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Department: Artemis Cancer Institute
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Oesophagus
An oesophagus, also known as the food pipe, is a hollow tube that carries food and liquids from the throat to the stomach. When a person swallows, the muscular walls of the oesophagus contract, to push the food down into the stomach. Glands in the lining of the oesophagus produce muscus, which keep the passageway moist and make swallowing easier. In an adult, the oesophagus is about 10 inches long.
WHAT IS CANCER OF THE OESOPHAGUS?
Your body is made up of many types of cells. In normal course, cells grow, divide, and produce more cells to keep your body healthy. However, at times, this process goes wrong and cells become abnormal, forming more cells in an uncontrolled manner. These extra cells form a mass of tissue, called a growth or a 'tumour'. A tumour which keeps on growing uncontrollably is called a malignant / cancerous tumour. Cancer of oesophagus occurs when a malignant tumour forms in the tissue of your oesophagus.
WHO IS AT A RISK OF THE CANCER OF OESOPHAGUS?
Oesophageal cancer is more likely to occur as people get older. Smoking or using tobacco is one of the major risk factors. Chronic or heavy use of alcohol is an important factor and people who use both alcohol and tobacco have a high risk of developing oesophageal cancer. Tissue at the bottom of the oesophagus can become irritated if stomach acid frequently "backs up" into the oesophagus. This problem is called gastric reflux. It increase the risk of cancer.
WHO IS AT A RISK OF THE CANCER OF OESOPHAGUS?
Oesophageal cancer is more likely to occur as people get older. Smoking or using tobacco is one of the major risk factors. Chronic or heavy use of alcohol is an important factor and people who use both alcohol and tobacco have a high risk of developing oesophageal cancer. Tissue at the bottom of the oesophagus can become irritated if stomach acid frequently "backs up" into the oesophagus. This problem is called gastric reflux. It increase the risk of cancer.
WHAT ARE THE SYMPTOMS OF CANCER OF THE OESOPHAGUS ?
Early oesophageal cancer usually does not have any symptoms. However, as the cancer grows, symptoms may develop. The common ones are :
HOW IS CANCER OF THE OESOPHAGUS DIAGNOSED?
If any of the above symptoms are present, your doctor will ask you for a detailed medical history and will perform a physical examination before conducting any of the following tests :
Barium swallow : This is a series of X-rays of the oesophagus. You will be asked to drink a liquid containing barium, which coats the inside of the oesophagus. An X-ray will then be taken and any abnormalities in the oesophagus will become visible on the X-ray.
Oesophagoscopy : In this a thin lighted tube called an endoscope is passed through your mouth into the oesophagus. Your doctor is able to see the insides of your oesophagus. If an abnormal area is found, your doctor collects the cells and tissues through the endoscope for examination under a microscope. This is called a biopsy.
To learn the extent of disease and suggest a course of treatment, your doctor may order some of the following tests :
Chest X-ray : This procedure detects the spread of cancer to your lungs.
CT Scan / MRI : These procedures may be able to detect the spread of cancer to your lungs, liver, neck or elsewhere in your body.
Bone Scan : This technique helps to detect the spread of cancer to your bones.
Bronchoscopy : Your doctor will put a bronchoscope (a thin, lighted tube) into your mouth or nose and down through your windpipe to look into the breathing passages.
HOW IS CANCER OF THE OESOPHAGUS TREATED ?
Depending on the size, location, and extent of your tumour, and your general health, cancer of the oesophagus may be treated with :
Some patients receive a combination of these treatments.
Surgery
This is the most common treatment for oesophageal cancer. Your surgeon may remove the tumour along with a portion or the entire oesophagus, nearby lymph nodes, and other tissue in the area. He connects the remaining healthy part of the oesophagus to the stomach so that you are able to swallow.
Chemotherapy
Treatment of cancer using drugs is called chemotherapy. Anticancer drugs used to treat oesophageal cancer are usually given by injection into a vein (IV). Chemotherapy may be combined with radiation therapy as primary treatment (instead of surgery) or to shrink the tumour before surgery. It may also be used after surgery and to treat cancer that has spread to other organs.
Radiation therapy
This form of therapy uses high - energy rays to kill cancer cells. Radiation therapy may be used alone or combined with chemotherapy, as primary treatment instead of surgery, especially if the size or location of your tumour would make it difficult to operate. Your doctor may also combine radiation therapy with chemotherapy to shrink the tumour before surgery. Even if the tumour cannot be removed by surgery or destroyed entirely by radiation therapy, radiation therapy can often help relieve pain and make swallowing easier.
Laser therapy
This form of therapy uses high-intensity light to destroy tumour cells. Laser therapy affects the cells only in the treated area. Your doctor may use laser therapy to destroy cancerous tissue and relieve a blockage in the oesophagus when the cancer cannot be removed by surgery. The relief of a blockage can help to reduce symptoms, especially swallowing problems.
WHAT ARE THE SIDE EFFECTS OF TREATMENT?
Cancer treatment may damage healthy cells and tissues, unwanted side effects sometimes occur. These side effects depend on may factors, including the type and extent of the treatment. The common side effects are loss of appetite, nausea, vomiting, mouth sores, hair loss, and reduction in number of blood cells. Some of these side effects can be treated with medicines.
PAIN MANAGEMENT
The management of pain is an integral part of cancer therapy. Medications are the cornerstone of cancer pain treatment, and their use is aimed at providing the greatest pain relief possible with the fewest number of side effects and the most ease of administration. Your doctor will prescribe medications that ensure maximum pain relief. Sometimes your doctor might recommend some interventional procedures like surgery and / or injections.
FOLLOW UP CARE
In cancer treatment, follow up care is an essential element of the overall treatment plan. Regular checkups will be advised to detect any recurrence of cancer.
CANCER CARE AT ARTEMIS
At Artemis Health Institute, state-of-the-art facilities are available for cancer diagnosis, treatment, follow up care and rehabilitation. These include advance imaging technologies such as PET scan, DWIBS and 3T MRI for diagnosing cancer. The hospital is also equipped with state-of-the-art radiation therapy such as Image Guided Radiation Therapy (IGRT) and Brachytherapy.
In temporary brachytherapy, the radioactive material is placed inside or near a tumour for a specific amount of time and then withdrawn. In temporary brachytherapy, a delivery device, such as a catheter, needle or applicator is placed into the tumour using fluoroscopy, ultrasound or CT to help position them. The physician may insert the radioactive material at the same time remotely through the delivery device, and later remove the material and delivery device. Temporary brachytherapy can be administered at a high-dose rate (HDR).
AHI has HDR Brachytherapy from Nucletron, Model Microselectron HDR.X.
Diseases:-
The oncologists at AHI are equipped to treat various kinds of cancers, including but not limited to:
- Larynx
- Colorectal Cancer
- Hodgkin's Disease
- Leukaemia
- Prostate Cancer
- Oesophagus Cancer
- Oral Cancer
- Thyroid Cancer
Special Care Units / Diagnostic Equipment / Facilities
- Diffusion Weighted Whole Body Imaging with Background Body Signal (DWIBS)
- 3 Tesla MRI (Magnetic Resonance Imaging)
- Mammography System
- PET Scan
- Advanced CT Scan (64-slice CT)
- PET-CT Fusion Technology
- Dual Head Gamma Camera
- Brachytherapy
- Image Guided Radiation Therapy (IGRT) - the first in North India
Team of Specialists:
- Dr Ranga Rao Consultant- Medical OncologyView Profile
- Dr. Deep Goel, Gastrointestinal Surgeon Consultant- Surgical OncologyView Profile
- Dr Subodh Pandey Consultant- Radiation OncologistView Profile