What Kinds Of Doctors Treat Esophageal Cancer
Esophageal cancer is a condition that usually requires surgical procedures. In addition to the general surgeon, there are many other types of physicians who may contribute to care.
- Gastroenterologists may be involved in diagnosing, treating, and monitoring the disease.
- Oncologists make treatment plans that include chemotherapy and radiation therapy.
- Radiation is administered by a radiation oncologist.
- Surgeons are responsible for operating and removing organs that are involved by tumor. General surgeons and thoracic surgeons are commonly responsible for the operation. Other types of surgeons may provide care depending upon what other organs are affected by the cancer.
- The primary care provider may help care for side effects, controlling other illnesses and providing nutrition and metabolic support. The primary care provider may also be a resource and provider of emotional support to the patient and their family.
- Dieticians are important to help maintain nutrition to aid healing and prevent complications when food cannot be easily swallowed, both before and after surgery.
Should the cancer become untreatable or symptom control be needed, palliative care specialists may be involved to help improve quality of life.
Black Stool And Anemia
Individuals with esophageal cancer may expect the symptoms that occur in their throat but be less prepared for symptoms that present elsewhere. Notably, some people with the disease report black stools, caused by esophageal bleeding. The blood travels down the esophagus into the stomach and digestive tract. It eventually leaves the body with the waste, discoloring the stool. In some cases, blood loss is severe enough to cause anemia.
When To See A Healthcare Provider
It’s important to see your healthcare provider if you have any of the symptoms mentioned above. While there are many potential causes for most of these symptoms, it’s important to seek answers so that appropriate treatment can be initiated no matter the cause.
Symptoms are your body’s way of alerting you to potential problems. Talk to your healthcare provider, and if you aren’t getting answers, ask again. Being your own advocate can make a big differencesometimes a life and death differencein getting the care you need and deserve.
Esophageal Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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Is It Painful To Die Of Esophageal Cancer
If a person is given medications to control physical pain and is provided fluids and nutrients through a tube to bypass swallowing problems, then the end of life with esophageal cancer doesnt have to be a painful or scary experience.
But because the medications used to treat pain are often quite strong, an individual may be sleepy much of the time or experience confusion.
These responses are exacerbated by the slowing down of the bodys functions. For example, the heart rate slows, meaning less oxygenated blood reaches the brain. A person may slip in and out of consciousness and have trouble remembering or focusing.
Changes in bodily functions also lead to shallower breathing and a loss of bladder and bowel control.
Watching a loved one go through these changes can be emotionally painful for others, but for the individual with cancer, many of these physical changes will occur without notice.
How Are The Stages Of Esophageal Cancer Treated
Treatment options for esophageal cancer by stage may involve the following:
- Stage 0 . Options include surgery, photodynamic therapy, radiofrequency ablation, or endoscopic mucosal resection.
- Stage I, II, and III . Surgery, chemotherapy, radiation
- Stage IV . Chemotherapy, radiation, targeted therapy, immunotherapy treatment for this stage focuses on “palliative” therapy. Palliative therapy is meant to relieve the pain and difficulty swallowing caused by cancer.
According to the American Cancer Society, the percentages of people who live for at least five years after being diagnosed with esophageal cancer is 47% for localized cancer to the esophagus, 25% for cancer that has spread regionally, and 5% with distant cancer spread.
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Reflux May Not Be Such A Big Risk
Another study, published in the American Journal of Gastroenterology,5 investigated whether having GERD increases a persons chances of developing this cancer, and found that in individuals with chronic GERD who were female or younger than 50 years of age, the incidence of adenocarcinoma was very low. For example, in women of all ages, the incidence of adenocarcinoma is about the same rate as male breast cancer. This means that regular screening is unnecessary for these individuals. However, researchers found that in men older than 60 years of age, the incidence of esophageal adenocarcinoma was quite substantial, so screening may be useful for that group.
What Are The Early Warning Signs Of Esophageal Cancer
In many cases, esophageal cancer does not cause noticeable symptoms until it reaches an advanced stage. The initial symptoms are usually related to swallowing, eating, drinking or digestion. Usually, the first sign is difficulty swallowing . At first, the dysphagia may be mild, causing a sensation that food is stuck in the throat. Then, as the tumor grows, it may eventually cause bouts of coughing and choking.
Other early signs of esophageal cancer can include:
- Heartburn
- Unintended weight loss
- Pain, pressure or burning sensations in the chest
Because most early-stage esophageal cancer symptoms are nonspecific and also associated with other medical conditions, it is best to promptly discuss any unusual changes with a general physician or specialist who can provide an accurate diagnosis. This is especially important for individuals who have Barretts esophagus, gastroesophageal reflux disease or long-term heartburn, all of which can change the cells in the esophagus and increase the risk of esophageal cancer.
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Pain Under Ones Clavicle In The Chest Area Can Have So Many Causes And For Those Worrying That This Means Esophageal Cancer Unfortunately This Is A Possible Cause
Normally, when a person begins feeling pain or aching beneath their clavicle bone, near the chest area, esophageal cancer is not the first suspect that pops into their mind.
But if they have a family history of this disease, or know someone who has it, or were by sheer chance recently reading up about this disease, it might be first on their radar.
Symptoms Of Esophageal Cancer
Esophageal cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the cancer thickens the wall of the esophagus. Esophageal tumours can also cause symptoms if they grow large enough to block the esophagus or the opening to the stomach, or if they grow into surrounding tissues and organs. Other health conditions can cause the same symptoms as esophageal cancer.
The most common symptom of esophageal cancer is having problems swallowing . Other signs and symptoms of esophageal cancer include:
- weight loss
- pain in the throat, chest or back
- fatigue
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What You Should Expect
You will receive a thorough diagnostic evaluation by an experienced surgeon who specializes in cancer of the esophagus. Your experience post-treatment will vary depending upon the stage of your cancer. Early detection and the involvement of an experienced surgeon are important to the successful outcome for esophageal cancer treatment.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.
The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with esophageal cancer. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
Less Pain More Diagnoses
An interesting new study from the journal, Archives of Surgery,6 shows that individuals suffering from GERD who have fewer symptoms are more likely to get adenocarcinoma or Barretts esophagus than those who experience severe GERD symptoms. These findings were even more pronounced for those who had GERD for 10 or more years, and those whose symptoms were masked by acid suppression therapies like proton pump inhibitors .
Acid suppression therapy is the best treatment we currently have for those with GERD, but it does not decrease refluxing episodes it just makes the refluxing contents less acidic, thereby reducing symptoms. Even though the reflux content is less acidic, it is still a bit too acidic, and over time it can have a mutagenic effect on the esophageal tissue. Since the patient doesnt feel pain or discomfort, they do not report symptoms to their physician, who, therefore, is not alerted to test the individual for esophageal problems. This study shows that it is important for all individuals with GERD to have regular endoscopies to look for adenocarcinoma and Barretts esophagus, whether or not they are taking PPIs.
In 2004 and 2005, the Canadian healthcare system spent $52,235,910 on hospital stays for 7,554 patients who had a primary diagnosis of diseases of the esophagus and associated complications.7
First published in the Inside Tract® newsletter issue 179 2011
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Potential Warning Signs Include:
- Difficulty swallowing : The most common symptom, this usually begins with solid foods and then eventually progresses to include liquids. Pain may also occur with swallowing, as well as a sensation of food sticking in the esophagus.
- Back pain between the shoulder blades
- Hoarseness or loss of voice
Since some of these symptoms may occur with acid reflux, and since acid reflux is a risk factor for esophageal cancer, it’s important for people to be aware not only of new symptoms they experience but of any change in their chronic symptoms.
What About Difficulty With Swallowing That Goes Away
Dr. Little explains, Many patients begin to switch their diet toward softer foods as difficulty swallowing begins and progresses.
They may not be fully aware theyre doing this the switch may occur on a subconscious level, such as desiring apple sauce over apples, and mashed potatoes over boiled potatoes, and no longer eating steak.
This makes it easier to swallow, so it seems to them their dysphagia is lessening, continues Dr. Little.
If youve recently had difficulty swallowing but it seems to have disappeared its vital that you ask yourself if youve switched to softer foods and only after that has the symptom resolved?
If this describes your experience, you need to see a doctor. Do NOT put this off.
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Receive Nationally Ranked Care At Moffitt Cancer Center
If you would like to discuss your esophageal cancer symptoms with an expert in the Gastrointestinal Oncology Program at Moffitt Cancer Center, you can request an appointment by calling or completing our new patient registration form online. Floridas top cancer hospital is changing the patient care model for the better, and your diagnosis is our top priority. You can count on a rapid response from us, and if you are ultimately diagnosed with esophageal cancer, we will support you with personalized treatment and compassionate care every step of the way.
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Re: Process And Pain Of Dying With Esophagus Cancer
I know, it’s horrible isn’t it. I’ve coped with cancer since the age of 4 because my mum passed away from it. Sorry too hear about your dad, I spend a lot of time with my grandad like you did with your dad. I’m just trying to have the best time with him possible! Hope you’re okay.
Thanks for the reply xxxxx
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Signs And Symptoms Of Esophageal Cancer
Esophageal cancer often doesnt cause symptoms in its early stages. Diagnosis in people without symptoms is usually discovered accidentally, because of tests run for other medical problems. Although the early signs of esophageal cancer are difficult to detect, it is important to recognize the small signs your body gives you that might indicate esophageal cancer.
What Causes Esophageal Cancer
As with most cancers, the cause of esophageal cancer isnt yet known. Its believed to be related to abnormalities in the DNA of the cells related to the esophagus. These mutations signal the cells to multiply more rapidly than normal cells.
These mutations also disrupt the signal for these cells to die when they should. This causes them to accumulate and become tumors.
Experts believe that the irritation of esophageal cells contributes to the development of cancer. Some habits and conditions that can cause irritation include:
- consuming alcohol
- having a reflux disorder, such as gastroesophageal reflux disease
- having Barretts esophagus, which is a condition characterized by damaged esophageal lining due to GERD
- being overweight
- not eating enough fruits and vegetables
- having achalasia, a condition where the muscle at the bottom of the esophagus doesnt relax properly
People at increased risk of esophageal cancer include the following:
- Men are
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Symptoms Usually Occur As The Disease Progresses
Esophageal cancer symptoms can include difficulty swallowing, regurgitating food, heartburn, weight loss, and a persistent cough. Less common symptoms such as hiccups, pneumonia, or enlarged lymph nodes in the neck and above the collarbone may occur if esophageal cancer has spread.
Many people takes steps to address the symptoms of esophageal cancersay, by consuming more soft foodswithout getting a formal diagnosis. Having an awareness of the potential symptoms of this disease can help prompt you get evaluated as early as possible.
How Is Esophageal Cancer Classified
Most cancers are grouped by stage, a description of the cancer that aids in planning treatment. The stage of a cancer is based on the location and depth of the tumor the involvement, if any, of the lymph nodes and the degree that the cancer has spread, if at all, to other tissue and organs.
In addition to staging the cancer, tumors may also be graded. Grading is a way of rating a tumor based on how much its cells look and act like normal cells. Tumor grading can also tell the doctor how fast the tumor is growing. Tumors with almost normal-looking cells that grow slowly are called low-grade tumors. Tumors with very abnormal-looking cells that divide rapidly are called high-grade tumors. High-grade tumors are more likely to spread than low-grade tumors.
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Do You Have The Above Symptoms Of Esophagus Cancer
How is Esophageal Cancer diagnosed?
Testing methods for diagnosing esophagus cancer include the following:
- An endoscopy is the use of an instrument with a camera attached to a tube that goes down your throat and allows your doctor to view the lining of your esophagus to check for abnormalities.
- A barium swallow is an X-ray imaging test which allows your doctor to check the lining of your esophagus. This is done by swallowing a chemical called barium while the images are being obtained.
- A biopsy is a process in which your doctor will remove a sample of the suspicious tissue with the help of an endoscope and send it to the lab for testing.
- A CT scan, PET scan, or MRI is used to check if cancer has spread to other parts of the body.
What are the Stages of Esophagus Cancer?
The stages of esophagus cancer are numbered the higher the number means that the cancer is advanced.
- Stage 0: Abnormal cells are found only in the layer of cells lining the esophagus.
- Stage I: Cancer cells are found only in the layer of cells lining the esophagus.
- Stage II: Cancer has reached the muscle layer, which is the outer wall of the esophagus. It may have also spread to 1 or 2 lymph nodes.
- Stage III: Cancer has reached deep into the inner muscle layer which is the connective tissue wall. It may have also spread to the surrounding organs or to the lymph nodes nearby.
- Stage IV: Cancer has spread to other organs in the body or to the distant lymph nodes.
Is It Possible To Prevent Esophageal Cancer
Since squamous cell carcinoma is associated with smoking , stopping smoking will significantly decrease the risk of this type of esophageal cancer.
Alcohol abuse is also related to squamous cell carcinoma, especially when combined with tobacco product use. Alcohol products should be used in moderation.
Eating a diet rich in fruits and vegetables may decrease the risk of esophageal cancer.
Obesity is a risk factor for esophageal adenocarcinoma and weight loss may be appropriate.
Esophageal adenocarcinoma is associated with GERD and the subsequent development of Barrett’s esophagus. It is important to limit the risk factors for developing esophageal reflux. These include
- losing weight,
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Process And Pain Of Dying With Esophagus Cancer
Hi guys my name is Katie and I’m 14 years old. My grandad has terminal esophagus cancer, aged 56. I was just wondering if anybody on here could tell me if it’s a very painful death and the process of dying with it. Feel free too comment with any stories from family members ect.
Thanks.
Hi sweetie,
My dad recently died from this cancer, he was 51, I am alot older than you but age dont make cancer any easier, I was caring for my dad and was always with him, the pain control was good, my dad had a driver which means the pain relief is constantly going into the blood stream so your grandad shouldn’t be in any pain, i know my dad was happy with the pain relief he had. take care hunni be strong for your grandad.
With Love Kim xxxx
Hi katie
How are things.Have you managed to talk to anyone in your family about whats happening with your grandad?I am sorry i cannot tell you about his cancer but i do have a lot of experience of pain control and the main issue is that it works.Modern medicine cannot always save us but it can give us an easyer time of it .I came very close to dieing and the knowledge that it has left me with is that it is not nearly as frightening as it seems. It seemed to me like a gradual walking away.It will always be sad but the sadness is because he is loved.
