I saw two esophageal cancer surgeries last week. Both were squamous cell carcinoma (a histological description) and both were in the upper third of the esophagus, closer to the mouth. To do the surgery, the section of esophagus with the tumor is removed along with some lymph nodes. Then the doctors turn the stomach into a tube with fancy stapling and attach it to the end by the mouth.
The interesting thing is that esophageal cancer in China is flipped from that in the US. In China, most cases are squamous and in the upper or middle third. In the US, most are adenocarcinoma and in the lower third, close to the stomach (gastroesophageal junction).
A diet high in spicy food and perhaps smoking and pollution explain the Chinese esophageal cancer. The American cases are caused by obesity and overeating. Those things lead to acid reflux, which causes cellular change in the lower portion of the esophagus into cells that are more resistant to acid. Unfortunately this change (called Barretts esophagus) also predisposes to the cancer that we see in the USA.
Nick
Sent from my Verizon Wireless BlackBerry
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3 comments:
Super interesting
super super interesting!
I just went over this in lowly nursing school and it really is interesting. Good to know I'm getting a decent and correct education.
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