I have just been diagnosed with early stage esophageal cancer by the doctor, I am very confused about why I got the disease and what is the prognosis after treatment? (Hoang Binh, 55 years old, Binh Duong)
Reply:
Esophageal cancer is one of the 10 most common and deadly cancers in the world. According to statistics from the Global Cancer Organization (Globocan) in 2020, Vietnam had more than 3,200 new cases and more than 3,000 deaths from esophageal cancer.
The esophagus is a part of the digestive tract, a tubular structure, about 25 cm long, about 2.5 cm wide. This organ is located behind the trachea (airway) and in front of the spine, divided into three upper, middle, and lower segments. When food enters from the mouth, the digestive tract contracts with the simultaneous effect of gravity, moving food through the esophagus to the stomach.
Esophageal cancer occurs when cells in the esophagus grow abnormally and uncontrollably. There are two main types of the disease: squamous cell carcinoma, which is common in the upper and middle esophagus. Adenocarcinoma is most common in the lower esophagus, but can also occur in the middle.
Symptoms of early-stage esophageal cancer are unclear and are often detected when the tumor has spread, with a poor prognosis. If detected and treated early, as in your case, the 5-year survival rate can be more than 80%. Therefore, you should follow your doctor's treatment methods.
Treatment depends on the stage of the disease and the patient's health condition. For early-stage esophageal cancer, treatments may include esophagectomy and concurrent chemoradiotherapy (chemotherapy combined with radiotherapy).
Currently, the cause of the disease is still unclear. Some factors that increase the risk include drinking alcohol, smoking, gastroesophageal reflux disease, Barrett's esophagus, and human papillomavirus (HPV) infection.
People who are overweight, obese, have had a gastrectomy, have atrophic gastritis, have esophageal damage, or have a history of other cancers are more likely to develop esophageal cancer. Unhealthy diets such as foods low in fiber, foods containing nitrosamines found in pickles, salted fish, and canned foods; and the habit of chewing betel nut in some Asian countries are also risk factors.
The rate of esophageal cancer is increasing and getting younger, especially in developing countries like Vietnam. Some measures to limit the risk include regular exercise, maintaining a suitable weight; not smoking; limiting alcohol; eating less fermented, processed, canned foods...
Several studies worldwide have shown that HPV vaccination plays an important role in preventing esophageal cancer associated with this virus infection. However, HPV infection is only one of the risk factors for esophageal cancer. Therefore, HPV vaccination does not reduce the risk of esophageal cancer due to other causes (Barrett's esophagus, gastroesophageal reflux...).
MD.CKI Vu Tran Minh Nguyen
Oncology Department, Tam Anh General Hospital, Ho Chi Minh City
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