When all's not well...

Oesophageal cancer

When all's not well...

Despite the fact that cancer in the gastrointestinal tract is one of the most common reasons for cancer-related deaths in India, people are oblivious about its symptoms, prevention and treatment options. Oesophageal cancer is born in the food pipe, between the throat and the stomach. Also called gullet, oesophagus is the tunnel through which food reaches your tummy.

What are its symptoms?

Since this cancer affects the food pipe, problems start in the throat and can go all the way till your intestines. Here are some common symptoms:

Problem in swallowing: This is a common sign of oesophageal cancer, wherein patients feel as if the food is stuck in their throat and chest. Sometimes, they even complain of choking.

Anaemia: Over time, blood loss can lead to anaemia, further leading to tiredness and low energy level. Very often, this is treated with iron tablets, only to realise later that the cause was oesophageal cancer.

Heartburn: Pain and discomfort, especially in the middle part of the chest, are the most common symptoms of oesophageal cancer. Unfortunately, people often confuse it with gastritis and tend to delay the treatment.

Weight loss: Around half of the patients with oesophageal cancer complain of weight loss. This is mainly because of difficulty in swallowing.

Other symptoms like hoarseness in speech, chronic cough, vomiting, hiccups, pneumonia and pain in the bones appear in the later stages of the disease. But if you have any one of these symptoms currently, don’t be alarmed. Reach out to a doctor only when one or more symptoms persist for a long time. 

Early detection and the right treatment are key to survival. Contrary to common belief, only surgery is curative in most of such cancer cases. Additional therapies like chemotherapy and radiotherapy are mostly supportive. Avoiding surgery will only bring down the chances of recovery.

Treatment options

As far as surgical options are concerned, all types of oesophageal cancer surgeries can be performed either by the conventional open approach or through a minimally invasive oesophagectomy. Video-assisted thoracic surgery (VATS) is also another option.

However, the minimally invasive surgery has several advantages over open surgery with the same success rate. In laparoscopy or a robotic surgery, doctors don’t need to cut open the patient. The surgery is done by making small cuts in the body and inserting the surgical devices and a pinhole camera, which helps the surgeons to control the movement by looking at the monitor.

Due to negligible cuts in the chest and abdomen, and less disruption to the internal organs, minimal access surgery ensures minimum blood loss, faster wound healing, shorter hospital stay, quicker recovery, less follow-ups and complications post surgery and most importantly, improved clinical outcomes and better quality of life after the surgery. In cancers like oesophageal cancer, where surgery is almost always a necessity, minimal access cancer surgery could bring in radical change in the way the disease has been treated in the country till date.

Possible prevention

Experts suggest that including more fresh fruits and vegetables in your diet helps reducing the chances of this cancer as they contain high amounts of antioxidants. Reducing alcohol intake and giving up on tobacco go a long way in helping you. Also, avoid drinking very hot beverages.
However, there are some non-modifiable risk factors like age (risk increases after the age of 60), gender (men are more prone as compared to women) and family history (more chances of others in the family being at risk) that play a role in this disease.
In other words, if anyone in your family is exhibiting any of the symptoms, it’s best to seek medical advice. With advanced surgical options and treatment modalities, the disease can be cured.

(The author is robotic & laparoscopic cancer surgeon, MACS Clinic, Bengaluru)

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