Esophageal Cancer

Esophageal Cancer; GA 3.11
Topic Started: Aug 9 2008, 11:03 AM (77 Views)
Carter	Aug 9 2008, 11:03 AM Post #1
O'Malley Forever Posts: 5,374 Group: Admin Member #1 Joined: August 2, 2008 Favorite Character George O'Malley Favorite Couple Callie & Arizona	SIX DAYS - Part 1 Episode 311 Air date 01/11/07 Esophageal Cancer. It's hard to blog about -- since -- well, I don't want George's Dad to be sick. But, George's Dad IS sick, so we might as well know what's going on& First off, let's start with what the esophagus is... The esophagus is a tube of muscle lined with mucus producing membrane that runs from the mouth to the stomach. The top portion -- closest to the mouth -- is a special muscle known as the upper esophageal sphincter. This sphincter opens when it senses food or liquid coming down the pipe. The bottom portion of the esophagus is the gasteroesophageal junction (more commonly called the GE junction). This junction regulates the flow of food and drink to the stomach and keeps the acid and stomach fluids that break down food away from your esophagus, which isn't designed to withstand stomach acid. So what goes wrong to make cancer? Well, a cell becomes ambitious and begins to split itself. Only, the cell it splits into is abnormal and this abnormal cell splits too and creates more abnormal cels which split and split and then become a cluster of abnormal cells called a tumor. The tumor is either benign or cancerous. If it's benign it can usually be surgically removed and there is a low rate of recurrence. If it's cancerous (or malignant) -- then it's more complicated. If it's caught early, then it's much easier to treat, but this type of cancer is tricky to catch because the symptoms so often masquerade as less serious conditions. The type of esophageal cancer is defined by the kind of cell that begins to divide abnormally. Typically, the cells in the epithelium layer are the culprit. Then it's called squamous cell carcinoma. Typically this type of cancer is found in the upper (closest to the mouth) or center of the esophagus, though it can occur closer to the GE junction. Adenocarcinoma begins in the glandular cells -- the cells that make the mucus. This occurs closer to the stomach. What're the symptoms? Pain or difficulty with swallowing. Weight loss Pain behind the breastbone Hoarseness and coughing Indigestion and heartburn (George's Dad had this) Getting full quickly Why's it happen? Who knows? Genetics? Predisposition? Smoking and excessive alcohol consumption are risk factors. If you have chronic heart burn you should talk to your doctor about whether or not you should be tested. How do you find out if you have the esophageal cancer? Tests. Could you be more specific? Sure. Chest-x-ray with and without barium swallow. The barium is a metallic compound that you drink which helps the doctors see your insides on the x-rays better. Esophagoscopy. They put you under light sedation and put a camera down your throat either through your nose or mouth to see what's goin' on inside. Biopsy. They take a sample of your tissue to look at under a microscope and analyze it to see if your cells are cancerous or not. Why didn't they catch George's Dad's cancer sooner? Here's the thing. George's Dad has Gastroesophageal Reflux Disease or GERD. It's easy to dismiss that as heartburn and not take care of it. But, years of your stomach acid coming through the GE junction and eating away at the esophagus can cause the cells to break down and start splitting abnormally. That's why it's so important to take your medication and change your diet and exercise if you have GERD. After years and years it can significantly increase your chances of esophageal cancer. So, when the diagnosis is esophageal cancer -- like with George's Dad what do you do? First, you do a whole bunch of tests to stage the cancer. This tells the doctors where all of the cancer cells are, how many systems are effected and how serious the cancer is. Stage 0 means that the cancer is only in the epithelium and therefore contained. It's also called Carcinoma in Situ. Stage 1 means it's gotten into the next layer of the esophagus. Stage IIA it's in the muscle or the outer walls of the esophagus and IIB means it in 3 layers of the esophagus and also the lymph nodes. In stage III the cancer has spread into the lymph nodes and nearby tissues. Stage IVA it's spread to distant lymph nodes. Stage IVB it's spread to other organs. Like the stomach. What're the treatments? Surgery to remove the tumor followed by a variety of therapies (chemotherapy and radiation therapy being the most famous) that are designed to kill cancer cells. When they remove part of the esophagus -- it's called an esophagectomy. As you can imagine, the esophagus performs a very important function -- getting food and drink from your mouth to your tummy. When you remove a portion of it -- you have to replace it . If there isn't enough esophagus left they use a plastic tube, a portion of the intestine or some of the stomach to patch you up. For more information about esophageal cancer please go to: http://www.cancer.gov/cancertopics/types/esophageal Credit: Sara (mcobsessed)



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