Esophageal cancer in Kenya: Critical Facts for prevention, Diagnosis and Treatment.

What is Esophageal Cancer?

Esophageal cancer is a condition where cancerous cells develop in the esophagus, the tube connecting the throat to the stomach. It poses significant health risks and requires timely diagnosis and treatment for better outcomes.

It’s an increasing health problem in Kenya, especially in the central and western parts of the country.

Key Points/Summary

• Eosophageal cancer can be squamous cell carcinoma or adenocarcinoma, affecting different parts of the esophagus.
• Risk factors include smoking, heavy alcohol use, Barrett esophagus, and hot liquid consumption.
• Symptoms include difficulty swallowing, weight loss, chest pain, hoarseness, and coughing.
• Diagnosis involves various tests like endoscopy and imaging studies.
• Treatment options include surgery, chemotherapy, radiation, and supportive care.

Prevalence/Incidence

• Eosophageal cancer incidence varies globally, with higher rates in certain regions like eastern Asia and Africa.
• In the United States, it is the seventh-leading cause of cancer-related deaths among males.
• In Kenya, it is the fourth commonest cancer, with over 3,000 cases reported in 2022, according to Globocan figures

Risk Factors for Esophageal Cancer

• Smoking,
• Heavy alcohol use
• Barrett’s oesophagus
• Hot liquid consumption

In Kenya, Consumption of very hot tea and consumption of traditional and adulterated alcohol is thought to increase the risk for oesophagal cancer

Signs and Symptoms of Oesophageal Cancer

Esophageal cancer presents a range of signs and symptoms that individuals should be aware of to facilitate early detection and treatment. Understanding these indicators can help individuals seek timely medical attention and improve their prognosis.

1️⃣Difficulty Swallowing

Difficulty and pain with swallowing, especially when consuming solid foods like meat, bread, or raw vegetables, can be a common early symptom of oesophageal cancer. In advanced disease, swallowing semi-solids or even liquids becomes difficult

2️⃣Chest Pain

Pressure or burning sensations in the chest may be experienced by individuals with oesophageal cancer. Pain behind the breastbone or in the throat can also be a symptom of this condition

3️⃣Weight Loss

Unexplained weight loss is a significant symptom of esophageal cancer, often due to swallowing difficulties that hinder adequate food intake.

4️⃣Hoarseness and Coughing

Hoarseness and chronic cough can be signs of esophageal cancer, especially as the tumor progresses and affects nearby structures

5️⃣Indigestion and Heartburn

Indigestion, heartburn, and discomfort in the chest area are symptoms that individuals with esophageal cancer may experience[1][4].

6️⃣Vomiting

Vomiting, particularly if it contains blood, can be a symptom of advanced esophageal cancer. This is especially encountered in advanced disease.

Other Symptoms may include frequent choking on food, bone pain (if cancer has spread to the bone). Bleeding into the oesophagus leading to black stools and anemia.

Recognizing these signs and symptoms of oesophageal cancer is crucial for early intervention and improved outcomes. If individuals experience any of these symptoms, especially persistent difficulty swallowing, it is essential to consult a healthcare professional promptly for further evaluation and appropriate management.

Read More: Understanding the commonest cancers in Kenya

Prevention Strategies

• Avoiding risk factors like smoking, excessive alcohol consumption, and maintaining a healthy diet can help prevent oesophagal cancer.

Screening Modalities

Regular screenings are not common for oesophageal cancer. It’s advisable for persons with risk factors or symptoms listed above to consult healthcare professionals for early detection.

Diagnosis of Esophageal Cancer

Diagnosing oesophageal cancer is a crucial step in determining the appropriate treatment plan and improving patient outcomes. Laboratory diagnosis plays a significant role in confirming oesophageal cancer and providing valuable insights into the type and stage of the disease.

Biopsy and Molecular Testing

• Biopsy: When a suspected oesophageal cancer is identified through imaging tests or endoscopy, a biopsy is often performed. This procedure involves removing a small tissue sample for analysis to confirm the presence of cancer cells.
• HER2 Testing: Biopsy samples may undergo HER2 testing to identify if the cancer cells overexpress the HER2 protein. This information helps determine the potential effectiveness of targeted therapies that inhibit HER2 protein activity.
• PD-L1 Testing: Some oesophageal cancers are tested for PD-L1 protein levels, which can indicate the likelihood of response to immunotherapy drugs.
• MMR and MSI Testing: Testing for microsatellite instability (MSI) and mismatch repair (MMR) gene changes in oesophageal cancer cells can guide treatment decisions, especially for immunotherapy.

Blood Tests

• Complete Blood Count (CBC): This test measures various blood cell counts and can indicate conditions like anemia, which may be caused by bleeding from the tumor in oesophageal cancer.
• Liver Panel: Blood tests assessing liver function can help detect if oesophageal cancer has spread to the liver, influencing treatment decisions.

Imaging Tests

CT Scan, MRI, and PET/CT: These imaging modalities provide detailed images of the esophagus, detect tumor spread, and assess treatment response in oesophageal cancer patients.

Endoscopic Ultrasound (EUS): EUS allows for a detailed view of the esophagus and surrounding structures, aiding in staging and treatment planning.

Treatment and Management

Treatment options include surgery, chemotherapy, radiation therapy, and supportive care to manage oesophagal cancer effectively.

By understanding the key aspects of oesophagal cancer, individuals can take proactive steps towards prevention, early detection, and appropriate treatment, enhancing their overall health and well-being.

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Disclaimer

The information provided on this medical blog is for general informational purposes only and should not be considered as a substitute for professional medical advice. Always consult with a qualified healthcare provider before making any healthcare decisions or taking any actions based on the information provided on this blog. The authors and publishers of this blog are not liable for any errors or omissions in the content or for any actions taken based on the information provided.