Investigatory Project
BIOLOGY
Oesophageal cancer
Name: Maryam Naseer
Class & section: 12C c
Table of content
About oesophageal cancer
Oesophageal cancer is a cancer of the food pipe.The oesophagus is part of the digestive system. It is the tube that carries food from your mouth to your stomach. Cancer can develop in any part of the oesophagus. The outlook for oesophageal cancer varies depending on things such as how far it has spread, your age and your general health. If it’s detected while it’s still quite small, it may be possible to get rid of it completely. But as oesophageal cancer doesn’t usually cause any symptoms until a late stage, it has often spread quite far by the time it’s diagnosed.
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Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.
Stages, types, and grades
Stages of cancerThe stage of cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.The tests and scans you have to diagnose your cancer give some information about the stage. Sometimes it’s not possible to be certain about the stage of cancer until after surgery. Doctors can use a number system or the TNM system to stage your cancer.
TNM staging
Stage 0 or high-grade dysplasia
Abnormal cells are found only in the inner layer of the esophagus. It’s called carcinoma in situ.
Stage 1
cancer has grown through the inner layer to the submucosa.
Stage 2
cancer has grown through the inner layer to the submucosa, and cancer cells have spread to lymph nodes.
Or, cancer has invaded the muscle layer. Cancer cells may be found in lymph nodes.
Or, cancer has grown through the outer layer of the esophagus.
Stage 3
cancer has grown through the outer layer, and cancer cells have spread to lymph nodes.
Or, cancer has invaded nearby structures, such as the airways. Cancer cells may have spread to lymph nodes.
Stage 4
Cancer cells have spread to distant organs, such as the liver.
Types of oesophageal cancerThe type of oesophageal cancer you have tells you the type of cell that cancer started in. Knowing this helps your doctor decide which treatment you need. 666750
AdenocarcinomaAdenocarcinomas are cancers that develop in gland cells. These cells make mucus in the lining of the oesophagus. They mainly start in the lower part of the oesophagus and are the most common type of oesophageal cancer.
Squamous cell cancerThese cancers develop from cells that make up the inner lining of your oesophagus. They tend to develop in the upper and middle part of the oesophagus.Squamous cells are resistant to hot liquids and sharp foods and can heal quickly if damaged. As cells are damaged new cells are made to replace them.
Undifferentiated cancersUndifferentiated means the specialist cannot tell what type of cell your cancer started from. This is usually because the cells are not mature enough to be specialised. The specialisation of cells is called differentiation. So these primitive cancer cells are known as undifferentiated cancer cells.
Rare CancersOther rare cancers can develop in the oesophagus they include
melanoma
lymphoma
Sarcomas
GradesThe grade of cancer tells you how much cancer cells look like normal cells. The grade gives your doctor an idea of how the cancer might behave and what treatment you need.The grades of cancer cells are from 1 to 3:
grade 1 (low grade) look most like normal cells
grade 2 look a bit like normal cells
grade 3 (high grade) look very abnormal and not like normal cells
Causes
Esophageal cancer occurs when cells in your esophagus develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.
The chronic irritation of your esophagus may contribute to the changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:
Having gastroesophageal reflux disease (GERD)
Smoking
Having precancerous changes in the cells of the esophagus (Barrett’s esophagus)
Being obese
Drinking alcohol
Having bile reflux
Having difficulty swallowing because of an esophageal sphincter that won’t relax (achalasia)
Having a steady habit of drinking very hot liquids
Not eating enough fruits and vegetables
Undergoing radiation treatment to the chest or upper abdomen-152399171450
Symptoms
During the early stages of esophageal cancer, you probably won’t experience any symptoms. As your cancer progresses, you may experience:
unintentional weight loss
indigestion
heartburn
pain or difficulty when swallowing
frequent choking while eating
vomiting
food coming back up the esophagus
chest pain
fatigue
chronic cough3209925104775
hiccups
Diagnostics
Testing methods for diagnosing esophageal cancer include the following:
An endoscopy involves the use of an instrument with a camera attached to a tube that goes down your throat and allows your doctor to view the lining of your esophagus to check for abnormalities and irritation.3352800152400
A barium swallow is an X-ray imaging test that allows your doctor to see the lining of your esophagus. To do this, you swallow a chemical called barium while the images are being obtained.
A biopsy is a process in which your doctor removes a sample of the suspicious tissue with the help of an endoscope and sends it to a lab for testing.
A CT scan, PET scan, or MRI may be used to see if cancer has spread to other parts of the body.
A new method has been developed by the Researchers at the University of Cambridge, known as the Cytosponge to detect Barrett’s esophagus, a condition that increases one’s chance of developing esophageal cancer.
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Treatment
What treatments you receive for esophageal cancer are based on the type of cells involved in your cancer, your cancer’s stage, your overall health and your preferences for treatment. Your doctor may recommend surgery if cancer hasn’t spread to other parts of your body. Your doctor may instead recommend chemotherapy or radiation therapy as the best course of action. These treatments are also sometimes done to shrink tumors in the esophagus so that they can then be removed more easily with surgery.SurgeryIf the cancer is small and hasn’t spread, your doctor can remove the tumor using a minimally invasive approach, using an endoscope and several small incisions. In the standard approach, the surgeon operates through a larger incision to remove a portion of the esophagus and sometimes the lymph nodes around it. The tube is reconstructed with tissue from the stomach or large intestine. In severe cases, a portion of the top of the stomach may be removed as well.
ChemotherapyChemotherapy involves the use of drugs to attack cancer cells. Chemotherapy may be used before or after surgery. It sometimes accompanies the use of radiation therapy. Radiation therapyRadiation therapy uses beams of radiation to kill cancer cells. Radiation may be administered externally (with the use of a machine) or internally (with a device placed near the tumor, which is called brachytherapy). Radiation is commonly used along with chemotherapy, and side effects are usually more severe when a combined treatment is used. Targeted therapyTargeted therapies can target specific proteins on cancer cells as a way to treat the cancer. A small portion of esophageal cancers can be treated with Trastuzumab. It targets the HER2 protein on the surface of cancer cell where the protein has been helping cancer cells to grow. Also, cancers can grow and spread by creating new blood vessels. Ramucirumab is a type of targeted therapy called “monoclonal antibody,” and this bonds to a protein called VGEF, which helps make new blood vessels.Other treatmentsIf your esophagus is obstructed as a result of cancer, your doctor may be able to implant a stent (a tube made of metal) into your esophagus to keep it open. They may also be able to use photodynamic therapy, which involves injecting the tumor with a photosensitive drug that attacks the tumor when exposed to light.
Side effects
Surgery
The risks of surgery can include pain, bleeding, leaking in the area where the rebuilt esophagus is attached to the stomach, lung complications, problems swallowing, nausea, heartburn, and infection.
Chemotherapy Chemotherapy has a number of possible side effects. Most arise because chemotherapy drugs also kill healthy cells. Your side effects will depend on the drugs your doctor uses. These side effects can include:
hair loss
nausea
vomiting
fatigue
pain
neuropathy
Radiation therapy
The side effects of radiation can include:
skin that looks sunburned
pain or difficulty when swallowing
fatigue
painful ulcers in the lining of the esophagus
It’s possible to experience some side effects of treatment long after treatment finishes. These can include esophageal stricture, where the tissue becomes less flexible and can cause the esophagus to narrow, making it painful or difficult to swallow.
Prevention
Limit your alcohol intake: Drinking in moderation is fine, but too much alcohol can significantly raise your risk of getting one of the main types of esophageal cancer. Stick to drinking alcohol only occasionally
Toss your cigarettes. Smoking is one of the biggest risk factors for esophageal cancer, and there are of course a number of other health problems that can arise from smoking as well.
Watch your weight. Being obese not only increases your risk for heart disease and diabetes, it’s also a plus-sized indicator of your risk for esophageal cancer. Finding a diet and exercise program that works for you can help you maintain a healthy body weight for a lifetime of good health and reduced cancer risk.
Eat right. It may be tough to squeeze in the recommended five daily servings of fruits and vegetables, but it’s a small price to pay to prevent esophageal cancer. Add veggies to every meal; they also make great snacks. Watch the amount of red and processed meats in your diet, and always opt for whole-grain food choices when possible.
Control Gastroesophageal Reflux Disease (GERD). If you have persistent heartburn, popping pills to reduce your symptoms and then ignoring it is not the answer. See your doctor about getting GERD under control. GERD is a major risk factor for esophageal cancer, and it can be controlled early enough to possibly prevent esophageal cancer. You should also ask your doctor if you should be checked for a condition called Barrett’s esophagus, which occurs in about 10 to 15 percent of people with GERD. You may need regular monitoring of your condition to check for early signs of esophageal cancer.
Society and culture
The occurrence of oesophageal cancer depends mainly on a person’s personal intake. The personal intake of people nowadays is enormously encouraged by the society and their culture.
In India, the number of people suffering from oesophageal cancer is increasing every year. I feel that the reason for this is the fast transitioning into a modern lifestyle. Back in the days, people had access to healthier, organic and chemical free food, but since the arrival of fast food chains and social media, the food quality is decreasing. The food is becoming more tastier, bigger in size, and less healthy and nutritious. Another reason for this increase is the lack of physical exercise. People nowadays forgot that there is a world outside their device’s screen. They are opting easier modes of getting around like cars motorcycles, etc..All of these factors are slowly leading to a more obese population. Obesity is one of the major cause of all diseases especially cancer.
Younger Indian citizens nowadays are getting heavily influenced into drinking alcohol and smoking. It might bring you momentary bliss but it will surely bring you everlasting misery.
Case study
Bibliography
http://www.cancerresearchuk.org/about-cancer/oesophageal-cancerhttps://www.nhs.uk/conditions/oesophageal-cancer/https://en.wikipedia.org/wiki/Esophageal_cancerhttps://www.mayoclinic.org/diseases-conditions/esophageal-cancer/symptoms-causes/syc-20356084https://www.healthline.com/health/esophageal-cancer#treatmenthttps://www.gbhealthwatch.com/esophagealcancer-details.php
