Esophageal Cancer

Esophageal cancer is a common cancer that has a major gender difference, with men being affected more often than women. According to statistics, around 1 in 125 men and 1 in 417 women will develop esophageal cancer in their lifetime. We are going to explain about esophageal cancer treatment, cost, causes, diagnosis etc.

This disease often begins in the inner lining of the esophagus—a vital passageway for food from the throat to the stomach—and progresses outward through several different layers.

Esophageal cancer is the 6th leading cause of cancer deaths worldwide, with rates influenced by factors such as tobacco use, alcohol intake, and eating habits. Esophageal cancer treatment in India includes a variety of treatments, including surgery, chemotherapy, radiation therapy, and immunotherapy.

Types of Esophageal Cancer

Based on the cells involved, esophageal cancer is divided into two types:

• Squamous Cell Carcinoma: Squamous cell carcinoma develops from the thin, flat squamous cells that line the inside of the esophagus. It was previously the most common type of esophageal cancer, primarily affecting the upper and middle esophagus. While squamous cell carcinoma is still common around the world, its prevalence has decreased over time, accounting for less than 30% of esophageal cancers. Squamous cell carcinoma is connected with heavy alcohol intake, smoking, and certain medical conditions, such as organ transplants.
• Adenocarcinoma: Adenocarcinoma originates in the glandular cells of the esophagus that make mucus. It is the most common type of esophageal cancer, often affecting the lower esophagus. White men are more likely to develop adenocarcinoma, which is strongly associated with illnesses such as chronic acid reflux, gastroesophageal reflux disease (GERD), Barrett’s esophagus, and chronic heartburn.

There are several rare types of esophageal cancer, including small-cell carcinoma, sarcoma, lymphoma, melanoma, and choriocarcinoma. These rare types are less prevalent and may have special features and treatment approaches.

Signs and Symptoms of Esophageal Cancer

Esophageal cancer can often appear with insignificant signs and symptoms, making early detection complicated. Some of the signs and symptoms of esophageal cancer include:

• Difficulty Swallowing (Dysphagia)
• Unexplained Weight Loss
• Chest Pain
• Persistent Cough or Hoarseness
• Indigestion and Heartburn
• Vomiting or coughing up blood.
• Pain in the throat or back.
• Lump under the skin.
• Intractable coughing or frequent pneumonia.
• Epigastric or retrosternal pain.
• Bone pain with metastatic disease.
• Bleeding leading to black stools.
• Fatigue due to anemia.

Causes of Esophageal Cancer

Esophageal cancer is caused by changes in the DNA of esophageal cells, which leads to uncontrolled cellular development and tumor formation. These changes, which originate inside the cellular genetic code, hinder the normal regulatory processes that govern cell division and death. While the specific causes of these genetic changes are unknown, factors such as tobacco and alcohol use are believed to be associated with DNA damage, which may contribute to the development of esophageal cancer.

Risk Factors Associated with Esophageal Cancer

There have been several risk factors found that may enhance the chance of getting esophageal cancer:

• Tobacco Use: Smoking and smokeless tobacco use are both major risk factors for esophageal cancer.
• Alcohol intake: Chronic and heavy alcohol intake has been linked to an increased risk of esophageal cancer.
• Obesity: Being overweight or obese can increase esophageal inflammation, which may contribute to the development of cancer.
• Barrett’s Esophagus and Chronic Acid Reflux: Barrett’s esophagus, caused by untreated chronic acid reflux, and long-term heartburn has been associated with an increased risk of esophageal cancer.
• Human Papillomavirus (HPV): HPV is a common virus that can cause tissue changes in many places of the body, including the esophagus.
• Cancer History: People who have had cancer in their neck or head are more likely to get esophageal cancer.
• Other Disorders: Esophageal cancer has been associated with rare and/or inherited disorders such as achalasia (difficulty in swallowing) and tylosis (excess skin on hands and feet).
• Occupational Chemical Exposure: Prolonged exposure to dry cleaning solvents may increase the risk of getting esophageal cancer.

Diagnosis of Esophageal Cancer in India

A range of tests and procedures are performed to confirm the presence of cancer in the esophagus, including:

• Endoscopy: A flexible tube with a camera is used to visually inspect the esophagus, allowing abnormalities to be detected and biopsy samples to be collected.
• Barium Swallow Test: It involves swallowing a barium-based liquid for X-ray imaging, which helps in the identification of abnormalities in the esophageal lining.
• Imaging Techniques: CT scans, PET scans, and MRIs are all performed to determine the extent of cancer spread to surrounding organs and distant regions of the body.
• Endoscopic Ultrasound: A procedure that combines endoscopy and sound waves to detect tumor size, depth, and possible involvement of surrounding lymph nodes.
• Thoracoscopy: A surgical procedure used to examine the organs of the chest. A thoracoscope, a tube-like equipment with a light and lens, is inserted through a small incision between the ribs. It can also take tissue or lymph node samples for studies on cancer. In certain cases, partial esophageal or lung removal may be required.
• Laparoscopy: A surgical technique used to examine the organs of the abdomen. A laparoscope, a thin, lighted tube, is inserted through small incisions in the abdominal wall. Other devices, such as organ removal or tissue sample collection, can be inserted through these incisions and examined under a microscope for signs of disease. It is a minimally invasive procedure that provides an extensive view of the abdominal organs.
• Biopsy: Tissue samples collected during endoscopy are tested in the lab for HER2, PD-L1, MMR, and MSI, providing molecular insights important for targeted medicines and immunotherapy.
• Blood Tests: Complete blood count and liver enzyme testing provide vital information regarding overall health and possible esophageal cancer problems.
• Early Detection and Staging: Early detection and staging are essential for selecting the most appropriate treatment approach, with correct staging being important for positive results for patients.

Staging of Esophageal Cancer in India

Esophageal cancer staging plays an important role in evaluating the extent of the disease and determining proper treatment decisions. Oncologists use the staging method to classify cancer based on its size, location, and distribution to other parts of the body.

• Stage 0: Carcinoma in situ.
• Stage I: The tumor limits itself to the esophageal inner layers.
• Stage II: The tumor has spread to the deeper layers of the esophagus or adjacent lymph nodes.
• Stage III: The tumor has spread to neighboring tissues or organs and may have affected nearby lymph nodes.
• Stage IVA: The tumor has spread to neighboring structures or organs and may have affected local lymph nodes.
• Stage IVB: Distant metastases is present.

Treatment Options for Esophageal Cancer in India

Treatment options for esophageal cancer in India are comprehensive and tailored to each patient’s specific needs depending on criteria such as cancer stage, overall health, and individual preferences.

• Surgery: Surgical procedures, such as esophagectomy, are often used to remove cancerous tissue. This could involve eliminating a portion or the entire esophagus, as well as neighboring lymph nodes. Minimally invasive procedures, such as those using endoscopes or laparoscopic techniques, are also being considered in order to reduce recovery periods and complications.
• Radiation Therapy:External beam radiation and brachytherapy are both used to provide focused radiation to cancerous cells. This method has been utilized in combination with other treatments, both before and after surgery, to improve its efficacy.
• Chemotherapy:Chemotherapy is a common aspect of esophageal cancer treatment in India, which includes the use of anti-cancer medications. It can be used as a neoadjuvant therapy prior to surgery or as an adjuvant therapy after surgery.
• Targeted Therapy:Particular drugs that target certain molecules involved in cancer growth may be included in the treatment plan. This is especially important in cases where certain markers, such as the HER2 protein, are present in cancer cells.
• Immunotherapy:Immunotherapy, which uses the body’s immune system to fight cancer, is a new and promising therapeutic option for esophageal cancer treatment in India.
• Innovative Techniques:Depending on the unique characteristics of the cancer, innovative procedures such as photodynamic therapy, electrocoagulation, and cryotherapy may be considered. These techniques aim to precisely target and kill cancer cells while causing the least amount of damage to healthy tissues.
• Supportive Therapies:In addition to the major treatments, supportive therapies such as nutritional support, pain management, and counseling are important components of the entire care plan. Patients with esophageal cancer may have difficulties in swallowing, and nutritional support is provided as needed using feeding tubes or intravenous techniques.

Treatment for esophageal cancer in India involves a multidisciplinary team of oncologists, surgeons, radiologists, and other specialists. The collaborative approach guarantees that each patient receives a complete and personalized treatment plan.

Cost of Esophageal Cancer Treatment in India

The cost of esophageal cancer treatment in India often ranges from USD 3000 to 5000. Because of the low cost of treatment and the good quality of medical care, India is becoming a more popular destination for patients looking for great healthcare at a low cost. The stage of cancer, methods of treatment chosen, hospital facilities, and the experience of the medical staff are all factors that influence the cost. Many Indian hospitals provide all-inclusive packages that include diagnostics, surgery, chemotherapy, and post-operative care. Patients considering esophageal cancer treatment in India can benefit from world-class medical care while staying within the limits of their finances.

Survival Rate after Esophageal Cancer Treatment in India

The survival rate for esophageal cancer treatment in India varies depending on factors such as the stage of diagnosis and the methods of treatment used. In India, doctors use a multidisciplinary approach to deliver the best esophageal cancer treatment. The 5-year relative survival rate for localized cases might be around 47%, demonstrating the benefit of early treatments. Cases detected at a regional or distant stage, on the other hand, have rates of 26% and 6%, respectively. The survival rates highlight the importance of early detection and the extensive care offered by Indian medical professionals.

Top Hospitals for Esophageal Cancer Treatment in India

Several top hospitals in India excel at providing comprehensive esophageal cancer treatment. These hospitals are well-known for their modern facilities, skilled medical experts, and cutting-edge treatment approaches. Patients looking for the best esophageal cancer treatment options should look into these top oncology hospitals. These best esophageal cancer treatment hospitals in India provide a multidisciplinary approach that includes surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Some of the Top Hospitals for Esophageal Cancer Treatment in India are:

• Medanta – The Medicity, Gurgaon
• BLK Super Speciality Hospital, New Delhi
• Indraprastha Apollo Hospitals, New Delhi
• Fortis Memorial Research Institute, Gurgaon
• Artemis Hospital, Gurgaon
• Max Super Specialty Hospital Saket, New Delhi
• Marengo Asia Hospital, Gurgaon
• Apollo Hospital Chennai

Best Esophageal Cancer Treatment Doctors in India

Choosing the best esophageal cancer treatment doctors in India involves taking into account doctors who are well-known for their skills, experience, and dedication to oncology. These doctors have plenty of knowledge in identifying and treating esophageal cancer, and they use a multidisciplinary approach to provide thorough care. The top doctors in India for esophageal cancer treatment are often skilled in surgical treatments, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Some of the Best Esophageal Cancer Treatment Doctors in India are:

• Sandeep Batra- Max Super Specialty Hospital, Saket, Delhi
• Ankur Bahl- Fortis Memorial Research Institute, Gurugram
• Praveen Kumar Garg- Indraprastha Apollo Hospitals, Delhi
• Niranjan Naik- Fortis Memorial Research Institute, Gurugram
• Sameer Kaul-Indraprastha Apollo Hospitals, Delhi
• Kamal Verma- Artemis Hospital, Gurugram
• Suman Karanth Gupta- Medanta-The Medicity Hospital, Gurugram
• Devavrat Arya- Max Super Specialty Hospital, Saket, Delhi