The document summarizes esophageal cancer, including its causes, risk factors, types, signs and symptoms, methods of diagnosis and treatment. It discusses that esophageal cancer occurs when cells in the esophagus grow abnormally and form tumors. Risk factors include GERD, smoking, Barrett's esophagus, alcohol consumption and not eating enough fruits and vegetables. Treatment options include surgery to remove the esophagus and nearby lymph nodes, radiation therapy, chemotherapy and immunotherapy. Prevention methods include avoiding smoking and excessive alcohol, and maintaining a healthy diet and weight.

1. ESOPHAGEAL
CANCER
By
S.Jafar Ali

2. Review Anatomy & physiology
 The esophagus is a
muscular tube connecting
the throat (pharynx) with the
stomach. The esophagus is
about 8 inches long, and is
lined by moist pink tissue
called mucosa.
 The esophagus runs
behind the windpipe
(trachea) and heart, and in
front of the spine. Just
before entering the
stomach, the esophagus
passes through the
diaphragm.

3. Review Anatomy & physiology
 The upper
esophageal sphincter
(UES) is a bundle of
muscles at the top of
the esophagus. The
muscles of the UES
are under conscious
control, used when
breathing, eating,
belching, and
vomiting. They keep
food and secretions
from going down the
windpipe.

4. Cont,,,,,
 The lower esophageal
sphincter (LES) is a
bundle of muscles at
the low end of the
esophagus, where it
meets the stomach
 When the LES is
closed, it prevents
acid and stomach
contents from
traveling backwards
from the stomach.
The LES muscles are
not under voluntary
control.

5. Causes
 It's not exactly clear what causes esophageal
cancer.
 Esophageal cancer occurs when cells in the
esophagus develop changes (mutations) in
their DNA. The changes 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

6. Signs and symptoms
 Difficulty swallowing (dysphagia)
 Weight loss without trying
 Chest pain, pressure or burning
 Worsening indigestion or heartburn
 Coughing or hoarseness

7. Types of esophageal cancer
 Adenocarcinoma.
 Adenocarcinoma begins in the cells of mucus-
secreting glands in the esophagus.
 Adenocarcinoma occurs most often in the
lower portion of the esophagus.
 Adenocarcinoma is the most common form of
esophageal cancer.

8. Types of esophageal cancer
 Squamous cell carcinoma.
 The squamous cells are flat, thin cells that line
the surface of the esophagus.
 Squamous cell carcinoma occurs most often in
the upper and middle portions of the
esophagus.
 Squamous cell carcinoma is the most
prevalent esophageal cancer worldwide.

9. Risk factors
 Having gastro esophageal reflux disease (GERD)
 Smoking
 Having precancerous changes in the cells of the
esophagus (Barrett's esophagus)
 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

10. complication
 Obstruction of the esophagus.
 Metastases.
 Bleeding in the esophagus.
 Tracheo-esophageal fistulas
 Pneumonia.
 Weight loss.
 Anemia.

12. esophagectomy
 During esophagectomy,
the surgeon removes
the portion of your
esophagus that
contains the cancer,
along with a portion of
the upper part of your
stomach, and nearby
lymph nodes. The
remaining esophagus is
reconnected to your
stomach. Usually this is
done by pulling the
stomach up to meet the
remaining esophagus.

13. esophagogastrectomy
 During esophagogastrectomy, the surgeon
removes part of your esophagus, nearby
lymph nodes and a larger part of your
stomach. The remainder of your stomach is
then pulled up and reattached to your
esophagus. If necessary, part of your colon is
used to help join the two.

14. Medical management
 Radiation therapy. Kills cancer cells with
radiation.
 Chemotherapy.
 Immunotherapy. Helps the immune system to
attack cancer cells.
 Photodynamic therapy. Targets cancer cells
with a special laser light.
 Electro coagulation. Uses electric current to
destroy cancer cells.
 Cryotherapy. Freezes cancer cells to help
shrink a tumor.

15. Prevention esophageal cancer
 Avoiding cigarettes and chewing tobacco is
key.
 Limiting your consumption of alcohol is also
thought to lower your risk.
 Eating a diet with lots of fruits and vegetables
and maintaining a healthy weight may also be
effective ways to avoid esophageal cancer.