Let’s learn, check, fight oral cancer

HEARTBURN and indigestion are a part of everyday life and we never really think it could be anything sinister. We almost always chalk it down to the food we ate or something we drank.

People only start to get worried when this heartburn does not stop or they start experiencing other problems like difficulty in swallowing. But sometimes, it would be too late, a disease would have already taken root.

Many Zimbabweans rarely seek medical attention for such small things like heartburn. Sometimes even when the symptoms get worse, they would rather take home remedies first, then see a doctor when all else has failed.

But cancer is real and its cells can grow anywhere in the human body, even in the oesophagus.

As we continue with raising awareness of different types of cancer in the month of January, this week we look at cancer of the oesophagus.

The national cancer registry notes that cancer of the oesophagus is the fifth most common cancer in Zimbabwe accounting for at least four percent of all cases reported in 2018.

Among men, the cancer affected 6,3 percent of those who were diagnosed with cancer while it was the third most frequent type of cancer detected among women at 3,8 percent of total cases.

While the cancer seems to be common, not many know that they can be affected or how it would present.

Oesophageal cancer occurs in the oesophagus, the long, hollow tube that runs from the throat to the stomach.

The oesophagus helps move the food swallowed from the back of the throat to the stomach to be digested.

According to experts, this type of cancer usually begins in the cells that line the inside of the oesophagus. It can occur anywhere along the oesophagus and is more common among men than women.

Globally, oesophageal cancer is the sixth most common cause of cancer deaths. Incidence rates vary within different geographic locations. In some regions, higher rates of oesophageal cancer may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.

Signs and symptoms of oesophageal cancer include difficulty swallowing, loss of weight, chest pain, pressure or burning, worsening indigestion or heartburn as well as coughing or hoarseness.

However, the disease typically causes no early signs or symptoms so it is usually detected at a later stage.

Oesophageal cancer occurs when cells in the oesophagus develop changes (mutations) in their DNA. The changes make cells grow and divide out of control. The accumulating abnormal cells form a tumour in the oesophagus that can grow to invade nearby structures and spread to other parts of the body.

However, experts say it is not exactly clear what causes this to happen.

Oesophageal cancer is classified according to the type of cells that are involved. The type of oesophageal cancer diagnosed then helps health professionals to determine treatment options.

The types include adenocarcinoma which begins in the cells of mucus-secreting glands in the oesophagus. This often occurs in the lower portion of the oesophagus.

Squamous cell carcinoma is another type of oesophagus cancer. The squamous cells are flat, thin cells that line the surface of the oesophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the oesophagus and is the most prevalent oesophageal cancer worldwide.

Other rare types of oesophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.

The risk factors associated with cancer of the oesophagus may vary but it is believed that chronic irritation of the oesophagus may contribute to the changes that cause oesophageal cancer. Factors that cause irritation in the cells of the oesophagus and increase the risk of oesophageal cancer include having gastroesophageal reflux disease (GERD), smoking, having pre-cancerous changes in the cells of the oesophagus (Barrett’s oesophagus), being obese, drinking alcohol and having bile reflux.

Other factors also include having difficulty swallowing because of an oesophageal sphincter that won’t relax (achalasia), having a steady habit of drinking very hot liquids, not eating enough fruits and vegetables as well as undergoing radiation treatment to the chest or upper abdomen.

Since the cancer may not be detected early, it can cause complications as it advances.

It can cause obstruction of the oesophagus and make it difficult for food and liquid to pass through the oesophagus.

Like other cancers, it comes with pain when it is in the advanced stage. Oesophageal cancer can cause bleeding which is usually gradual, but it can be sudden and severe at times.

Treatment for this cancer might include surgery, radiotherapy or chemotherapy or a combination of these treatments. This depends on a number of factors including the stage and type of your oesophageal cancer.

While statistics might not be too specific, there are chances of survival depending on the stage at which the cancer is detected.

According to Cancer Research UK, almost 55 out of 100 people (almost 55 percent) with stage 1 oesophageal cancer will survive their cancer for 5 years or more after they are diagnosed.

At least 30 out of 100 people with stage 2 oesophageal cancer will survive their cancer for 5 years or more after they are diagnosed. The number drops to around 15 out of 100 people at stage 3.

The research unit says there are no 5-year survival statistics for stage 4 cancer because sadly many people don’t live for that long after diagnosis.

However, what affects survival is one’s outlook depending on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread.

The type of cancer and grade of the cancer cells can also affect survival. Grade means how abnormal the cells look under the microscope.

One’s general health and fitness also affect survival, the fitter one is, the better they may be able to cope with their cancer and treatment.

However, as with most cancers, health professionals say cancer of the oesophagus can be prevented.

Those who smoke can quit smoking while non-smokers will do good to stay away from tobacco.

People who drink alcohol will not appreciate this bit of advice but limiting their intake would be a step towards avoiding oesophageal cancer.

Adding a variety of colourful fruits and vegetables to the diet could never hurt and also maintaining a healthy weight.

After all is said and done, it remains important to focus on prevention rather than cure as treatment may not always work for everyone.

◆