As a result, I've seen a lot of esophageal cancer cases, a few lung
cancers, and one breast cancer. The esophageal cancer cases in China
are intriguing since some of them are more proximal (IE closer to the
mouth) than ones we have in the United States (which are closer to the
stomach). I was talking to one of the senior thoracic surgeons today
and he was telling me he actually doesn't think it is the spicy food
(which I had posited as one cause in an early blog post). The reason
he thinks the cancer is not spice related is because in Sichuang
Province, the food is the spiciest in China (and incidentally some of
my favorite food here) and they don't have higher rates of esophageal
cancer. He thinks a contributing factor could be the extremely hot
tea that people in the southern areas of China regularly drink,
perhaps burning their throats frequently. Another possibility is that
eating pickled foods causes it.
Anyway, when a patient has an upper esophageal cancer, the tumor has
to be removed but something has to connect what is left of the throat
to the rest of the digestive tract. In the first step of the case,
the patient is on their right side and the surgeons go in from the
left rib cage, removing the section of the esophagus with cancer.
Then they go into the abdominal cavity, and remove half of the
stomach's blood supply (the less important half), and pull the stomach
halfway out of the body. Then with a specialized staple gun they can
actually turn the stomach into a tube. They then feed the
tube-stomach up through the chest underneath the sternum and directly
attach it to what is left of the esophagus near the mouth.
I've included three pictures. The first has a view of the stomach
after it has been turned into a tube. The second picture is of the
small section of esophagus that was above the tumor, which still
remains and needs to be attached to the lower section. Finally, I've
added a photo of a removed esophageal tumor. Keep in mind the entire
object isn't tumor; a good chunk of it is, but other parts are
actually just collateral fat and esophageal tissue.
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