Esophageal Cancer

Overview

Esophageal cancer develops in the food pipe (esophagus), the tube that carries food from the throat to the stomach. It is relatively common in Asia, including India, and is often diagnosed late because early disease produces minimal symptoms. However, with improved imaging, multimodality therapy, and precision radiotherapy, outcomes are steadily improving.

Two major types exist:

• Squamous cell carcinoma – more common in India and linked to lifestyle factors

• Adenocarcinoma – associated with acid reflux and Barrett’s esophagus

Causes and Risk Factors

Several factors damage the esophageal lining over time and lead to cancer:

• Tobacco use (smoking and chewing) – strongest risk factor

• Alcohol consumption – synergistic with tobacco

• Chronic acid reflux (GERD)

• Barrett’s esophagus

• Very hot beverages and spicy preserved foods

• Nutritional deficiencies

• Obesity

• Previous radiation exposure to chest

Common Symptoms

Early esophageal cancer may not cause symptoms. As the tumor grows, typical complaints include:

• Progressive difficulty swallowing (first solids, then liquids)

• Food sticking in throat or chest

• Unintentional weight loss

• Persistent vomiting or regurgitation

• Chest pain or burning sensation

• Hoarseness or chronic cough (advanced disease)

Any persistent swallowing difficulty lasting more than 2–3 weeks requires evaluation.

Screening and Prevention

Unlike cervical or breast cancer, population screening is not routine, but high-risk individuals benefit from surveillance.

Who should undergo screening endoscopy:

• Long-standing GERD (>5 years)

• Barrett’s esophagus

• Strong tobacco and alcohol history

• Family history of esophageal cancer

Prevention strategies

• Stop tobacco and alcohol

• Treat chronic acidity early

• Maintain healthy body weight

• Increase fruits and vegetables in diet

• Avoid very hot beverages regularly

Early endoscopic detection can identify precancerous lesions and dramatically improve cure rates.

Treatment Approaches

Treatment depends on stage and patient fitness and usually involves a multidisciplinary approach:

• Early Stage:
  Endoscopic resection or surgery

• Locally Advanced Disease:
  Concurrent chemoradiation followed by surgery (trimodality therapy)
  OR definitive chemoradiation in non-surgical candidates

• Advanced Disease:
  Chemotherapy, targeted therapy, or immunotherapy for control and symptom relief

Radiation therapy plays a major role — both curative and palliative — especially in improving swallowing.

Cutting-Edge Cancer Care by Dr. Rajesh Natte

Dr. Rajesh Natte, an experienced radiation oncologist, provides advanced treatment for gastrointestinal malignancies including colorectal and esophageal cancers using high-precision radiotherapy techniques.

By combining Image-Guided Radiotherapy (IGRT), Intensity-Modulated Radiotherapy (IMRT), and Volumetric Modulated Arc Therapy (VMAT), radiation is sculpted to match the tumor’s exact shape while protecting nearby organs such as the heart, lungs, liver, and spinal cord.

With 4D motion management, adaptive planning, and AI-assisted contouring, even tumors that move during breathing can be treated safely. This results in:

• Better tumor control

• Reduced swallowing complications

• Shorter treatment duration

• Improved quality of life

Patients benefit from world-class precision therapy delivered locally with compassionate care.

Conclusion

Esophageal cancer can be aggressive, but early detection and modern multimodality treatment offer strong chances of cure. Awareness of swallowing symptoms, risk factor control, and timely medical evaluation are critical.

Through advanced radiotherapy technology and individualized treatment planning, Dr. Rajesh Natte continues to improve outcomes and quality of life for patients battling gastrointestinal cancers.