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Oesophageal cancer: Difference between revisions
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(Created page with "There are two major types of oesophageal cancer, adenocarcinoma and squamous cell carcinoma. Both type typically affect elderly men. Oesophageal adenocarcinoma evolves from the Barrett-mucosa and is the most common type of oesophageal cancer in the Western world. Its incidence is rising. It’s usually found in the lower part of the oesophagus. Oesophageal SCC is more common in developing countries, and the most common type overall. It’s usually found in the middle an...") |
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There are two major types of oesophageal cancer, adenocarcinoma and squamous cell carcinoma. Both type typically affect elderly men. Oesophageal adenocarcinoma evolves from the Barrett-mucosa and is the most common type of oesophageal cancer in the Western world. Its incidence is rising. It’s usually found in the lower part of the oesophagus. | There are two major types of '''oesophageal cancer''', adenocarcinoma and squamous cell carcinoma. Both type typically affect elderly men. Oesophageal adenocarcinoma evolves from the [[Barrett oesophagus|Barrett-mucosa]] and is the most common type of oesophageal cancer in the Western world. Its incidence is rising. It’s usually found in the lower part of the oesophagus. | ||
Oesophageal SCC is more common in developing countries, and the most common type overall. It’s usually found in the middle and upper parts of the oesophagus. Its prognosis is worse than adenocarcinoma. | Oesophageal SCC is more common in developing countries, and the most common type overall. It’s usually found in the middle and upper parts of the oesophagus. Its prognosis is worse than adenocarcinoma. | ||
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== Etiology == | == Etiology == | ||
Because adenocarcinoma evolves from GERD and Barrett oesophagus, the risk factors are the same as for GERD, especially smoking. | Because adenocarcinoma evolves from [[Gastroesophageal reflux disease|GERD]] and [[Barrett oesophagus]], the risk factors are the same as for GERD, especially [[smoking]]. | ||
The risk factors for SCC are: | The risk factors for SCC are: | ||
* Alcohol consumption | * [[Alcohol]] consumption | ||
* Smoking | * [[Smoking]] | ||
* Diet low in fruits and vegetables | * Diet low in fruits and vegetables | ||
* Exposure to nitrosamines in diet | * Exposure to [[Nitrosamine|nitrosamines]] in diet | ||
* Frequent consumption of very hot beverages, like the coffee at McDonalds. | * Frequent consumption of very hot beverages, like the coffee at McDonalds. | ||
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== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
Upper endoscopy is the investigation of choice, as it allows for both visual diagnosis and biopsy. Endoscopic ultrasound may also be necessary to assess the depth of invasion accurately, to distinguish T1A and T1B stages. | [[Upper endoscopy]] is the investigation of choice, as it allows for both visual diagnosis and biopsy. [[Endoscopic ultrasound]] may also be necessary to assess the depth of invasion accurately, to distinguish T1A and T1B stages. | ||
CT thorax and abdomen is required for staging. Bronchoscopy is required if extension into the bronchial system is suspected. | [[CT]] thorax and abdomen is required for staging. [[Bronchoscopy]] is required if extension into the bronchial system is suspected. | ||
== Prognosis == | == Prognosis == | ||
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Surgery may be performed open, laparoscopically, or in combination. | Surgery may be performed open, laparoscopically, or in combination. | ||
Locally advanced oesophageal cancer is treated with neoadjuvant chemoradiation, followed by surgery if the tumour is considered resectable on restaging. | Locally advanced oesophageal cancer is treated with [[neoadjuvant]] chemoradiation, followed by surgery if the tumour is considered resectable on restaging. | ||
Palliative therapy is often employed for stage IV disease. The placement of stents is the major palliative option for oesophageal cancer. | [[Palliative therapy]] is often employed for stage IV disease. The placement of stents is the major palliative option for oesophageal cancer. | ||
[[Category:Gastrointestinal surgery]] | [[Category:Gastrointestinal surgery]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||