Neoplasm of Esophagus

Overview of Neoplasm of Esophagus

Esophageal cancer occurs when cells in the esophagus develop changes (mutations) in their DNA.

The changes make cells grow and divide out of control.

The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.[5]

Spread of carcinoma

1. Direct-

• The lesion may fill the lumen and infiltrate the wall of esophagus. It may also spread to the adjoining structures such as the trachea, left bronchus, aorta or pericardium.
• Involvement of the recurrent laryngeal nerves causes aspiration problems.

2. Lymphatic–

• Depending on the site involved, cervical, mediastinal or coeliac nodes may be involved.
• Cervical and thoracic lesions also spread to supraclavicular nodes.
• “Skip lesions” may also occur due to spread through the submucosal lymphatics.

3. Blood borne-

• Metastases may develop in the liver, lungs, bone and brain.[1]

Indian epidemiology then other

Causes of Neoplasm of Esophagus

• Smoking and alcohol consumption are high-risk factors and so are some particular dietary habits.
• High incidence is associated with tobacco chewing and smoking.
• About 5% of esophageal cancers arise in the pre-existing pathological lesions, such as benign strictures, hiatus hernia, cardiac achalasia and diverticula.
• Plummer–Vinson syndrome is another predisposing factor.

Classification of Neoplasm of Esophagus

1. Benign neoplasms:

• Benign neoplasms are rare compared to malignant ones. Leiomyoma is the most common and accounts for two thirds of all the benign neoplasms.
• It arises from the smooth muscle and grows in the wall of esophagus.
• Dysphagia is produced when tumor exceeds the diameter of 5 cm. Barium swallow shows an ovoid filling defect.
• Endoscopy reveals a submucosal swelling. Biopsy should not be taken.
• Treatment is enucleation of the tumor by thoracotomy. Mucosal polyps, lipomas, fibromas and hemangiomas are other benign tumors.
• They are often pedunculated and present in the esophageal lumen. Endoscopic removal is avoided because of the danger of esophageal perforation. Treatment is surgical excision by esophagostomy.

2. Carcinoma esophagus

• Incidence of esophageal carcinoma is high in China, Japan, USSR and South Africa.
• In India, it constitutes 3.6% of all body cancers in the rich and 9.13% of those in the poor.[1]

Risk factors are things that make you more likely to develop a disease in the first place.

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology of Neoplasm of Esophagus

Squamous cell carcinoma is the most common (93%). Adenocarcinoma (3%) is also seen, but in the lower esophagus, and may be an upward extension of the gastric carcinoma.

Other types are rare..

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Sign & Symptoms of Neoplasm of Esophagus

1. Early symptoms. They include substernal discomfort and preference for soft or liquid food.
2. Progressive dysphagia and emaciation. Dysphagia first to solids and then to liquids. Patient loses weight and becomes emaciated.
3. Pain. Usually signifies extension of tumor beyond the walls of esophagus. It is referred to the back.
4. Aspiration problem. Spread of cancer may cause laryngeal paralysis or fistulae formation leading to cough, hoarseness of voice, aspiration pneumonia and mediastinitis.[1]

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Diagnosis of Neoplasm of Esophagus

1. Barium swallow-

• It shows narrow and irregular esophageal lumen, without proximal dilatation of the esophagus.

2. Esophagoscopy-

• Useful to see the site of involvement, extent of the lesion and to take biopsy. Flexible fiberoptic oesophagoscope obviates the need for general anesthesia and gives a magnified view.

3. Bronchoscopy-

• It helps to exclude extension of growth into the trachea and bronchi.

4. CT scan-

• It is useful to assess the extent of disease and nodal metastases [1]

Prognosis of Neoplasm of Esophagus

Five-year survival is not more than 5–10%.[1]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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Treatment of Neoplasm of Esophagus

Surgery of upper two-thirds of esophagus is difficult due to great vessels and involvement of mediastinal nodes.

Radiotherapy is the treatment of choice.

Surgery is the preferred method of treatment for cancer of lower one-third.

The affected segment, with a wide margin of esophagus proximally and the fundus of stomach distally, can excise with primary reconstruction of the food channel.

Disease of esophagus in advanced lesions, only palliation is possible. An alternative food channel can provide by:

1. A by-pass operation.
2. Esophageal intubation with Celestin or Mousse au barb in or a similar tube.
3. Permanent gastrostomy or a feeding jejunotomy.
4. Laser surgery: esophageal growth is burnt with Nd: YAG laser to provide a food channel. Chemotherapy use only as a palliative measure in the locally advanced or disseminated disease.

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Homeopathic Treatment of Neoplasm of Esophagus

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Neoplasm of Esophagus:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.

Homoeopathic Approach:

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’.

The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for.

Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Medicines

Acetic Acid

• Scirrhous of pylorus; additionally cancer of stomach, ulcerative gnawing at one spot in stomach, with agony and depression, preventing sleep.
• Moreover, Intense and constant thirst.
• Severe burning pain in stomach also abdomen.
• Vomiting after every meal of yellow, either yeast-like matter, or blood.
• Besides this, Pale, waxen skin.
• Lastly; Tongue pale and flabby; marked debility; copious pale urine.

Arsenic Album

• Basically; Cancer of stomach, with burning pain and excessive thirst, desire for acids.
• Aggravation specifically from cold drinks and cold diet, on the other hand amelioration from hot drinks.
• In detail, Vomiting of all he takes; terrible sensation of weakness and exhaustion with anxiety in region of stomach.
• Uterine cancer with burning pain in uterine region also shooting, stinging pains in upper part of abdomen.
• Thirst and dryness of mouth and throat, worse by motion.
• All in all; Acrid, corroding, burning discharges, often very offensive, light or dark-colored.[3]

Bismuth

• Cancer of stomach with burning, stinging, crampy pains.
• Stomach hangs down to the crest of the ilium; hard lumps between navel and edges of lower ribs, side.
• Vomits only at intervals of days when food has filled the stomach, then vomits large quantities of food during the whole day; vomits all fluids.

Causticum

• Patient cannot bear the pressure of the clothes on the stomach.
• The lightest food or even the smallest quantity causes a violent lancinating pain in the stomach.
• Scirrhous of the lips, with itching and soreness, which when ulcerated has a violent burning pain; pus bloody, or greenish, or corroding, or thin, watery and yellow.

Hydrastis Canadensis

• Cancers hard, adherent, skin mottled, puckered, cutting pain like knives also even after ulcerations sets in, where it may regulate faulty nutrition.
• Epithelioma, cancer to rectum, cancer of stomach vomits everything except water with milk; additionally pain in pit of stomach, emaciation.

Lachesis

• Cancer of stomach, the pit very sensitive to touch, with a gnawing pressure, better by eating, but coming on again in a few hours, and the more violent the emptier the stomach.
• Cancer of breast with lancinating pains and a constant painful feeling of weakness and lameness in left shoulder and arm;[3]

Mezereum

• Cancer of stomach with burning, corroding pains.
• Great emaciation; the muscles of the face are tensely drawn, like strings; additionally internal surface of the gastric mucous membrane feels raw, with sensation as if food remained for a long undigested in the stomach.
• Constant vomiting of chocolate-coloured masses, with great burning in throat.
• Hematemesis; violent retching, accompanied with the agony of death.
• Sleepiness and exhaustion; hard lumps in epigastrium region; hypochondriasis; constipation.

Spigelia

• Cancer of Esophagus, pylorus or rectum, narrowing the lumen of the canal, with constant severe and pressing pains, pressing through to the back and shooting down into the thighs.
• Cancer of uterus, with pressure and pain in the whole pelvic region and shooting down the limbs.
• Burning heat in vagina, with sense of fulness and pressure, worse standing and dislike to move.[3]

Diet & Regimen of Neoplasm of Esophagus

• Eat foods high in calories and protein.
• These include whole, full-fat dairy products, nut products, and meats. For example milkshakes, smoothies with protein powder, peanut butter, beans, eggs, cheese, and yogurt.
• If swallowing is still hard, soften your foods with gravies or sauces. Chop up meat into small pieces. For example scrambled eggs, pasta, custard, pudding, and soups and stews made with ground meat.
• Furthermore; If you’ve had surgery, your stomach may be smaller.
• You may fill up quickly. It may help to eat smaller meals more often. You should also avoid drinking fluids before meals. And keep lots of snacks on hand for between meals.
• You may need to sip fluids while you’re eating. This can help make swallowing easier. It can also help food pass through your esophagus.
• Besides this, Highly acidic or spicy foods, foods with sharp pointed edges, or extremely hot or cold foods.
• Fluids may be irritating, especially during certain types of treatments.
• Overall; Use caution with foods like tough cuts of meat, doughy bread, alcohol, citrus juices or sauces, also piping hot beverages.[4]

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References use for Article Neoplasm of Esophagus

[1] Diseases_of_Ear_Nose_and_Throat_6Edition

[2]https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=34&ContentID=17970-1

[3] Homoeopathic Therapeutics by Lilienthal

[4]https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=34&ContentID=17970-1#:~:text=Eat%20foods%20high%20in%20calori

[5]https://www.google.com/search?q=overview+of+neoplssm+of+esophagus&rlz=1C1CHBF_enIN990IN990&oq=overview+of+neoplssm+of+es

Frequently Asked Questions

What is Neoplasm of Esophagus?

A neoplasm is a type of abnormal and excessive growth of tissue. In addition; The process that occurs to form or produce a neoplasm is called neoplasia.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Neoplasm of Esophagus?

• Acetic Acid
• Arsenic Album
• Bismuth
• Causticum
• Hydrastis Canadensis
• Lachesis
• Mezereum
• Spigelia

What causes Neoplasm of Esophagus?

• Smoking and alcohol consumption
• Tobacco chewing and smoking
• Benign strictures, hiatus hernia, cardiac achalasia and diverticula.
• Plummer–Vinson syndrome

What are the symptoms of Neoplasm of Esophagus?

• Substernal discomfort and preference for soft or liquid food
• Progressive dysphagia and emaciation
• Pain
• Aspiration problem