How to treat esophageal cancer metastasis?

Written by Peng Li Bo
Oncology
Updated on August 31, 2024
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The metastasis of esophageal cancer involves several aspects. The first aspect is the metastasis of lymph nodes, including those around the esophagus. If the number of metastatic lymph nodes is small and the tumor's location is suitable for surgical removal, then surgery can still be considered.

The second issue involves cases where there is lymph node metastasis but with a higher number and wider spread, making surgical treatment unfeasible. In such cases, radical radiotherapy and chemotherapy can be considered to treat the esophageal cancer.

Of course, there are also some new methods available now, such as immunotherapy, which can be considered along with others. Also, to improve symptoms of esophageal stricture, using an esophageal stent to control the difficulty of swallowing associated with esophageal cancer is also possible.

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Esophageal cancer screening methods

The screening methods for esophageal cancer primarily involve checks of the esophagus, including upper gastrointestinal barium meal and gastroscopy. Gastroscopy, in particular, is a relatively accurate method for examining patients. This is because during a gastroscopy, biopsy samples can be taken, and pathology can definitively determine whether cancer is present. There might be issues regarding whether a patient can undergo a gastroscopy as it requires significant patient tolerance. Therefore, depending on the patient's health condition, if a gastroscopy is not feasible, an upper gastrointestinal barium meal can be conducted first.

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Typical symptoms of esophageal cancer

The most typical symptom of esophageal cancer is progressive difficulty swallowing, and a progressive sensation of swallowing obstruction is the most typical symptom. It's actually quite simple; the esophagus is akin to a water pipe or a tubular cavity. Esophageal cancer is like having a tumor grow inside this cavity, similar to something blocking the pipe, which causes the flow of water to be impeded. However, not only water passes through this esophagus, but also food. Therefore, if there's something inside the cavity, both water and food cannot pass through, leading to this difficulty swallowing and discomfort while swallowing.

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Distinction between esophagitis and esophageal cancer

Esophagitis and esophageal cancer are different diseases. Esophagitis refers to inflammatory changes in the esophagus, characterized by mucosal congestion, edema, and even erosion, commonly seen in middle-aged patients. Patients most often seek medical attention for abdominal discomfort or chest pain, and some may also experience nausea, belching, and so on. Esophageal cancer is more common in older patients, primarily presenting with progressively worsening dysphagia, accompanied by nausea, vomiting, and so on. Some cancer symptoms may be similar to those of esophagitis. The main method for differential diagnosis includes a thorough gastroscopic examination to provide further clarification. Esophagitis mainly manifests as inflammatory changes in the esophageal mucosa; in the case of esophageal cancer, a gastroscopic examination can directly reveal esophageal tumors, thereby facilitating differentiation.

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Esophageal cancer T3 belongs to which stage?

For the staging of esophageal cancer, it not only depends on the T stage, but also on the N and M stages. If we are just considering the T stage, it is T3. If there are no N0 and M0 stages, it is relatively early and surgery can be considered. However, if looking only at T3 and the N stage involves lymph node involvement (N1, N2, or N3), with regional or distant lymph node metastasis, then the staging of the esophageal cancer is relatively late. Furthermore, if there is an M stage, which indicates the presence of distant organ metastasis, then it is classified as advanced stage. Therefore, the T stage alone for esophageal cancer does not determine whether it is early, intermediate, or late stage. It is necessary to look in conjunction with the N and M stages to determine the overall staging.

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What should I do about esophageal cancer?

Currently, effective treatments for esophageal cancer include surgical treatment, radiation therapy, and chemotherapy. Integrated treatment with surgery as the main approach is the primary method for treating esophageal cancer. This may include preoperative radiotherapy followed by surgery, preoperative chemoradiotherapy followed by surgery, preoperative chemotherapy followed by surgery, or direct surgery followed by adjuvant chemoradiotherapy. These are all major treatment methods for esophageal cancer. However, the choice of a personalized integrated treatment should be based on factors such as the stage of the disease, the location of the lesion, age, and physical condition.