The specialist explained that in case of any symptoms it is important to carry out medical follow-up.
Dr. Carlos Micames gastroenterologist, Interventional Gastroenterologist. Photo: MSP Archive
Dr. Carlos Micames, gastroenterologist Interventionist, explained that in Puerto Rico there has been a change, in which the squamous cell cancer was the most common, however, in the last 50 years it has been seen that cases of adenocarcinoma have increased drastically.
“In general, the prognosis is 5 years, which is how we usually measure malignant tumors, the 5-year survival is close to 50%, we are talking regarding all types esophagus cancerhowever, we know that if the patient already has an advanced condition, where the tumor has spread to other parts of the body, because it drops significantly, it may already be regarding 5% over life”, commented the gastroenterologist.
Bearing this in mind, the expert emphasizes the importance of doing the tests on time, being aware of the symptoms and going to the doctor promptly in order to identify these injuries early and avoid complications.
The esophagus cancer is a condition in which a tumor or a mass in the area of the esophagus, which is a tube that carries food from the mouth to the stomach, as a consequence, the patient may present different symptoms and complications associated with the condition. This type of cancer occurs most often in adults over 50 years of age.
The specialist explained that there are two types of esophageal cancer, there is squamous cell cancer and the adenocarcinomathe squamous cell cancer it originates in the upper part, in the higher parts of the esophagus. However, this type of cancer is less frequent, among the risk factors, is the excessive use of alcohol and cigarettes.
In the case of adenocarcinomathe greatest risk factor is a disease known as Barrett’s esophagus, “it is a condition that arises secondary to gastroesophageal reflux, usually in males and people who have suffered from reflux and heartburn for many years, typically obese and Caucasian,” he emphasized.
Similarly, obesity is a risk factor along with alcohol, cigarettes and the patient’s family history, in the case of the last mentioned, it refers to those patients who have a family member who has suffered esophagus cancer.
Most frequent symptoms:
Infrequent symptoms and in more advanced cases:
Diagnosis
Regarding the diagnosis, the expert explained that there are several tests, “usually when a person presents the symptom of dysphagia, many doctors already identify this as an alarm signal and therefore, many times they refer it to a gastroenterologist“. The specialist will then request an upper tract endoscopy, “in many cases we can identify these lesions, particularly if they are of significant size.”
Similarly, the gastroenterologist explained that the most significant advance that has been made is that when entering the patient’s esophagus, different samples can be collected through tweezers that are later analyzed, in order to identify early and small lesions, which can reach to alter treatment for tumor or cancer.
In the case of radiological studies, chest computed tomography can be performed, in which a large lesion can be observed, however, it is not 100% accurate. Similarly, there is a study of a fluoroscopy with barium, in which an esophagogram is done, in which the patient takes a contrast and through an X-ray machine, some plates are taken. This study shows severe lesions and tumors.
Treatments
There have been many advances in the last 15 years, especially in those small tumors and in which there is no evidence that it exists in another part of the body, regarding this the expert explained “previously many of these patients were referred to surgery to remove the tumor of the esophagus, although it sounds simple, it is not at all a simple surgery, because it carries a high risk.
Although surgery, in some cases, is still an option, the specialist emphasized that there are alternatives that have served a lot in terms of recovery, “many of the treatments are going to be defined depending on the stage of the tumorLikewise, he explained that if the tumors are localized and small, they can be removed endoscopically.
However, if the tumor is more advanced, a multimodal treatment is given, in which chemotherapy is combined with radiation, usually this option is used before surgery, even in certain cases it has been seen that the tumor disappears without the need for surgical intervention.
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