Esophagectomy surgery for Esophageal Cancer

Q1 What is esophagus?

 

A1 Esophagus, also referred to as food pipe, is a muscular tube through which the food passes from your mouth down to your stomach.

 

Q2. What is Oesophageal cancer?

 

A2 Cancer that starts in the food pipe or esophagus is referred to as Esophageal cancer. Like other cancers, oesophageal cancer is also characterized by uncontrolled growth of the cells, of the esophagus, due to damaged genetic material in them. Tumor forms due to uncontrolled multiplication of these abnormal cells resulting in the formation of a lump in the wall of the oesophagus.

 

Q3 What are the types of esophageal cancer?

 

A3 There are mainly two types of esophageal cancer:

• Squamous cell carcinoma- The flat, thin cells that form the lining of the esophagus or the food pipe are called Squamous cells and the cancer developing in these cells is referred to as Squamous cell carcinoma.
• Adenocarcinoma- This cancer may happen in the changed lining of the esophagus from thin flat squamous cells to mucus producing gland cells called Goblet cells, a condition also known as Barrett's esophagus.

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Q4 What is done during Esophagectomy surgery?

 

A4 Esophagectomy literally means removal of whole or part of the esophagus or the food pipe. Your surgeon will remove the cancer inflicted part of the esophagus along with adjoining healthy esophageal tissue above and below the cancer affected part. Some part of the stomach may also be removed. The extent of the tissues to be removed are greatly determined by the location and the stage of the tumor with an ultimate goal to get rid of the cancer. The remaining healthy part of the esophagus and the stomach are joined back. Your surgeon may also remove some nearby lymphnodes to find if cancer has already spread to them.

 

Q5 What are the types or variations of esophagectomy?

 

A5 Once whole or the part of the esophagus is removed it may be replaced by:

1. Pulled up remaining part of the stomach, which is referred to as Esophagectomy and gastric pull-up.
2. Colon or Large intestine, also referred to as Esophagectomy and Colon Interposition
3. Small intestine,in few patients, which is referred to as Esophagectomy and Jejunal Interposition.

​The type of esophagectomy is determined by location and depth of the tumor, overall health condition of the patient and your surgeon's preference.

 

Q6 What are the indications for Esophagectomy surgery?

 

A6 Besides esophageal cancer, other conditions that call for esophagectomy surgery are the following:

• Advanced GERD
• Intractable Peptic ulcer disease
• Advanced Achalasia

 

Q7 What are the signs and symptoms of Esophageal cancer?

 

A7 There may be no sign or symptom in the early stages of esophageal cancer.  At a later stage, the patient may present with the following signs and symptoms:

• Difficulty in swallowing (referred to as "Dysphagia" in medical terms) when the tumor size is large enough to block the passage in the esophagus.
• Weight loss in a short period of time due to difficulty in eating.
• Hoarse voice
• Chronic cough
• Chest or neck pain, the location of the tumor in the esophagus will determine the site of pain.

 

Q8 What is Barrett's esophagus?

 

A8 Some people suffer from GERD(Gastroesophageal reflux disease), a condition which is characterized by frequent backflow of the acid formed in the stomach, into the esophagus. Eventually, GERD causes the squamous cells(thin and flat cells) of the lining of the lower esophagus to be replaced with mucus forming gland cells, aslo referred to as Goblet cells. This condition characterized by change in the lining of the esophagus is referred to as Barrett's esophagus.

 

Q9 What are the treatment options for Esophageal cancer?

 

A9 After your clinical examination and evaluation of your medical reports, your doctor may recommend one or more of the following treatment options for you:

• Surgery
• Chemotherapy
• Radiation Therapy

​Surgery is considered as first line of therapy especially in the early stages of esophageal cancer when the tumor size is small.

Chemotherapy is considered as mainstay of treatment if the tumor is in its advanced stage and it is also recommended before the surgery in order to shrink the tumor. Chemotherapy,as t​he name implies, uses drugs to prevent the spread of the cancer by either stopping its growth or slowing it down.

Radiation therapy may also be used alongside chemotherapy. A type of radiation therapy is EBRT(External beam radiation therapy). It damages and kills the cancer cells.

 

Q10 Can esophageal cancer be prevented?

 

A10 You can take certain prudent steps to decrease your vulnerability towards esophageal cancer.

• ​​Stop smoking
• Quit alcohol
• Get timely treatment for GERD.

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​Q11 What is the usual hospital stay required after esophagectomy surgery?

 

A11 The usual hospital stay after esophagectomy surgery is 7 to 10 days. However, it may vary as per the response of the patient to the surgery.

 

Benefits of Esophageal cancer surgery(Esophagectomy) in India

 

• Most advanced esophageal cancer treatment at the most affordable cost 

• No waiting period

• State of the art world class cancer hospitals with complete cancer care under one roof.

• Most advanced equipment,technology and the latest internationally accepted treatment protocols are adopted.

• Multidisciplinary integrated approach- Team of experts from various disciplines such as Radiation Oncologist,Medical Oncologist,Surgical Oncologist, specialist of the concerned specialty, all work in coordination taking consolidated review of your condition, right from the screening,diagnosis,treatment and rehabilitation to bring out the best clinical outcome for you.

• Globally trained, highly experienced doctors.

• Great ambience.

• Compassionate staff to look after.

• Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

• Language no barrier. English speaking people and if required, translators are available for your convenience.

• Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

• Good flight connectivity.

• India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

Dr Harit Chaturvedi
MBBS,MS,MCh(Surgical Oncology)
Chairman,Cancercare, Director and Chief Consultant Surgical Oncology
Max Super Specialty Hospital Saket,New Delhi

 

Dr Pawan Gupta
MBBS,MS(Surgery),MCh(Surgical Oncology)
Fellowship from Royal College of Surgeons, Glasgow, UK.
Active Member,International Society of Surgery (ISS/SIC).
Additional Director,Institute of Cancer Care
Jaypee Hospital, Noida, Delhi-NCR

Dr Adarsh Choudhary
MBBS,MS(General Surgery)
Chairman, Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery
Medanta The Medicity, Gurgaon,Delhi-NCR

Dr Rajesh Kapoor

MBBS,MS(General surgery),M.Ch(Surgical Gastroenterology)

Director, GI and Hepatopancreaticobiliary sciences

Jaypee Hospital, Noida, Delhi-NCR