chemotherapy and radiation therapy is carried out 2-3 weeks before the operation. Such a scheme can significantly increase the chances of successful treatment.

Much attention is paid to the preparation of patients for surgery. Patients are severely malnourished, so they are given daily vitamins, nutrient fluids, and protein preparations. If nutrition through the mouth is possible, then they give small portions of high-calorie protein foods, juices, and fruit drinks. In another case, the patient is fed through a tube.

Esophageal cancer is rarely diagnosed in the early stages, since its first manifestations are so mild that they do not bother the patient at all. Before going to the doctor, a person usually experiences discomfort when swallowing food, which intensifies as the pathology develops. Esophageal carcinoma is more common in men than in women.

The essence of the disease

The esophagus is one of the parts of the digestive system. If too cold or too hot food passes through this organ, then in the future it can lead to the development of a tumor. Benign neoplasms do not pose a danger to human life and health. Another thing is when it comes to atypical cells.

Usually, oncological diseases are difficult to diagnose in the early stages, since at this time they practically do not manifest themselves in any way. A patient suffering from esophageal cancer may not see a specialist for a long time, which leads to tumor growth. Usually it makes itself felt after it hits this organ halfway.

Esophageal cancer is four times more common in men than in women. The risk group is made up of people aged from fifty to sixty years. Atypical cells affect the organ unevenly. In the amount of 50% they are localized in its lower part. As the disease develops, a person experiences discomfort, because of which he consults a doctor.

The main causes of pathology

Pathology can occur for the following reasons:

Violation temperature regime nutrition (eating too cold or too hot food, very spicy foods, as well as alcoholic beverages and their surrogates).
Place of residence. Residents of some parts of China, Central Asia and Iran are more likely to suffer from esophageal cancer because they eat mold mushrooms, pickled and too hot dishes.
Avitaminosis. The lack of retinol and ascorbic acid can provoke the development of oncological pathology.
Alcohol abuse. This factor increases the likelihood of developing esophageal carcinoma by 12 times.
Chemical burns of the organ (can lead to the onset of the disease even after several years).
Some pathologies, for example, achalasia of the esophagus.

The first symptoms of esophageal carcinoma

Early detection of the disease increases the chances of a favorable prognosis for the life and health of the patient. The last stage can end with early death of the patient, especially in the absence of treatment. To stop the development of cancer, it is necessary to detect its first symptoms in time and consult a doctor.

It is worth paying attention to difficulties with swallowing food. If a person constantly has a feeling while eating that there is a foreign object in the throat that prevents the normal passage of food, then you should not hesitate to visit a specialist. To reduce discomfort, before swallowing food, it must be thoroughly chewed.

If carcinoma is not treated, the consequences can be very serious. Over time, it will become difficult for a person to swallow not only food, but also liquids, including their own saliva. It is worth noting that almost all stages of the pathology (except for the initial ones) are accompanied by unusual and unpleasant sensations in the esophagus.

Signs of esophageal cancer

As a rule, pain occurs with esophageal carcinoma. The nature of the pain may be sharp or dull. In this case, a person feels discomfort not in the throat itself, but in the neck, lower jaw area or between the shoulder blades. Localization of pain often confuses the patient, forcing them to look for other health problems.

Sometimes belching indicates esophageal cancer. Many people are familiar with this phenomenon. healthy people, so when it appears, do not panic. When burping occurs infrequently after a heavy meal or eating spicy foods, this is normal. If reflux bothers a person, regardless of external factors and constantly, then you should consult a doctor.

The growth of the tumor provokes nausea and even vomiting. Bloody inclusions in the vomit should alert. This phenomenon is due to the appearance of wounds and ulcers in the esophagus due to tumor progression. Part of the blood can come out with vomit, some can enter the stomach, and then into the patient's feces.

Esophageal carcinoma is often accompanied by increased salivation, as it becomes difficult for a person to swallow saliva and it accumulates in the oral cavity. Air hardly passes through the affected organ, which provokes frequent hiccups.

Fatigue and weight loss are common signs of cancer. The patient complains of a breakdown, weight loss, and sometimes an increase in body temperature. Weight loss and fatigue are attributed to insufficient intake of vitamins due to difficulty swallowing food.

The weakening of the body's defenses is far from the first symptom of the disease. This phenomenon is due to the depletion of the body. The patient may complain that infections constantly “stick” to him, which are sometimes accompanied by an increase in body temperature.

A symptom of esophageal cancer is a change in the timbre of the voice and cough. This is due to the penetration of metastases into the bronchi and larynx. The patient's voice becomes hoarse, as in a respiratory illness. There may be pain in the vocal cords.

Breath odor is not the first symptom of cancer. Sometimes there is an increase in lymph nodes, which indicates their defeat by atypical cells. The smell of rot from the mouth indicates the decomposition of a cancerous tumor.

The first signs of esophageal cancer in women are no different from those in men. Only the localization of the process is different. So, in women, oncological pathology usually originates in the upper part of the esophagus, and in men, it begins at the cardia itself, gradually moving to the stomach, and at the border of the middle and lower thirds of the esophagus.

Stages and complications of the disease

Esophageal cancer goes through four stages:

Complications of carcinoma are:

Esophageal bleeding. This phenomenon over time can provoke a black stool in a patient. After detecting this symptom, you should immediately consult a doctor.
Tumor perforation. Due to the underlying pathology, a hole can form in the esophagus, and then an inflammatory process in the mediastinum. This condition is accompanied by increased body temperature and general intoxication of the body.

Esophageal cancer is a dangerous and widespread oncological pathology, the first symptoms of which are quite difficult to detect. Some people who suffer from difficulty swallowing food do not see a doctor for a long time, which leads to the development of the disease.