CHN (ESOPHAGEAL CANCER)

two main types of esophageal cancer

• squamous cell carcinoma (historically the more prevalent form),

• and adenocarcinoma (since risen sharply in incidence due to risk factors like gastroesophageal reflux disease (GERD) and obesity)

• occurs when cancer cells develop in the esophagus, the long muscular tube that runs from your throat to your stomach.

• cancer starts in the inner layer of the esophagus and can spread throughout the other layers of the esophagus and to other parts of the body (metastasis).

   Esophageal cancer

Environmental lifestyle factor of esophageal cancer?

• Smoking and Alcohol: Primary contributors, especially in males.

• Diet: High intake of smoked or pickled foods (e.g., nitrosamines).

• GERD and obesity (higher risk for adenocarcinoma in urban areas).

At-Risk Groups:

• Age: Higher incidence over age 55.

• Gender: Men are more frequently affected.

• Ethnic Groups: Higher prevalence among certain Asian and African populations.

• Socioeconomic Status: Lower-income individuals often face limited healthcare access, leading to delayed diagnosis.

Worldwide:_____ most common cancer; 6th in cancer-related deaths

8th

• More common in East Asia, Africa, and certain parts of Europe.

• Linked to smoking, alcohol use.

Squamous Cell Carcinoma

Rising in Western countries due to obesity, GERD

Adenocarcinoma

Clinical manifestation

• dysphagia

• unintentional weight loss

• chest pain/discomfort

• regurgitation of food

• hoarseness or voice changes

• chronic cough

• hematemesis (vomiting blood) or melena (black, tarry stools)

• fatigue

• anorexia

• hiccups

• lymphadenopathy

factors that transmit risk developing esophageal cancer are?

• Smoking and exposure to tobacco smoke.

• Heavy alcohol consumption.

• Dietary factors, such as a diet low in fruits and vegetables or high in smoked and pickled foods.

• Obesity and conditions like GERD, which increase the risk of adenocarcinoma.

• Involves using an endoscope to examine the esophagus and collect tissue samples to confirm the presence of cancer cells.

Endoscopy with Biopsy:

• A series of X-rays taken after swallowing a barium solution to highlight abnormalities in the esophagus.

• Combines endoscopy and ultrasound to assess the depth of tumor invasion and nearby lymph nodes.

• Combines endoscopy and ultrasound to assess the depth of tumor invasion and nearby lymph nodes.

Endoscopic Ultrasound (EUS):

• Used to detect the spread (metastasis) of cancer to other organs.

CT Scan and PET (positron emission tomography) Scan

monoclonal antibody that targets the HER2 receptor on the surface of cancer cells. By binding to HER2, it blocks the receptor's ability to receive growth signals, inhibiting the proliferation of cancer cells. It also recruits the immune system to attack cancer cells

trastuzumab

Surgery

• Esophagectomy: Removes part of the esophagus, used for early-stage cancer.

• Endoscopic Resection: Minimally invasive removal of small, localized tumors.

Chemotherapy:

• Neoadjuvant: Before surgery to shrink tumors.

• Adjuvant: After surgery to prevent recurrence.

• Systemic: For advanced cancer; includes drugs like 5-fluorouracil (5-FU), cisplatin.

Radiation Therapy:

• External Beam Radiation Therapy (EBRT): Targets cancer cells from outside the body.

• Brachytherapy: Radioactive material placed near the tumor for localized treatment.

Targeted Therapy:

HER2-Positive: Trastuzumab (Herceptin) for cancers overexpressing HER2 protein

Immunotherapy

• Checkpoint Inhibitors: Drugs like nivolumab and pembrolizumab help the immune system recognize and attack cancer cells, especially effective for advanced case

Community Management of Esophageal Cancer:

1. Prevention Programs

• Smoking Cessation Programs

• Alcohol Reduction Campaigns

• Dietary Education

2. Awareness and Screening Initiatives:

• Public Awareness Campaigns

• Screening Programs

3. Support Groups and Resources:

• Patient Support Groups

• Family and Caregiver Support

• Nutritional Support

4. Advocacy and Policy Development

5. Collaboration with Healthcare Providers