The Esophagus and Acid Reflux

As background, the esophagus is a tube located in the neck and chest region of the body. What some people might not know is actually how far this tube travels down the chest cavity. This round tube starts at the neck and extends all the way down to the stomach. The normal length of the esophagus is around 25-30 cm (9.8”-11.8”). The primary function of the esophagus is the carrying of food to the stomach for digestion.

Over duration of time, the lining of the esophagus gets eaten away by certain foods and liquids. Often times, doctors treat patients for acid reflux problems when there are symptoms of indigestion and heartburn. If left untreated, acid reflux can cause damage to the esophagus. The acid being refluxed into the esophagus irritates the area and eventually damages the esophagus. The main area of the esophagus susceptible to damage is the lower portion near the stomach.

The majority of esophageal cancer cases in the United States are also located at the base of the esophagus where food empties into the stomach. Acid reflux is not the only causes of esophageal cancer. Other possible causes are:

• Smoking(my father was a smoker)
• Frequent alcohol drinking
• Diets low in fruits and vegetables
• Age(65 and older greater risk factor)
• Obesity

Signs And Symptoms

The main symptoms and signs of esophageal cancer include:

• Weight loss (Can be fast and significant)
• Difficulty in swallowing(both food and liquids)(worse symptom for my dad)
• Pain in the chest area
• Fatigue or tiredness
• Heartburn(same with acid reflux)
• Food pieces getting lodged in the esophagus
• Vomiting of blood
• Passing blood during bowel movement

If you experience any of the above symptoms please contact your health care provider for further evaluation. A lot of patients experiencing these symptoms are going to be treated for acid reflux initially. Demand further evaluation if problems persist. My father was treated for years with acid reflux disease (GERD). The problems worsened but the doctors insisted that it was only GERD.

Diagnosing Esophageal Cancer

Next, I want to cover the different methods to diagnose esophageal cancer. Some of the ways include:

• Endoscopy(scope is used to examine the entire esophagus area for damage)
• X-rays(typically referred to as a barium swallow test, a chalky-like liquid is swallowed to evaluate its track through the system)
• Biopsy(scope is used to take a specific area of the esophagus and examine for cancer or any other abnormalities)
• Types Of Esophageal Cancer
• Esophageal cancer is classified as two different types. The two types are:
• Squamous cell carcinoma(normally located in the upper portion of the esophagus, more common around the world but not as common in the USA)
• Adenocarcinoma(typically located in the lower portion of the esophagus near the stomach, most common type in the USA)(my father’s diagnosis)

Testing For Esophageal Cancer Staging

There are numerous tests and exams to check for stages of esophageal cancer. Some of the more typical ones are:

• Endoscopic ultrasound (scope is used to see how deep the cancer may have attacked the esophagus wall, physician may use a needle to sample lymph nodes)
• PET scan (patient is injected with a sugar type compound, cancer shows up as bright or lighted up areas on a monitoring screen)(same test used on my father)(very expensive test)
• MRI (magnet is linked to a computer screen to provide a detailed image of the body, can show spread of cancer to surrounding lymph nodes)
• CT scan (x-rays linked to a screen to provide a detailed image of the chest and abdomen area)
• Laparoscopy (doctor makes small cuts around the abdominal region and a thin lighted scope (laparoscope) is used to look for cancer cells)

Stages

Esophageal cancer stages range from 0-4 and several factors determine which stage the diseased may have progressed. The stages and expected results are:

• Stage 0(cancer cells only in the inner layer)
• Stage 1(cancer has grown through the inner layer)
• Stage 2 may involve one of the following situations:

1. Cancer has grown through the outer layer
2. Cancer has attacked the muscle layer and may be found in the lymph nodes
3. Cancer has grown through the inner layer and spread to surrounding lymph nodes

• Stage 3 also involves of the following:

1. Cancer has attacked nearby structures like the air passages and may have spread to lymph nodes
2. Cancer has grown through the outer layer and spread to lymph nodesStage 4(cancer has spread to organs such as the liver, lungs, and stomach)

Treatment Options

There are basically three different conventional methods of treatment. The options include:

• Radiation therapy (machine with high-energy rays are used to destroy cancer cells)
• Chemotherapy (drugs are administered to kill cancer cells)
• Combo therapy (using both radiation and chemo to attack the cancer cells)(my father went through both)
• Surgery (the most risky option and patient is faced with possible post-surgery complications)
• All of the above (using radiation, chemo, and surgery to attack the disease)(option my father chose)

My Father’s Story – If You Choose Surgery, Find a Qualified Surgeon

My father chose the route of all three methods of treatment for his esophageal cancer diagnosis. The radiation and chemo were successful but definitely very agonizing. Once he was finished with chemo and radiation, he chose surgery to get rid of the esophagus. While no evidence of cancer was found by PET scan after chemo and radiation, my dad didn’t want to take a chance on the cancer coming back. He made it through the surgery successfully. On day 9 after surgery, he suffered what is called an “Anastomotic Leak”. This is a leakage of fluids at the site where the esophagus was removed. My father passed away of this often fatal condition.

There are various reasons as to why a leak may happen. One reason is the skill and care of the surgeon(s). I want to emphasize to find a very qualified physician to perform surgery if that’s the route chosen. My father gained the trust of his doctors and was confident in them. However, we didn’t go to a specific cancer hospital like MD Anderson in Texas. We stayed local and he didn’t want to burden the family on traveling. I tried to convince him otherwise. He said that he trusted his surgeons and followed through with it. Another reason that a leak can occur is due to insufficient wound healing. Less common reasons are infections and stress at the adjoining site.

We were never given the reason form my father’s sudden and fatal leak. We did have a meeting with one of his surgeons a few weeks after his death. The excuses given to us were a weakened immune system. You find me a cancer patient that doesn’t have a weakened immune system. My dad was in pretty bad health anyhow with other health problems but telling us the reason for the leak was due to a weakened immune system didn’t set too well with the family. We are a family of faith so we just decided it was his time to go. However, we didn’t like the approach by the surgeons in that they didn’t seem to care to find out what happened for future reference. We weren’t given any indication that an investigation would happen by the surgeons to keep this from possibly happening to someone else.

I would just say to do your homework on finding a qualified surgeon(s). I suggest finding a proven cancer facility to have the surgery along with the best surgeon(s). Find out about your surgeons by looking up information on them. I would also suggest getting a surgeon that has extensive experience in this type surgery. A good number to look for is at least 100 operations. You shouldn’t have a problem in finding a surgeon with that number at a cancer facility.

I know what a terrible time my dad had in facing this cancer. However, local hospitals might not be qualified enough to handle a situation like this. This is why I strongly recommend finding a cancer facility if ever faced with esophageal cancer surgery. If through this article, I can help anyone facing this troubling disease it’s a success to me.

Author Bio:

This guest post was contributed by Tony Bowen who is a member of the fastest growing online education communities and writes on topics like education, online school, learning etc.

General trend in RSD Progression is that it often starts as a mild attack but as the days pass by the severity and consequential pain grows and if not taken care of could lead to crippling the victim with some physical deformity. While the physician in particular and the society at large have responsibilities to bear in prevention or cure of RSD, there are certain responsibilities that the patient himself or herself should bear.

Suppose you feel that aggravation of RSD in your case is a result of medical negligence or malpractice and you seek the assistance from one of the RSD Attorneys for drafting a claim and filing a lawsuit. The first thing an expert attorney will look at is whether you have fulfilled your side of contract or not.

In RSD Lawsuits it will be examined whether the patient has fulfilled his or her two obligations of: -

1. Seeking medical attention immediately for any unexplained burning pain, especially those developing after an injury, and
2. Cooperating with medical treatment including physical therapy completely.

If these conditions have been fulfilled, you have a case to fight.

Experts on CRPS have chalked out four stages for RSD.  Determining the exact stage may be a difficult proposition due to lack of symptoms or understanding about their combinations. Another difficult part to determine is the time period taken at each stage of the CRPS that makes RSD extremely difficult to diagnose.

RSD Attorneys would not be very enthusiastic about the existence of the fourth stage of RSD in a lawsuit because evidences are remote. Yet there are evidences that such a stage do exist.

However, the majority of the doctors and scientists believe that RSD Progression covers four stages. The first one is the acute stage that could last up to three months. Stage two is the Dystrophic stage that could last up to six months.  Stage three is the atrophic stage and could continue for unlimited time. While stage four through which very few patients pass is one in which the RSD becomes resistant to many forms of treatments.

The patient confirmed with mesothelioma may not remember the cause of his catching the disease but his past employers may throw light upon the issue. Well, the asbestos exposure he succumbed to when he was working in a construction company has led to this suffering many decades after. His serous membranes are affected and show malignant growths. It may be chest lining, peritoneal lining or pericardium. He suffers from respective symptoms depending upon the area of involvement.

The physicians have a dual duty of assuring the patient and treating him according to his state. Though there are many treatment options available, exact cure still eludes the doctors worldwide. The doctors are trying to give temporary relief to the patient and make them asymptomatic as soon as possible. With the right kind of treatment, many patients attain a stable state, even if they have the cancer.

What if he would have cared about the least precautionary measure during his tenure? Well, the question haunts!