Esophageal cancer is a type of cancer that occurs in a part of the digestive system called the esophagus. The esophagus is a tube that extends from the mouth to the stomach, allowing food and liquids to pass through. Esophageal cancer occurs when cells in the lining of the esophagus grow and multiply abnormally.

Cancers that occur in the digestive system tube called the esophagus, which is approximately 25-30 cm long and extends from the neck to the stomach, are generally referred to as esophageal cancer or esophageal cancer.

Esophageal cancer symptoms

Esophageal cancer is a type of cancer that develops in a part of the digestive system called the esophagus. Symptoms of this cancer can vary depending on the tumor's location and stage. A more detailed look at esophageal cancer symptoms:

• Difficulty swallowing: The most obvious symptom of esophageal cancer is often difficulty swallowing. This can be difficult when eating or drinking. This is called dysphagia.
• A stuck feeling and painful swallowing: Symptoms of esophageal cancer may include a stuck feeling and pain when swallowing.
• Hoarseness: Hoarseness may be a symptom of a tumor near the neck area.
• Cough: Esophageal cancer that occurs in the middle region of the chest can cause cough.
• Reflux complaints: Cancers occurring in the area close to the stomach may present with severe reflux complaints.
• Bleeding: In rare cases, esophageal cancer can cause bleeding. This bleeding is usually not oral, but can be intestinal.

The symptoms of esophageal cancer according to stage are as follows:

• Stage 1: At this stage, cancer does not show any symptoms and is usually discovered by chance or through screening.
• Stage 2: Difficulty swallowing is a symptom of this stage. In rare cases, a stuck feeling and intestinal bleeding may also occur.
• Stage 3: Severe difficulty swallowing occurs, and consuming solid foods becomes difficult. Drooling may increase, especially in older patients.
• Stage 4: In this stage, symptoms vary depending on the site of metastasis. Significant weight loss is one of the most common symptoms. A cough may occur if the cancer has spread to the trachea, flank pain if it has spread to the liver, and bone pain if it has spread to the bones.

Important note: The symptoms above may not indicate esophageal cancer. These symptoms could be signs of other health problems. If you experience these symptoms, it's important to consult a healthcare professional. Early diagnosis is a key factor in cancer treatment.

Causes of esophageal cancer

The causes of esophageal cancer can vary depending on the cell type. The causes of different types of cancer include:

Squamous cell esophageal cancer: Causes of this type of cancer may include:

• Alcohol and tobacco use: Long-term alcohol and tobacco use can increase the risk of esophageal cancer.
• Excessively hot drinks: Consuming excessively hot drinks regularly can damage the lining of the esophagus and increase the risk of cancer.
• Burnt or smoked foods: Consuming foods that have been cooked at high temperatures, burned, or smoked may also increase the risk of esophageal cancer.

Adenocarcinoma esophageal cancer: The main causes of this type of cancer can be:

• Reflux disease: Long-term and uncontrolled reflux (stomach acid flowing back into the esophagus) can weaken the lining of the esophagus and increase the risk of cancer.
• Barrett's esophagus: A condition in which the lining of the esophagus changes due to reflux, Barrett's esophagus can increase the risk of esophageal cancer.
• Alcohol and cigarette use: The effects of alcohol and cigarette use may increase the risk of this type of cancer.

Some of the factors that increase the risk of esophageal cancer may include:

• Unhealthy diet: A diet high in red meat and high in fatty foods may increase the risk of esophageal cancer.
• Burnt foods: Frequent consumption of burnt foods prepared on a barbecue or at high temperatures may increase the risk of cancer.

It's important to remember that most causes of esophageal cancer are preventable. However, some rare diseases and genetic factors can also contribute to the development of this cancer. Adopting a healthy lifestyle, following regular medical checkups, and minimizing risk factors are important steps in reducing the risk of esophageal cancer.

How is esophageal cancer diagnosed?

Esophageal cancer is usually diagnosed using a variety of medical tests and imaging techniques. Some commonly used diagnostic methods include:

Endoscopy : In this procedure, a flexible tube (endoscope) is inserted into the esophagus. The end of the endoscope has a camera, allowing the doctor to view the inside of the esophagus. During this examination, a biopsy may be taken, meaning tissue samples from suspicious areas are taken and sent for laboratory analysis.

Biopsy: Tissue samples taken during endoscopy or surgery are examined in a pathology laboratory to help identify cancer cells or other abnormalities.

Imaging tests:

• Magnetic resonance imaging (MRI) and computed tomography (CT): These imaging modalities provide cross-sectional images of the body. They can help assess the size of esophageal cancer, its extent of spread, and its effect on nearby tissues.
• PET scan: A positron emission tomography (PET) scan can help determine if cancer has spread to other parts of the body. It can also be used to monitor response to treatment.

Chest X-ray: A chest X-ray can help evaluate whether esophageal cancer has spread to the lungs.

Laparoscopy: This surgical procedure involves inserting a small camera into the abdomen to examine internal organs. It can provide more information about the extent and extent of cancer spread.

Esophageal cancer is diagnosed by combining the results of multiple tests and collaborating with specialist doctors. The information obtained during diagnosis is used to determine the type, stage, and extent of cancer spread. This information is crucial in developing a treatment plan.

Esophageal cancer treatment

Treatment for esophageal cancer varies depending on the stage of the disease and the location of the tumor. Treatment for different stages of esophageal cancer includes:

Stage 3 Adenocarcinoma or squamous cell carcinoma:

• Chemoradiotherapy: This treatment, which is applied by adding chemotherapy to low doses of radiotherapy, aims to reduce the size of the tumor.
• Surgery: If the tumor has shrunk in size after chemoradiotherapy, surgery may be necessary. Surgery removes the tumor and may require reconstruction of the esophagus.

Stage 4 esophageal cancer:

• Chemotherapy and radiotherapy: In stage 4 cancers where surgery is not possible, a combination of chemotherapy and radiotherapy is used to control the tumor.

Cervical esophageal cancer:

• Chemoradiotherapy or surgery: Treatment options such as chemoradiotherapy or surgery are considered for cancers in the neck area. Research suggests that both approaches can provide similar success.

Chest region esophageal cancer:

• Chemoradiotherapy or surgery: If the tumor is located above the trachea, chemoradiotherapy is preferred, while if it's located below, surgery may be considered. Surgery involves removing the tumor and lymph nodes, and then creating a new esophagus from the stomach.

Esophageal cancer near the stomach:

• Surgery: For tumors in the esophagus near the stomach, surgical removal of the tumor and, if necessary, a portion of the stomach may be necessary. After a new esophagus is created, a special diet and careful eating habits may be necessary.

The treatment plan is determined based on the patient's overall health, the tumor's characteristics, and the extent of its spread. The treatment process requires a multidisciplinary approach and collaboration among specialists. Treatment aims to improve the patient's quality of life and control the cancer.

Who is more likely to get esophageal cancer?

Esophageal cancer may occur more frequently in people with the following risk factors:

• Smoking: Smoking may increase the risk of esophageal cancer.
• Excessive alcohol use: Consistently consuming excessive amounts of alcohol can increase the risk of esophageal cancer.
• Barrett's esophagus: Barrett's esophagus is a condition in which stomach acid flows back into the esophagus due to gastroesophageal reflux disease (GERD). This can increase the risk of esophageal cancer.
• Being overweight or obese: Being overweight or obese may increase the risk of esophageal cancer.
• Dietary habits: Inadequate consumption of fruits and vegetables and high consumption of processed meat or fried foods may increase the risk of esophageal cancer.
• Extremely hot liquids and foods: Consistently consuming extremely hot liquids or foods may increase the risk of esophageal cancer.
• Chronic reflux: Chronic acid reflux (GERD) may increase the risk of esophageal cancer.
• Family history: People with a family history of esophageal cancer may be at increased risk.
• Age: Esophageal cancer is generally more common in people over the age of 45.

The factors mentioned above increase the risk of esophageal cancer, but the presence of these factors does not guarantee that an individual will develop esophageal cancer. Healthy lifestyle choices, regular health screenings, and adherence to doctor's recommendations can play a significant role in reducing cancer risk.

How should esophageal cancer patients eat?

The diet of esophageal cancer patients may vary depending on their treatment process and individual health status. However, the following general nutritional recommendations may be helpful for esophageal cancer patients:

• Choose soft and easy-to-consume foods: Treatment can cause difficulty swallowing. Therefore, choosing soft and easy-to-consume foods like pureed foods, soup, and yogurt can be helpful.
• Eat frequent and small meals: Eating small amounts frequently throughout the day instead of large meals puts less strain on the digestive system.
• Ensure Adequate Protein Intake: Protein is essential for the healing process. Try to consume high-protein foods like chicken, fish, eggs, and dairy products.
• Continue to consume fruits and vegetables: Ensure your vitamin and mineral intake by consuming soft fruits and vegetables. Their fiber content can also support digestive health.
• Increase your fluid intake: Due to treatment and difficulty swallowing, you may be at risk of dehydration. Make sure you drink plenty of fluids. In addition to water, you can also choose liquids like soup and fruit juice.
• Limit fat intake : Highly fatty foods can cause digestive problems. Choose options that contain healthy fats, like olive oil.
• Avoid spicy and very hot foods: Spicy or very hot foods can increase esophageal irritation. Limit these foods if possible.
• Stay in touch with your doctor and nutritionist: It's important to stay in touch with your doctor and a nutritionist throughout your treatment process. They can create a personalized nutrition plan tailored to your individual needs.
• Eat slowly and chew thoroughly: Chewing food thoroughly can aid digestion. Try to eat slowly, without rushing.

Every patient is different, and treatment may vary from person to person. Therefore, it is best to follow the recommendations of your doctor and nutritionist.

What happens if esophageal cancer is not treated?

If left untreated, esophageal cancer can lead to serious health problems and a reduced quality of life. Untreated, the following negative consequences can occur:

• Cancer progression: If esophageal cancer is left untreated, cancer cells can multiply rapidly and spread to surrounding tissues. This can limit treatment options if the cancer is detected in advanced stages.
• Symptoms worsen: Esophageal cancer symptoms often worsen if left untreated. Symptoms such as difficulty swallowing, pain, and weight loss may increase.
• Increasing difficulty swallowing : Esophageal cancer can cause difficulty swallowing. As the condition progresses, eating and feeding can become more difficult.
• Feeding problems: Difficulty swallowing and digestive issues can make feeding difficult. This can lead to weight loss, wasting, and malnutrition.
• Pain and discomfort: Pain and discomfort can increase with advanced cancer, which can negatively impact quality of life.
• Metastases and organ damage: Untreated esophageal cancer can increase the risk of cancer cells spreading to other parts of the body. This is called metastases and can affect other organs.
• Decreased quality of life: Esophageal cancer and its symptoms can seriously reduce the patient's quality of life, both physically and psychologically.

Untreated cancers often become more complex and difficult to treat. Therefore, early diagnosis and exploration of appropriate treatment options are crucial for suspected esophageal cancer. Treatment options may vary depending on the patient's health, the stage of the cancer, and other factors. The treatment plan should be determined by a doctor and oncologist.