Esophagus Cancer - Cancer Treatment

Esophagus Cancer Treatment Abroad

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What is Esophageal Cancer or Cancer of the Esophagus?

The Esophagus is a hollow, muscular tube that connects our throat to the stomach. When we eat, the food goes into our mouth to the stomach through this tube.

Esophageal cancer begins when cancer cells develop abnormally (form mutations in their DNA) at the inner layer of the esophagus. The accumulated abnormal cells forms a tumor that can grow and invade other organs, and in turn spread (metastasize) to other parts of the body.

 

Two Main Types of Esophageal Cancer

Squamous Cell Carcinoma (Most Common Type)- Squamous cell carcinoma arises in the middle portion or along the entire esophagus.

Adenocarcinoma - Adenocarcinoma happens when squamous cells (normally found in theesophagus) are replaced by gland cells (mucus-secreting glands), which occurs in the lower portion of the esophagus.

 

Incidence of Esophageal Cancer

• Twice as high in men than in women
• Occurs more in African-American, Chinese, and Japanese males than in white males

 

Risk Factors of Esophageal Cancer

• Long-term alcohol use, tobacco and poor nutrition
• Achalasia - esophageal disorder that prevents normal swallowing
• Hiatal hernia - a part of the stomach pushes upward through the diaphragm
• Reflux – return flow of the stomach contents into the esophagus
• Stricture – the narrowing of the esophagus, making it hard to swallow food and water
• Poor oral hygiene

 

Signs and Symptoms of Esophageal Cancer

No symptoms will manifest until the tumor involves the whole esophagus.                                   

During the first stage, the first symptom to be felt is:

• Mild difficulty or pain when swallowing (dysphagia) - occurs when eating solids like meat.

In the advanced stages, you may feel:

• Constant difficulty or pain when swallowing (dysphagia)
• Signs of esophageal blockage:

1. Increased salivation & mucus in the throat
2. Regurgitation (the feeling of spitting something out)
3. Aspiration at night- drawing of gastric contents when breathing
4. Inability to swallow liquids likewater

 

How is Esophageal Cancer diagnosed?

Esophageal Cancer is confirmed thru:

• Barium Swallow [Upper Gastrointestinal (GI) Series]

A diagnostic test that uses a radiopaque contrast ofbarium sulphate. It is swallowed while standing in front of a fluoroscopy tube. The X-rays track its (barium sulphate) path to evaluate the integrity of the GI tract.

• Endoscopy

A diagnostic procedure that visually examinesthe esophagus, stomach and the small intestine (duodenum) through a long, flexible and lighted tube introduced through the mouth or anus.

• Cytologic Examination

Body fluids (urine, blood, cerebrospinal fluid) or materials scraped from specific areas of the body are spread onto a glass slide and stained to carefully examine cells.

• Direct biopsy

Esophageal cells taken from the patient is examined under a microscope todetermine extent of disease or malignancy

• Positron Emission Tomography (PET) scan and computed tomography (CT) scan– aid in cancer staging

These provide a detailed description of the size and extent of the tumor, where cancer cells have spread outside of the esophagus or GI tract.

 

What are the Stages of Esophageal Cancer?

Stage I

The mass (tumor) is only found on the superficial cell layers on the esophagus, and the lesion is operable. 70-90% (best) chance of survival.

Stage II 

There is local spread to the muscle layer (deeper layer of the esophagus) and 1-2 lymph nodes near the tumor. The tumor is still operable but cannot be removed completely. 50% (good) chance of survival.

Stage III 

The primary tumor is now widespread and has reached deeper into the inner muscle layer, lymph nodes and bone. The lesion can still be operable but gross disease will still be left behind. 20% chance of survival.

Stage IV 

Since this is the most advanced stage, cancer cells have spread to other organs and lymph nodes all over the body. Less than 5% chance of survival.

 

How is Esophageal Cancer Treated?

Cancer survival depends on the stage you have started treatment. Most cancers have a greater chance of cure if treatment has started early on. Unfortunately, most cancers are diagnosed on its later stages (III and IV), since most signs and symptoms are unnoticeable on the first two stages.

Esophageal Cancer Treatment depends on many elements. Importance is placed on the cancer stage and the overall health status of the patient.

• Surgery. All or a portion of the esophagus may be removed.
• Radiation therapy. Uses high-energy radiation to kill cancer cells in the esophagus.
• Chemotherapy. Uses potent drugs that target cancer cells. It is administered to the mouth or vein and used in conjunction with surgery and radiation therapy.
• Photodynamic therapy.Combines a special drug called photosensitizer and laser light to kill early cancer cells.
• Electrocoagulation. Uses an electric current to eradicate early cancer cells.
• Endoscopic Mucosal Resection (EMR). EMR is used to treat dysplasia (pre-cancers) or early stages of cancers. An instrument is passed down thru an endoscope to remove the inner lining of the esophagus.
• Radiofrequency ablation. This also uses endoscopic techniques to isolate and destroy pre-cancer cells using radiofrequency heat energy. 

What is the cost of treatment for Esophageal Cancer?

Brachytherapy - Internal Radiation Therapy in: Argentina $22,000, Belgium $16,950, Croatia $14,500, Germany $15,100, Hungary $18,400, India $19,000, Mexico $28,000, Poland $20,900, South Korea $21,000, Thailand $6,050, United States $16,500.

Conformal Radiation Therapy in: Argentina $6,850, Belgium $7,050, Brazil $8,900, Colombia $7,650, Costa Rica $2,050, Croatia $7,800, Hungary $5,350, India$5,950, Malaysia $6,100, Mexico $8,250, Panama $8,700, Philippines$6,000, Poland $6,550, Singapore $5,800, South Korea $6,450, Thailand $7,100, United States $18,250.

Cyberknife for Cancer in: Belgium $13,250, Costa Rica $12,500, Germany $11,400, Hungary $10,800, India $12,000, Malaysia $11,500, Mexico $16,500, Panama $15,050, Philippines $11,250,Singapore $11,000, South Korea $13,500, Thailand $12,500, United States $17,950 -$22,000.

Radiotherapy for Cancer in: Turkey $10,150-$20,300, Italy $20,048, Costa Rica $1,650-$7,550, Germany $1,800, Hungary $1,950-$3,250, India $2,100, Mexico $1,850-$8,400, Singapore $1,950 -$9,700, South Korea $2,100-$10,900, Thailand $1,900-$8,500, United States $2,350-$13,500.

 

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