Esophageal Cancer - One death occurs every three minutes in China, and most of the time it is found is late.
According to the latest national cancer statistics released by the National Cancer Center in February 2018, China is one of the countries with the highest incidence and mortality of esophageal cancer in the world. However, compared with lung cancer and gastric cancer, which have a higher incidence of malignant tumors, esophageal cancer is often not valued by too many people.
Esophageal cancer is a malignant tumor that originates in esophageal squamous epithelium and columnar epithelium. It can occur in any part of the esophagus. The esophagus has the most in the middle esophagus, followed by the lower esophagus and the least in the upper esophagus.
The incidence of esophageal cancer is more common in men than in women. Most patients over the age of 40 are ethnic and regional agglomeration tendencies. Central China is a high-risk area of esophageal cancer, including areas in the Taihang Mountains in parts of Henan, Hebei and Shanxi provinces.
The exact cause of esophageal cancer is still not fully understood
At present, it can be known that the irritation and certain physical and chemical factors of carcinogens in foods are important reasons. At the same time, alcohol, smoking, genetic mutations, genetic factors, and the lack of trace elements and minerals in foods also play an important role in the development of esophageal cancer:
1, nitrosamines and mycotoxins
Many animal experiments have confirmed that nearly 30 nitrosamines can induce tumors in experimental animals. Studies in high-incidence areas of esophageal cancer in China indicate that there is a positive correlation between local consumption of sauerkraut and the incidence of esophageal cancer. The favorite sauerkraut of local residents contains a large number of fungi, nitrates and nitrites. These fungi can reduce nitrates to nitrites and enhance the synthesis of nitrosamines. The lack of vitamins A, C, E and molybdenum, selenium and other trace elements can strengthen the carcinogenic effects of nitrates.
2, esophageal disease, esophageal injury and food stimulating effect
In patients with corrosive esophageal injury, esophageal-achalasia, and reflux esophagitis, the incidence of esophageal cancer is higher than in other populations. Barrett's esophagus in gastroesophageal reflux disease has a 30 to 125-fold higher rate of cancer than that in the same age control population.
In the living habits, including a long-term consumption of hot, rough food, lack of protein, lack of fresh vegetables and fruits, smoking, alcohol abuse, and a series of other factors are related to the incidence of esophageal cancer.
Eat hot food, drink hot drinks can cause esophageal injury, increase the chance of suffering from esophageal cancer
3, genetic factors
The onset of esophageal cancer has a pronounced tendency towards familial aggregation, and point mutations in tumor suppressor genes and chromosome aberrations in peripheral blood lymphocytes can be found in studies of high-risk cancer families.
Many esophageal cancers have been found late
What is more tragic is that the shape of the early esophageal cancer is generally not obvious, so it is easily overlooked. As a result, it is late in its discovery.
Early esophageal cancer is mainly characterized by post-sternal discomfort, burning sensation or pain, sometimes foreign body sensation or friction when swallowing food, and sometimes a feeling of stagnation when swallowed. In addition, non-specific symptoms such as epigastric discomfort, hiccup, and belching may also be associated. These symptoms are light, heavy, and of varying duration. A few patients with esophageal cancer may not even have any obvious symptoms.
When the disease progresses to the later stage, the extent of tumor involvement increases, and the area of obstructed esophageal obstruction becomes larger, and typical esophageal cancer symptoms, ie, progressively increased dysphagia, gradually develop from the difficulty of swallowing solid foods. Liquid foods are also difficult to swallow. This is the main symptom of the vast majority of patients at the time of treatment, but it is also the performance of the disease later.
Other than
Esophageal obstruction caused by tumor hyperplasia can cause reflux and cough; inflammation and ulcers caused by tumor infiltration can cause chest and abdomen pain; tumor invasion of the thoracic aorta can lead to fatal bleeding; tumor invasion of nearby nerves can cause hoarseness and hiccups; Compression of the trachea can cause an urge to dry and cough, and direct invasion of the trachea can cause esophageal tracheal spasm.
Progressively aggravated eating difficulties are accompanied by the gradual growth of the tumor. As a result, the patient’s nutritional status continues to deteriorate, resulting in weight loss, anemia, malnutrition, and cachexia. If treatment is not promptly effective, it will soon die.
Early diagnosis and treatment of esophageal cancer
The diagnosis of esophageal cancer is not difficult by relying on clinical manifestations and auxiliary examinations.
Endoscopic examination and pathological biopsy are the preferred methods for the diagnosis of esophageal cancer. Esophageal barium meal, esophageal CT, and endoscopic ultrasonography are also effective methods. Exfoliative cytology can be used for esophageal cancer screening.
Endoscopy is one of the preferred methods for the diagnosis of esophageal cancer
Esophageal cancer patients who have symptoms and have not been treated usually have a survival period of no more than 1 year. Therefore, after a clear diagnosis, the next step is to seize the time for treatment. The treatment of esophageal cancer is a combination of surgery and radiotherapy and chemotherapy:
surgery. The early surgical resection rate of esophageal cancer can reach 100%. The postoperative 5-year survival rate reaches 90%, and the 10-year survival rate reaches 60%. Therefore, as long as the heart and lung function is good, the tumor does not violate the adjacent structure of the esophagus, there is no cachexia, and distant metastasis, esophageal cancer treatment is still the preferred surgical resection. Radiotherapy. Esophageal cancer is mainly squamous cell carcinoma and sensitive to radiotherapy. Patients with early or mid-term patients who are unwilling to undergo surgery or cannot be operated due to physical reasons can receive radiotherapy without advanced metastases in advanced patients. Chemotherapy. Chemotherapy is often used in advanced patients who cannot undergo surgery or radiotherapy. Although the effect is not satisfactory, it is currently the only effective method for systemic metastasis. Current recommendations are reported to have an efficiency of between 20% and 50%. Endoscopic treatment. For small diameter lesions, the depth of infiltration does not reach the submucosal esophageal cancer, mucosal resection can be performed endoscopically, or esophageal stent can be placed under the microscope to relieve obstructive symptoms.
In short, the key to the treatment of esophageal cancer is early diagnosis, and the therapeutic effect and prognosis are closely related to the degree of disease progression at the time of diagnosis. The prognosis of early esophageal cancer is good, and the 5-year survival rate can reach more than 90%.
Prevention of esophageal cancer, starting from these two points
The first is to improve living habits and conditions. Smoking cessation limit alcohol; do not eat fresh and moldy foods, do not eat hot foods; improve the high incidence of disease areas lack soil trace elements and water pollution problems; use of vitamins, folic acid treatment of esophageal hyperplasia and other high risk factors for esophageal cancer.
The second is science-related knowledge, to do monitoring and screening of susceptible people. Even a healthy, asymptomatic population should have a gastroscopy every 1-2 years after age 40. For those over the age of 50 (the high incidence of esophageal cancer to 40 years of age or more), after the occurrence of post-sternal stagnation or dysphagia, should go to the hospital to do related checks in order to avoid delays in diagnosis and treatment.
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