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WHAT IS ESOPHAGEN CANCER?Cancers that occur in the esophagus, which is approximately 25-30 cm long

starting from the neck and extending to the stomach, are named as esophageal cancer or esophageal cancer.

The most important symptom of esophageal cancer is difficulty in swallowing. Symptoms of esophageal cancer include feeling stuck and painful swallowing. In cases where the tumor does not cover 60-70% of the esophagus, it usually does not give any symptoms. Since the symptoms of esophageal cancer occur very late, the tumor can be detected in advanced stages in most of the patients. In elderly people, drooling on the pillow at night and pain when swallowing may be the first signs of esophageal cancer.
Symptoms of esophageal cancer may differ, depending on where the tumor originated.
Difficulty in swallowing is a common symptom of esophageal cancers in every region.
• Another symptom of esophageal cancer that occurs near the neck area can be hoarseness.
• Cough may be a symptom of esophageal cancer that occurs in the middle of the chest.
• The symptom of esophageal cancer that occurs in the lower area close to the stomach may be in the form of severe reflux.
Although very rare, bleeding can sometimes be seen among the symptoms of esophageal cancer. This bleeding is seen as intestinal bleeding rather than blood coming from the mouth.
Esophageal cancer can give different symptoms according to the stages.
• Stage 1 esophageal cancer may not cause symptoms. Esophageal cancer is detected at stage 1, usually by chance or as a result of screening.
• A symptom of stage 2 esophageal cancer may be difficulty swallowing. Although rare, among the symptoms of esophageal cancer at this stage, there may be a feeling of being stuck and intestinal bleeding.
• The symptom in stage 3 esophageal cancer is severe difficulty in swallowing. The patient becomes unable to eat solid food. Drooling can occur more often in older people.
• Stage 4 esophageal cancer symptoms may differ depending on the area of ​​metastasis. Severe weight loss is among the first symptoms in stage 4 esophageal cancers. If the tumor has invaded the trachea, cough may be experienced. If it has spread to the liver, side pains can be seen. If it has spread to the bones, bone pain can be seen.

The causes of the esophagus vary according to the cell type.
Among the causes of squamous cell (squamous) esophageal cancer;
• Alcohol and cigarette use
• Consuming excessively hot beverages
• Consumption of burnt-smoked food can be counted.
Adenocarcinoma esophageal cancers are usually caused by reflux. Approximately 20% of the population has reflux, but not every reflux patient will have esophageal cancer. Long-term reflux (acid and bile) combined with alcohol and smoking can cause Barrett's esophagus (BARRETT). Barrett's esophagus is an important risk factor for esophageal cancer.
Most of the causes of esophageal cancer are preventable factors. Apart from this, some diseases and genetic factors are seen very rarely.
Eating a meat-based diet and consuming a lot of barbecued and burnt foods are among the risk factors for esophageal cancer as well as stomach and colon cancer.


How is Esophageal Cancer Diagnosed?
Diagnosis of esophageal cancer is made by endoscopic control. With endoscopic imaging, it may be sufficient for the doctor to see the inside of the esophagus for diagnosis. However, in order to confirm the diagnosis of esophageal cancer, the part taken should be examined pathologically.
Endoscopic ultrasound imaging method called EUS is used to determine the stage of esophageal cancer, that is, how far it has progressed in the esophageal wall. EUS provides important information in determining the stage of esophageal cancer.
In addition, every patient who will undergo treatment or esophageal cancer surgery requires Computed Tomography and Pet CT examination.

Treatment of esophageal cancer differs according to its stage and region.
In adenocarcinoma or squamous cell (squamous) stage 3 esophageal cancers, a treatment called chemoradiotherapy, which combines chemotherapy with a not very high dose of radiotherapy, is applied. Serious responses are received from this treatment. Esophageal cancer surgery is performed in patients who become suitable for surgery with chemoradiotherapy treatment.
In stage 4 esophageal cancers, surgery is usually not performed. This patient group is treated with chemotherapy and radiotherapy.
In stage 1-2-3 esophageal cancers, treatment is planned for the region where the tumor is located.

Treatment of neck region esophageal cancers
In cases where the cancer is located in the neck region of the esophagus, patients are not usually treated with surgery. Studies show that there is no difference between surgery or chemoradiotherapy treatment in neck region esophagus cancers. In esophageal cancers occurring in the neck region, significant success is achieved in a significant portion of patients with chemoradiotherapy method.
However, surgery is preferred in cases where chemotherapy and radiotherapy are not sufficient.
Since the tumors formed in the neck region of the esophagus are behind the voice region, in these surgeries, the larynx, thyroid, part of the pharynx and part of the trachea are also removed, so patients must breathe through the neck for the rest of their lives.
In order for the patient to be fed through the mouth, only a part of the esophagus can be removed and the esophagus can be made from the small or large intestine in esophageal cancer surgery. Sometimes, the esophagus can be completely removed and the esophagus can be made from the stomach to the root of the tongue.

Breast cancer treatment
In the treatment of tumors that occur in the chest area, that is, in the middle of the esophagus, the treatment varies depending on whether the tumor is above or below the dividing area of ​​the trachea. If the tumor is above the trachea, chemoradiotherapy treatment is preferred. Surgery is preferred in cases where the tumor is below the trachea.
In breast cancer esophagus cancer surgery, the entire esophagus is removed along with the lymph nodes (at least 16). Then, the esophagus can be made from the stomach and the patient can be fed through the mouth.

Treatment of esophageal cancers near the stomach
Treatment is planned according to the spread of the tumor to the stomach in areas close to the stomach, that is, in the lower region esophagus cancers.
In cases where the tumor has spread to 2 cm or more of the stomach, it is necessary to remove the entire stomach along with a significant part of the esophagus. In these patients, a new esophagus should be made from the small or large intestine. These patients need to apply a special diet and consume less-frequent food. However, it is possible for them to eat almost anything.

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