Esophageal cancer is cancer of the food pipe. It is more commonly seen in men who have a history of tobacco and alcohol consumption. Infection with human papilloma virus has also been reported as a causal risk factor. Obese patients and those with a long history of gastroesophageal reflux have a higher risk of developing cancer of the lower part of the esophagus. Painless progressive difficulty in swallowing is the most common symptom. Patients initially have difficulty in swallowing solid food. As the disease progresses even liquids become difficult to swallow. Patients lose weight, have poor appetite, can develop change in their voice and respiratory infections can occur from aspiration. An upper G.I endoscopy with biopsy is the first investigation done to confirm the diagnosis. Once confirmed, other tests like a barium swallow, CT scan, and PET scan are done to stage the disease. The treatment of disease involve a combination of surgery, chemotherapy and radiotherapy. Surgery plays an important role in the management of middle and lower third cancers and involves surgical removal of esophagus (esophagectomy) and creation of a new passage for food. It is a complex surgery and should be done by a specialist. Most often the procedure nowadays is done by the laparoscopic and thoracoscopic approach with excellent results. Following treatment patients are kept on regular followup.
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Cancer of the stomach is an aggressive tumor. It can involve either a part or the entire stomach. Certain factors increase the risk and these include a diet with high salt content...