2023-06-21 02:25:41
Text and pictures / uho Youhuo Health Network
Esophageal cancer is actually related to the stomach? Esophageal cancer is one of the common cancers. There are usually no obvious symptoms in the early stage. In the late stage, the esophageal tumor continues to grow, causing narrow and obstructed lumens, and symptoms of dysphagia appear. With more than 40 years of medical experience, Lin Zhaotang, vice president of Kaohsiung E-Da Hospital, wrote the book “Intestinal Health and Good Stomach”, which integrates common gastrointestinal-related diseases, diagnosis cases and treatments, and provides readers with the most detailed and easy-to-understand medical information.
Schematic diagram／photo AC
About 500,000 people worldwide die from esophageal cancer every year
Esophageal cancer is a common cancer in Taiwan. About 500,000 people around the world die from esophageal cancer every year. It has been among the top 10 causes of cancer death in Taiwan for many years, and it is the fifth among the top 10 cancer deaths among men. Esophageal cancer can be divided into squamous cell carcinoma and adenocarcinoma according to the characteristics of the cells, each with different causes and predilection locations.
In Taiwan, about 90% of patients are squamous cell carcinoma; in Europe and America, about 60% are esophageal adenocarcinoma. In recent years, the incidence of squamous carcinoma of the esophagus in the Chinese population is still increasing rapidly, and adenocarcinoma of the esophagus is the cancer with the fastest increasing incidence in Western countries. Esophageal cancer often occurs in middle-aged men aged 50 to 60. Once cancer occurs, many families will lose their main economic support, which will have a huge impact on social costs. Therefore, the prevention and health care of esophageal cancer is a health issue that requires great attention.
Because esophageal cancer does not have symptoms when it first occurs, when the symptoms of dysphagia appear and the diagnosis is confirmed, as many as 80% of the patients are already in the advanced stage, and radical treatment cannot be done, so the survival rate is very poor, 5 The annual survival rate is less than 20%. However, if diagnosed early, there is a chance that it can be completely eradicated with a cure rate of over 90%.
3 major risk factors for esophageal cancer
The esophagus is the pipe connecting the mouth and the stomach, so esophageal cancer can be said to be a disease caused by eating, including eating some carcinogens, liking to drink hot tea (over 67°C), lack of vitamins and minerals in the usual diet, overeating Lead to long-term gastroesophageal reflux and so on.
Although there are many risk factors for esophageal cancer, drinking, smoking, and betel nut chewing are still the three most important risk factors for cancer. People who have these habits are 8 times, 4 times and 2 times more likely to develop esophageal cancer than the general population. . People who have the above three habits at the same time have a risk of esophageal cancer that is 100 to 200 times that of ordinary people.
In the past few years, through the implementation of the oral cancer, tobacco and betel nut prevention and control policies of the National Health Department of the Ministry of Health and Welfare, initial and remarkable results have been achieved. The number of Chinese people smoking and chewing betel nuts has decreased year by year. Drinking alcohol, many past studies have shown that daily alcohol intake of more than 24 grams (more than 168 grams per week) may increase the risk of esophageal cancer.
[Alcohol grams can be converted with a simple formula]Drinking amount X concentration X alcohol density (0.8)
For example, if you drink a can of 350ml beer with an alcohol concentration of 5%, you can calculate that the alcohol intake is 14 grams, so you only need to drink two cans a day to exceed the standard. Colorectal cancer, etc. According to statistics, one out of every 30 cancer patients is caused by drinking.
What’s more noteworthy is that 45% of Taiwanese have the “red-faced” gene, which makes them blush when they drink alcohol, which is much higher than in European and American countries. These people are a high-risk group of esophageal cancer, and they are not suitable for drinking, because the main cause of blushing after drinking is mainly the lack of enzymes in the body that metabolize alcohol (aldehyde dehydrogenase, ALDH2). Lower than the average person, although it seems that the amount of alcohol is acceptable on the surface, in fact, after drinking, it will produce an intermediate product, acetaldehyde, which is also a carcinogen, and will accumulate in a large amount in the body, leading to esophageal cancer.
Up to 75% of esophageal cancer patients in Taiwan have the gene for this enzyme deficiency. If they have the habit of drinking alcohol, the risk of developing esophageal cancer is more than 80 times that of ordinary people. Therefore, it is very important to know your own physical condition. The recommended daily alcohol intake should not exceed 20 grams. Only by staying away from alcohol can you permanently stay away from esophageal cancer.
Three major precancerous lesions of esophageal cancer
The formation of esophageal cancer does not happen in one day. The epidermis of the esophagus needs to be exposed to carcinogenic factors for a long time. Precancerous lesions of the esophagus will first form and then evolve into esophageal cancer. Stage treatment can prevent the occurrence of esophageal cancer. Esophageal cancer has three major precancerous lesions, namely Barrett’s esophagus, dysplasia (Dysplasia), and esophageal background mucosa with spots, also known as leopard patterns (Speckled pattern).
Barrett’s esophagus: Long-term gastroesophageal reflux will lead to degeneration of the esophageal epithelium, from the original squamous epithelium to acid-resistant columnar epithelium, and the risk of cancer may occur during the transformation process, so Barrett’s esophagus is an esophagus Precancerous lesions of adenocarcinoma. According to statistics, the average annual risk of cancer is about 0.5%. Patients with long-term symptoms of gastroesophageal reflux, if they go to the doctor for endoscopic examination, they will find the strip-shaped red area on the left side of the picture above, which is a suspected Barrett’s esophagus lesion. If it exceeds 3 cm, the risk of canceration is high, and the doctor will conduct a biopsy and pathological confirmation.
Squamous dysplasia: This is a common precancerous lesion of esophageal squamous carcinoma in Taiwan. Under an iodine-stained endoscope, it will appear a pale yellow or pink area that cannot be stained with iodine. According to statistics, if this high-grade dysplasia is left untreated, there is a 75% chance that it will develop into severe esophageal squamous carcinoma within 3 years. Therefore, urgent treatment is required at the stage of dysplasia in the esophagus. Currently available endoscopic treatment techniques, such as endoscopic submucosal dissection or endoscopic radiofrequency electrocautery, can be safely and effectively eradicated to prevent the occurrence of esophageal cancer.
Leopard-striped plaques on the esophageal mucosa: Spray some low-concentration iodine solution on the esophagus, and there will be many plaques that cannot be dyed by tiny iodine, just like leopard prints, which may be a high-risk group for esophageal cancer. Past studies have found that most of these patients are long-term alcoholics and lack the enzymes that metabolize alcohol. The risk of esophageal cancer may be as high as 10% per year. Therefore, people with spots on the background mucosa of the esophagus should receive endoscopic follow-up more intensively. Esophageal cancer can be effectively prevented by examination or more aggressive endoscopic electrocautery treatment.
(This article is excerpted from / Intestinal Health and Good Stomach: Taiwan Digestion Authority Professor Lin Zhaotang, I wish you a smooth life / Fortress Culture)
The article is authorized to be reproduced from “uho》Drinking 2 cans of beer a day may increase the risk of “esophageal cancer”?The risk of “3 habits” soared 200 times
【Extended reading】
Eating the right food can prevent cancer!Nutritionist Names 12 “Super Anti-Cancer Foods” to Reduce Cancer Risk
Recurrent gastroesophageal reflux? Watch out for “Barrett’s Esophagus” report!Medical Police 1 is raised, be careful
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