Esophageal Cancer Cheat Sheet

Symptoms

• Progressive Dysphagia (difficulty swallowing, starting with solids then progressing to liquids).

• Weight loss, anorexia, vomiting, and hoarseness.

• Melena (black tarry stools) and sometimes a cough.

Adenocarcinoma:

• Location: Lower third of the esophagus.

• Risk Factors:

  • GORD (Gastro-oesophageal Reflux Disease).

  • Barrett's Esophagus (precancerous condition from chronic reflux).

  • Achalasia (esophageal motility disorder).

  • Obesity.

  • Smoking.

• Most common in developed countries, including the UK.

1. Squamous Cell Carcinoma:

1. • Location: Upper and middle thirds of the esophagus.

   • Risk Factors:

     • Plummer-Vinson Syndrome (iron deficiency, esophageal webs).

     • Smoking and alcohol (most common)

     • Achalasia.

   • Most common in developing countries.

Clinical Features

• Early Symptoms:

  • Nonspecific or asymptomatic.

• Advanced Symptoms:

  • Progressive Dysphagia: First solids, then liquids.

  • Anorexia and significant weight loss.

  • Vomiting and melena.

  • Hoarseness (from recurrent laryngeal nerve involvement).

  • Cough: May indicate tracheoesophageal fistula or aspiration.

Diagnosis

• Upper GI Endoscopy and Biopsy:

  • Gold standard for identifying and diagnosing esophageal cancer.

• CT Scan:

  • Used for staging to determine the extent of disease and metastasis.

Management

• Surgical Resection:

  • Esophagectomy (removal of the affected part of the esophagus).

  • Often combined with neoadjuvant (pre-surgery) therapy in advanced cases.

• Supportive Care:

  • Nutritional support for weight loss.

  • Palliative care in inoperable cases.

Key Points

• Adenocarcinoma: Common in developed countries, linked to GORD and Barrett's esophagus.

• Squamous Cell Carcinoma: Common in developing countries, affects the upper two-thirds of the esophagus.

• Progressive dysphagia and weight loss are hallmark symptoms.

• Early diagnosis is crucial for better outcomes; staging with CT scans guides treatment decisions.