Esophageal cancer: description of the disease
And esophageal cancer
Esophageal cancer that can be, many are squamous cell carcinoma arising from the esophageal mucosa. As a special esophageal cancer is Barrett adenocarcinoma,adenosquamous carcinoma,basaloid carcinoma, endocrine cell carcinoma, undifferentiated carcinoma, and malignant melanoma. Can be cured by surgery endoscopic If you can find early in is possible, there is a feature that causes the lymph node metastasis from an early stage in comparison with colon cancer and gastric cancer, when compared to these cancers, the grade I say high cancer. It is also an area that can cause extensive lymph node metastasis is the neck, chest and abdomen, is causing a high degree of malignancy. Total power, including not only doctors, but also other co-medical staff such as nurses, laboratory technicians and rehabilitation is an integral part of the medical esophageal cancer.
What many people do?
Esophageal cancer are over the age of 50 Mature much, it is a disease many men at a ratio of 9:1. In addition, it is said drinking history and smoking history is closely related with the development of esophageal cancer, it has been said that people with a high risk of both history and drinking habits, especially smoking history. It is also considered to be high risk, such as some people are constitutionally turns red immediately after drinking alcohol.
Symptom
Initially be asymptomatic in most cases, many cancers are the same for esophageal cancer. Becoming a high probability of pain and discomfort, dysphagia that gradually becomes larger as was tingling when swallowed food comes out. However, it may not even be aware of the symptoms can be quite large and it is important endoscopy.
Inspection
Esophageal cancer treatment is selected on the basis of highly accurate diagnosis progression, including imaging. Below, we describe the detailed examination of esophageal cancer.
1.X-ray angiography esophagus
X-ray angiography is finding the (early cancer) is quite difficult cancer mucosa, visualization of esophageal cancer invading the submucosa or more cancer is relatively easy, the presence of esophageal cancer can be diagnosed. Information obtained from many X-ray contrast, not only the diagnosis of progression range and extent (diameter), depth of invasion and occupying a certain place of the stenosis site, the stationary circumferential tumor size can be determined (Figure 1).
2.Endoscopy esophagus
Recently, a more detailed observation was made possible by the development and expansion of visual inspection and precision-weighted images, such as endoscopic band filters (Narow band imaging :: NBI) is applied to a narrow, a combination of these. Site of esophageal cancer, disease type, size, spread, information obtained from endoscopy, which is presence or absence of invasion depth of the lesion frequently, it is possible to obtain a pathological diagnosis by biopsy to collect tissue . Said the discovery of cancer is a disease mucosa adaptation of endoscopic resection is an important examination that can not be lacking. In addition, we also observe in detail the larynx and pharynx as well as the stomach and duodenum, we are also committed to the discovery of cancers. In order to undergo endoscopy comfortably without pain, in our department, we are doing a combination of sedative.
3.Esophageal endoscopic ultrasound
Tests that can not be essential to the diagnosis of lymph node metastasis and abdominal mediastinal diagnosis and depth of invasion of esophageal cancer, (EUS) is performed followed by endoscopy normal Endoscopic ultrasonography endoscopic ultrasonography. There are two tests to be used more ultrasonic probe integral with the ultrasonic probe is incorporated into an endoscope, biopsy forceps through the endoscope hole in the endoscopic ultrasound. I have observed using a 20MHz frequency from 5MHz. At present, I have been viewed as a means to obtain the most detailed information.
4. CT, MRI examination
Outer membrane invasion and lymph node metastasis to other organs adjacent ie local evolution of esophageal cancer, (CT) is useful in the diagnosis of distant organs such as the liver and lung metastases and Computed tomography. CT examination at the time of enforcement detailed information can be obtained from the vessel lumen and tumor imaging is by intravenous injection of contrast agent at high concentrations. Also, now allows the development of the MDCT column 64, a more precise diagnosis is performed in a short time. About the presence or absence of lymph node metastasis and invasion of esophageal cancer aortic tracheobronchial invasion and progression will be important information in determining the course of treatment, including surgery.
(MRI) is a test image to be configured as a digital tomographic image by calculating the distribution of the electromagnetic resonance computer that is out of the organism Magnetic resonance imaging. Is superior in terms of image obtained of sagittal and coronal cross-section not. MRI is a useful test image and adjacent organ invasion in the outer membrane of tumor invasion and lymph node metastasis.Others have been enforced as ultrasound examination is also an important external expression.
5.PET-CT
A new test method called PET (positron emission tomography radiation) has been paid attention recently. This is a way that can be detected with high sensitivity that is active metabolism of cancer cells than normal cells. By combining There was not using the test CT, MRI, and ultrasound, only inferred from the size and shape of lymph node metastasis until now, PET examination and inspection CT, lymph node metastasis little was hard to find until now We were able to discover and distant metastases.It is determined that a comprehensive picture of these test results, we make a proper treatment plan based on the age and general condition, such as organ function. The Company has enforced to
the extent possible If it is possible to visit the day without eating during the initial visit to our hospital, these checks, we are committed to rapid diagnosis.
Treatment
Considering the state of esophageal cancer, and the general condition, the treatment of esophageal cancer have been made to the following treatment.
1.Thoracic esophageal cancer surgery
Esophagus is divided into three cervical esophagus, thoracic esophagus, and abdominal esophagus. Because there are a lot of things that can thoracic esophageal cancer, it is a surgical procedure that is performed most. Adaptation is a cancer that has invaded the wall invasion depth deeper than the submucosa. Adaptation cases deviate from esophageal cancer invading the trachea and large blood vessels, such as the cases that have spread to the lungs or liver. Thoracic esophageal cancer surgery is not only breast surgery with cancer. Surgery three regions chest, abdomen, and neck is performed.We performed the resection of thoracic esophageal cancer, including breast operations.Food in the stomach to create a new path in the operation of the abdomen (stomach tube created).We do the anastomosis of the cervical esophagus and gastric tube was lifted up to the neck in the neck. Surgery for esophageal cancer is not the only resection of the cancer. It is important that the lymph nodes along the resection (lymph node dissection). Possible that there is a lymph node metastasis in thoracic esophageal cancer is not only the chest, abdomen and neck as well. Lymph node dissection is performed three regions cervical, thoracic, abdominal and therefore. Pathway reconstruction to lift up the neck There are three gastric tube.
(Through a subcutaneous route) route chest wall before
(Between the sternum and the heart) retrosternal route
(There was a part of the original esophagus)vertical path after
We have been selected according to the case because there each with its own advantages and limitations. Immediately after surgery are managed in the intensive care unit and return to the ward the day after state permitting. We will prevent complications of pneumonia you for the gait training from an early stage.Meal begins around 1 week after surgery. Hard to swallow at first, starting from the diet soft banana and taro easy to choke, the discharge will be happy to eat gruel. I will explain later in the outpatient observation results and pathology of the resected esophageal cancer with surgery prior to discharge. Whether the cancer had invaded to a depth how microscopic examination, the specific content is about the presence or absence of lymph node metastasis. Recently endoscopic surgery, using minimally invasive surgery in order to improve esophageal cancer, performed by inserting an endoscope into the chest or abdomen, the laparoscope has been performed and thoracoscopy. At our institution, depending on the progress of esophageal cancer, surgery is performed under endoscopic esophageal cancer aggressively.
2.EMR / ESD esophagus
It is said that esophageal cancer is early detection and disease, difficult to treat. But you can be discovered in the early stage of the cancer, the curative endoscopic resection is less burden on the patient in the same way as gastric cancer and colorectal cancer. Treatment is to resect the esophageal mucosa, including cancer of the esophagus using an endoscope inserted orally and endoscopic resection. Mucosal epithelium, lamina propria, muscularis mucosa, submucosa, and muscularis propria from the inside, the thickness of the outer wall of the esophagus is covered with about 4mm in most outer membrane.Adaptation of endoscopic resection is determined by the depth of invasion and the circumferential wall superficial primarily. Wall with respect to depth of invasion, infiltration cancer is cancer of the mucosa to the lamina propria. Because there is no risk of lymph node metastasis why. Zhou is with respect to superficial lesions less than 2 laps / 3.
Because it is difficult to pass through diet and cicatricial stenosis of reason in the process of healing is resected to near the whole circumference. Method of endoscopic resection can be classified into two broad. There endoscopic submucosal dissection is (ESD) and endoscopic mucosal resection (EMR).
EMR is a way of sucking the esophageal mucosa resection including lesions in the cap that is attached to the distal end of the endoscope tube and dedicated. Than the initial EMR is now performed on esophageal cancer in our hospital, he has been carried out using a special tube, which was developed by Professor Hiroyasu Makuuchi. I've been treating esophageal cancer more than 800 cases to date. Can be performed safely and can exhibit still better results, I believe good therapy. ESD is a method of esophageal mucosal resection in bulk, including cancer of the esophagus using a special knife. In this hospital we have decided to adapt depending on the case.Cancer and other smoking as a risk factor for esophageal cancer, drinking, men, ENT area is well known. Find out more cases of cancer mucosa, In our hospital, we are actively working to esophageal cancer screening test so that it can be curative endoscopic resection.
3.Chemoradiotherapy
The method of treatment other than resection of the esophagus, there is a radiation therapy and chemotherapy (anticancer drug treatment). Higher therapeutic effect by combination chemoradiotherapy called what was a combination of these two effects can be expected synergistic additive, than they do chemotherapy or radiation therapy alone.If it is not possible to determine from such surgery useless due to a history degree and progression of esophageal cancer is one of the treatment carried out for the purpose as well as curative surgery. It is the treatment of choice even if you do not want surgery or even surgery.
For fairly high degree of invasiveness, as well as late effects occur in addition to side effects, it does not say the treatment and pain but never less. In addition, by chemoradiation treatment, the disease may relieve the symptoms can be achieved a reduction in tumor metastasis and recurrence for such.According to the information service, such as cancer by National Cancer Center, it is reported that in the 5-year survival rate comparable to surgery.
4.Esophageal stent insertion technique
Surgical stent insertion has been done for the purpose of securing the lumen when the occluded blood vessels, trachea, bile duct, pancreatic duct, and digestive tract, hollow organ in the body or stenosis. Esophagus is a hollow organ of organs for straight to the stomach, stent insertion is easy to insert among the digestive tract from the mouth. Esophageal stent has a structure that fine woven piece of shape memory alloys. Because that is folded thin, at the time of insertion can be safely inserted into the stricture that I get. Because of the shape memory alloy, we are in close contact with the wall of the esophagus lumen and to ensure a natural extension
Adaptation of esophageal stent treatment is the following cases. Stenosis cancer unresectable advanced esophageal cancer: advanced esophageal cancer esophageal cancer invasion to adjacent organs, organ metastasis, patients without chemotherapy or chemotherapy and radiation therapy can also be bad general condition. This is a difficult case of serious complications due to surgery also. Stenosis after chemoradiotherapy: main lesion stenosis was enhanced even reduced by chemotherapy or chemoradiotherapy, it is not indicated in patients with surgical resection.
May form a fistula and mediastinal trachea and bronchial esophageal cancer also increased Esophageal stent insertion surgery is not a treatment for esophageal cancer itself. To be able to eat even a little spread narrowed esophagus for cancer it is the purpose of the maximum. For those who can not get enough to eat after stent insertion, perform endoscopic gastrostomy. We are also teaches home care management of nutrition in combination with diet and tube feeding.
5.Therapeutic strategy for esophageal cancer
You can combine the above treatment, provide medical care advanced esophageal cancer based on the latest clinical guidelines in our hospital. Furthermore, even when treatment options is difficult, based on the extensive experience of our previous, in collaboration with departmental as General Hospital, we have made medical care the best possible state of esophageal cancer and comorbidity. Total power, including not only doctors, but also other co-medical staff such as nurses, laboratory technicians and rehabilitation is essential, in esophageal cancer clinics are a good practice to reflect the performance of our hospital.
Matters related inquiries esophageal cancer
If you have any questions, such as: related to esophageal cancer, please contact us at any time in consultation with the attending physician.
If you have symptoms such as dysphagia swallowing worry like that? "Esophageal cancer" No way.If you would like a more accurate diagnosis, was diagnosed with "suspected esophageal cancer."Diagnosed with "esophageal cancer", people with anxiety regarding your future treatment.
If you have concerns regarding your future treatment are diagnosed with "suspected recurrence" or "recurrent esophageal cancer."
Treatment of esophageal cancer who until now may not work, you have an anxiety regarding future treatment.
And esophageal cancer
Esophageal cancer that can be, many are squamous cell carcinoma arising from the esophageal mucosa. As a special esophageal cancer is Barrett adenocarcinoma,adenosquamous carcinoma,basaloid carcinoma, endocrine cell carcinoma, undifferentiated carcinoma, and malignant melanoma. Can be cured by surgery endoscopic If you can find early in is possible, there is a feature that causes the lymph node metastasis from an early stage in comparison with colon cancer and gastric cancer, when compared to these cancers, the grade I say high cancer. It is also an area that can cause extensive lymph node metastasis is the neck, chest and abdomen, is causing a high degree of malignancy. Total power, including not only doctors, but also other co-medical staff such as nurses, laboratory technicians and rehabilitation is an integral part of the medical esophageal cancer.What many people do?
Esophageal cancer are over the age of 50 Mature much, it is a disease many men at a ratio of 9:1. In addition, it is said drinking history and smoking history is closely related with the development of esophageal cancer, it has been said that people with a high risk of both history and drinking habits, especially smoking history. It is also considered to be high risk, such as some people are constitutionally turns red immediately after drinking alcohol.
Symptom
Initially be asymptomatic in most cases, many cancers are the same for esophageal cancer. Becoming a high probability of pain and discomfort, dysphagia that gradually becomes larger as was tingling when swallowed food comes out. However, it may not even be aware of the symptoms can be quite large and it is important endoscopy.
Inspection
Esophageal cancer treatment is selected on the basis of highly accurate diagnosis progression, including imaging. Below, we describe the detailed examination of esophageal cancer.
 |
| Fig 1 X-ray view |
X-ray angiography is finding the (early cancer) is quite difficult cancer mucosa, visualization of esophageal cancer invading the submucosa or more cancer is relatively easy, the presence of esophageal cancer can be diagnosed. Information obtained from many X-ray contrast, not only the diagnosis of progression range and extent (diameter), depth of invasion and occupying a certain place of the stenosis site, the stationary circumferential tumor size can be determined (Figure 1).
2.Endoscopy esophagus
Recently, a more detailed observation was made possible by the development and expansion of visual inspection and precision-weighted images, such as endoscopic band filters (Narow band imaging :: NBI) is applied to a narrow, a combination of these. Site of esophageal cancer, disease type, size, spread, information obtained from endoscopy, which is presence or absence of invasion depth of the lesion frequently, it is possible to obtain a pathological diagnosis by biopsy to collect tissue . Said the discovery of cancer is a disease mucosa adaptation of endoscopic resection is an important examination that can not be lacking. In addition, we also observe in detail the larynx and pharynx as well as the stomach and duodenum, we are also committed to the discovery of cancers. In order to undergo endoscopy comfortably without pain, in our department, we are doing a combination of sedative.
3.Esophageal endoscopic ultrasound
 |
| Fig 2 Endoscopy esophagus view |
4. CT, MRI examination
Outer membrane invasion and lymph node metastasis to other organs adjacent ie local evolution of esophageal cancer, (CT) is useful in the diagnosis of distant organs such as the liver and lung metastases and Computed tomography. CT examination at the time of enforcement detailed information can be obtained from the vessel lumen and tumor imaging is by intravenous injection of contrast agent at high concentrations. Also, now allows the development of the MDCT column 64, a more precise diagnosis is performed in a short time. About the presence or absence of lymph node metastasis and invasion of esophageal cancer aortic tracheobronchial invasion and progression will be important information in determining the course of treatment, including surgery.
(MRI) is a test image to be configured as a digital tomographic image by calculating the distribution of the electromagnetic resonance computer that is out of the organism Magnetic resonance imaging. Is superior in terms of image obtained of sagittal and coronal cross-section not. MRI is a useful test image and adjacent organ invasion in the outer membrane of tumor invasion and lymph node metastasis.Others have been enforced as ultrasound examination is also an important external expression.
 |
| Fig 3 endoscopy of superficial esophageal cancer view |
A new test method called PET (positron emission tomography radiation) has been paid attention recently. This is a way that can be detected with high sensitivity that is active metabolism of cancer cells than normal cells. By combining There was not using the test CT, MRI, and ultrasound, only inferred from the size and shape of lymph node metastasis until now, PET examination and inspection CT, lymph node metastasis little was hard to find until now We were able to discover and distant metastases.It is determined that a comprehensive picture of these test results, we make a proper treatment plan based on the age and general condition, such as organ function. The Company has enforced to
the extent possible If it is possible to visit the day without eating during the initial visit to our hospital, these checks, we are committed to rapid diagnosis.
Treatment
Considering the state of esophageal cancer, and the general condition, the treatment of esophageal cancer have been made to the following treatment.
1.Thoracic esophageal cancer surgery
Esophagus is divided into three cervical esophagus, thoracic esophagus, and abdominal esophagus. Because there are a lot of things that can thoracic esophageal cancer, it is a surgical procedure that is performed most. Adaptation is a cancer that has invaded the wall invasion depth deeper than the submucosa. Adaptation cases deviate from esophageal cancer invading the trachea and large blood vessels, such as the cases that have spread to the lungs or liver. Thoracic esophageal cancer surgery is not only breast surgery with cancer. Surgery three regions chest, abdomen, and neck is performed.We performed the resection of thoracic esophageal cancer, including breast operations.Food in the stomach to create a new path in the operation of the abdomen (stomach tube created).We do the anastomosis of the cervical esophagus and gastric tube was lifted up to the neck in the neck. Surgery for esophageal cancer is not the only resection of the cancer. It is important that the lymph nodes along the resection (lymph node dissection). Possible that there is a lymph node metastasis in thoracic esophageal cancer is not only the chest, abdomen and neck as well. Lymph node dissection is performed three regions cervical, thoracic, abdominal and therefore. Pathway reconstruction to lift up the neck There are three gastric tube.
(Between the sternum and the heart) retrosternal route
(There was a part of the original esophagus)vertical path after
We have been selected according to the case because there each with its own advantages and limitations. Immediately after surgery are managed in the intensive care unit and return to the ward the day after state permitting. We will prevent complications of pneumonia you for the gait training from an early stage.Meal begins around 1 week after surgery. Hard to swallow at first, starting from the diet soft banana and taro easy to choke, the discharge will be happy to eat gruel. I will explain later in the outpatient observation results and pathology of the resected esophageal cancer with surgery prior to discharge. Whether the cancer had invaded to a depth how microscopic examination, the specific content is about the presence or absence of lymph node metastasis. Recently endoscopic surgery, using minimally invasive surgery in order to improve esophageal cancer, performed by inserting an endoscope into the chest or abdomen, the laparoscope has been performed and thoracoscopy. At our institution, depending on the progress of esophageal cancer, surgery is performed under endoscopic esophageal cancer aggressively.
2.EMR / ESD esophagus
It is said that esophageal cancer is early detection and disease, difficult to treat. But you can be discovered in the early stage of the cancer, the curative endoscopic resection is less burden on the patient in the same way as gastric cancer and colorectal cancer. Treatment is to resect the esophageal mucosa, including cancer of the esophagus using an endoscope inserted orally and endoscopic resection. Mucosal epithelium, lamina propria, muscularis mucosa, submucosa, and muscularis propria from the inside, the thickness of the outer wall of the esophagus is covered with about 4mm in most outer membrane.Adaptation of endoscopic resection is determined by the depth of invasion and the circumferential wall superficial primarily. Wall with respect to depth of invasion, infiltration cancer is cancer of the mucosa to the lamina propria. Because there is no risk of lymph node metastasis why. Zhou is with respect to superficial lesions less than 2 laps / 3.
EMR is a way of sucking the esophageal mucosa resection including lesions in the cap that is attached to the distal end of the endoscope tube and dedicated. Than the initial EMR is now performed on esophageal cancer in our hospital, he has been carried out using a special tube, which was developed by Professor Hiroyasu Makuuchi. I've been treating esophageal cancer more than 800 cases to date. Can be performed safely and can exhibit still better results, I believe good therapy. ESD is a method of esophageal mucosal resection in bulk, including cancer of the esophagus using a special knife. In this hospital we have decided to adapt depending on the case.Cancer and other smoking as a risk factor for esophageal cancer, drinking, men, ENT area is well known. Find out more cases of cancer mucosa, In our hospital, we are actively working to esophageal cancer screening test so that it can be curative endoscopic resection.
3.Chemoradiotherapy
The method of treatment other than resection of the esophagus, there is a radiation therapy and chemotherapy (anticancer drug treatment). Higher therapeutic effect by combination chemoradiotherapy called what was a combination of these two effects can be expected synergistic additive, than they do chemotherapy or radiation therapy alone.If it is not possible to determine from such surgery useless due to a history degree and progression of esophageal cancer is one of the treatment carried out for the purpose as well as curative surgery. It is the treatment of choice even if you do not want surgery or even surgery.
4.Esophageal stent insertion technique
Surgical stent insertion has been done for the purpose of securing the lumen when the occluded blood vessels, trachea, bile duct, pancreatic duct, and digestive tract, hollow organ in the body or stenosis. Esophagus is a hollow organ of organs for straight to the stomach, stent insertion is easy to insert among the digestive tract from the mouth. Esophageal stent has a structure that fine woven piece of shape memory alloys. Because that is folded thin, at the time of insertion can be safely inserted into the stricture that I get. Because of the shape memory alloy, we are in close contact with the wall of the esophagus lumen and to ensure a natural extension
Adaptation of esophageal stent treatment is the following cases. Stenosis cancer unresectable advanced esophageal cancer: advanced esophageal cancer esophageal cancer invasion to adjacent organs, organ metastasis, patients without chemotherapy or chemotherapy and radiation therapy can also be bad general condition. This is a difficult case of serious complications due to surgery also. Stenosis after chemoradiotherapy: main lesion stenosis was enhanced even reduced by chemotherapy or chemoradiotherapy, it is not indicated in patients with surgical resection.May form a fistula and mediastinal trachea and bronchial esophageal cancer also increased Esophageal stent insertion surgery is not a treatment for esophageal cancer itself. To be able to eat even a little spread narrowed esophagus for cancer it is the purpose of the maximum. For those who can not get enough to eat after stent insertion, perform endoscopic gastrostomy. We are also teaches home care management of nutrition in combination with diet and tube feeding.
5.Therapeutic strategy for esophageal cancer
You can combine the above treatment, provide medical care advanced esophageal cancer based on the latest clinical guidelines in our hospital. Furthermore, even when treatment options is difficult, based on the extensive experience of our previous, in collaboration with departmental as General Hospital, we have made medical care the best possible state of esophageal cancer and comorbidity. Total power, including not only doctors, but also other co-medical staff such as nurses, laboratory technicians and rehabilitation is essential, in esophageal cancer clinics are a good practice to reflect the performance of our hospital.
If you have any questions, such as: related to esophageal cancer, please contact us at any time in consultation with the attending physician.
If you have symptoms such as dysphagia swallowing worry like that? "Esophageal cancer" No way.If you would like a more accurate diagnosis, was diagnosed with "suspected esophageal cancer."Diagnosed with "esophageal cancer", people with anxiety regarding your future treatment.
If you have concerns regarding your future treatment are diagnosed with "suspected recurrence" or "recurrent esophageal cancer."
Treatment of esophageal cancer who until now may not work, you have an anxiety regarding future treatment.
No comments:
Post a Comment