A bitter pill to swallow
Dr Kan explains how a common problem might turn into cancer of the oesophagus
Most of the time , we just take a short trip to the local pharmacy for an acid remedy or make an appointment with the local family doctor for treatment
Cancer of the food pipe or gullet ( oesophagus ) is the eighth most common cancer and the sixth most common cause of cancer-related-deaths worldwide .
Most of us will experience a few episodes of heartburn or the sensation of bitter taste or acid in our mouth on a monthly basis , and this is a common aspect of modern life that should cause us no concern . It may be triggered by the food we eat , poor eating habits , stresses in life , medication , being overweight , or habits such as smoking and alcohol . Most of the time , we just take a short trip to the local pharmacy for an acid remedy or make an appointment with the local family doctor for treatment .
However , when the problem becomes intractable and constant , it can be cause for concern as this may be the first sign of oesophageal cancer . When the cancer develops and enlarges , there will be a sensation of food begin stuck in the throat or centre of the chest . Eventually , it may lead to the inability to swallow anything ( dysphagia ) as the cancer grows and the opening of the food pipe becomes completely blocked . Swallowing water , food , or pills becomes impossible . It may also present with vomiting blood or unintentional weight loss .
There are two main types of oesophageal cancer : “ squamous cell carcinoma ” and “ adenocarcinoma .”
In developed Western countries , being overweight is a major problem , often causing abdominal obesity and a large rotund stomach . At the lower part of the oesophagus , there is a muscular valve which keeps the stomach acid away from the oesophagus . Being obese puts pressure on the stomach , leading to acid refluxing back into the oesophagus and producing the symptoms of heartburn or pain in the chest . This is commonly referred to as acid reflux . If this damage from the acid is persistent and severe , it can lead to inflammation and subsequent changes in the cells ’ lining ( Barret ’ s oesophagus ) with the potential development of cancer ( adenocarcinoma ) at the lower portion of the oesophagus .
In Asia , squamous cell carcinoma is the predominant cancer . It ’ s considered more aggressive and occurs higher up in the oesophagus than adenocarcinoma . The main risk factor for developing this type of cancer is smoking , but others include :
1 . Age ( increased incidence over the age of 60 ) 2 . Gender - men are more likely than women to get oesophageal cancer 3 . Obesity 4 . Persistent chronic acid reflux leading to Barrett ’ s oesophagus 5 . Alcohol – chronic and heavy drinkers 6 . Ethnicity ( Caucasian – adenocarcinoma ) 7 . Caustic injury to the oesophagus 8 . Infection with human papillomavirus ( HPV ) - squamous cell carcinoma 9 . Diet high in processed meat and lacking fresh fruit and vegetables 10 . Previous history of other cancers 11 . Other conditions – Achalasia , Tylosis , Plummer- Vinson Syndrome
When the symptoms of heartburn persist despite medication or if dysphagia occurs , it will warrant
68 OCTOBER 2021 GlobalHealthAsiaPacific . com