Introduction
Esophageal cancer is among the key health problems that is associated with numerous complications. As such, esophageal cancer is a form of cancer that typically occurs in any part of the esophagus and is among the most severe malignancies (Spechler, 2013). Essentially, this form of cancer is categorized into various types based of the cells involved whereby the most prevalent forms of esophageal cancer are Squamous Cell Carcinoma (SCC) as well as Adenocarcinoma (AC). Among the major risk factors that usually increase the likelihood of developing this form of cancer are smoking, having GERD (Gastro-esophageal Reflux disease), obesity and consumption of alcohol.
Although, the key causes of this disease are not well established, the disease mainly occurs as a result of mutations that develop in the DNA of the esophagus cells. With regard to this, these mutations usually increases replication as well as growth of the cells beyond control and subsequently the accumulation of these abnormal cells usually form tumors within the esophagus (Zhang, 2013). In addition, the disease may spread and affect other body parts thereby resulting to various health complications. Thus, understanding the pathophysiology of this disease is a crucial aspect that assists healthcare professionals in effectively understanding the process as well as progression of this disease and subsequently develop and apply the most suitable interventions in proving care to patients suffering from esophageal cancer.
Esophageal cancer usually starts in the esophagus mucosa and subsequently progresses and invades the muscular layer as well as the sub-mucosa. Moreover, the disease may invade various other contagious structures like the laryngeal nerve, tracheobronchial tree as well as the aorta. Notably, the metastasis of this disease occurs mainly in the liver, periesophageal lymph nodes as well as the lungs (Napier, Scheerer & Misra, 2014). Although, the pathophysiological mechanisms for this disease are not well established, various studies shown a strong correlation between various mechanisms and the disease. As such, smoking as well as heavy alcohol consumption are among the key risk factors that increase the chances of developing the disease particularly Squamous Cell Carcinoma. In regard to this, the conversion of alcohol to acetaldehyde usually acts like a solvent to carcinogens thereby resulting to nutritional deficiencies. Moreover, an increase in carcinogenic acetaldehyde usually exposes the esophageal mucosa and causes mutations in as well as cellular proliferation thereby resulting to the disease.
On the other hand, tobacco smoke mainly consists various carcinogens that include nitrosamines as well as acetaldehyde that are associated with the development of this disease. Additionally, GERD is among the key risk factors associated with the development of this disease (Napier, Scheerer & Misra, 2014). In the light of this, chronic GERD is usually associated with a condition (Barrett’s metaplasia) that causes replacement of the SSE (Stratified Squamous Epithelium) that is involved in normal lining of the distal esophagus by the ACE (Abnormal Columnar Epithelium). As such, this internal metaplasia usually becomes dysplastic and subsequently malignant due to alterations of genes that disable the tumor suppressant genes thereby resulting to the disease. Moreover, Human papillomavirus is another key causes of the disease whereby various studies indicate that the infection usually disables the tumor suppressor genes such as Rb as well as P53 thereby increasing an individual’s risk in regard to developing this form of cancer. More importantly, various esophageal disorders such as achalasia, environmental as well as dietary factors that cause inflammations and irritations in the esophageal are associated with an increase in regard to the development of SCC. Overall, understanding the main pathophysiological mechanisms is an important aspect that helps care professionals to develop and utilize the relevant and appropriate interventions.
References
Napier, K. J., Scheerer, M., & Misra, S. (2014). Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol, 6(5), 112-20.
Spechler, S. J. (2013). Barrett esophagus and risk of esophageal cancer: a clinical review. Jama, 310(6), 627-636.
Zhang, Y. (2013). Epidemiology of esophageal cancer. World journal of gastroenterology, 19.
