Symptoms always present late into disease, hence poor prognosis, surgical intervention : not effective.
Squamous – RF: Smoking, HPV
Adenocarcinoma – barett’s., gerd
Symptoms: Dysphagia. (increase salivation is experienced in clerked patient),
Investigation: Barium swallow, endoscopy US (most eff). To rule out metastasis: CT, bone scan, bronchoscopy, laparoscopy, thoracoscopy.
Associated signs: -hoarseness of voice indicate involvement of recurrent laryngeal nerve, lymphadenopathy, bleeding, weight loss (2nd most common symptom(), cough, RS involvement, hepatomegaly, pain in the epigastric region, bony structure (metastatic)
D/D: achalasia, gastric cancer, esophageal stricture
Rx:
Radiotherapy provide relieve to dysphagia in half of the patients. Chemotherapy not so well received. Medical treatment provided before surgery to reduce tumor size to ease resectibility. PDT : photodynamic therapy (Drugs called photosensitisers that when exposed to light, kills nearby cells by releasing oxygen.
Surgical Rx: THE – transhiatal esophagectomy, TTE- transthoracic esophagectomy
c/I surgery: metastasis.
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