Are all tumors of the esophagus cancerous?
On the basis of reflux oesophagitis that has lasted for years, the so-called Barrett's mucosa develops in the inflamed area of the esophagus. Barrett's mucous membrane can develop into Barrett's carcinoma in 5 to 10% of cases. Whether Barrett's carcinoma develops depends, among other things, on the extent of the Barrett's mucous membrane and whether the acid reflux from the stomach into the esophagus is continuous. Other unfavorable factors are tobacco and alcohol consumption.
After the Barrett's mucous membrane has developed, the reflux symptoms, i.e. heartburn, often decrease. A deceptive pseudo-healing occurs. Unfortunately, the early forms of Barrett's carcinoma do not cause any symptoms. Only with increasing size of the tumor do swallowing difficulties and possibly pain arise.
The Barrette's epithelium is a precancerous condition. In order to detect the early stages of carcinoma development, regular endoscopic checks are necessary approximately every 2 years. Cancer-like changes in the Barrett's mucous membrane (dysplasia) or early carcinomas that have not yet grown deep into the esophagus wall can be endoscopically removed or endoscopically obliterated using radio frequency ablation. These technically very difficult interventions can only be carried out in specialized centers. More advanced stages of the tumor must be treated surgically by resection of the esophagus, possibly combined with radio-chemotherapy.
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