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The immune system works to destroy cancer and viruses throughout our life. When the immune system is weak or exposed to toxins or radiation, cancer cells develop quicker than the healthy cells can destroy them. Cancer is the result of mutation of genes that interferes with the cells proteins to survive, grow, and divide into healthy cells. This paper will demonstrate the homeostasis effects that cancer has on the esophagus and its progression as well as possible cause, treatments and risk factors.
The esophagus is part of the upper gastrointestinal system that is made of several layers; the inner flat lining that contains squamous cells, the submucosa layer that is glandular and produces the mucus to keep the esophagus wet and the muscle of the esophagus that contracts to push food down to the stomach. When normal cells in our bodies do not divide properly, cells can mutate and develop abnormal cell growth, which overcrowds normal cells and turns into cancer. Cancer can occur anywhere in the body and spread from the original growth called metastasis.
Esophageal cancer occurs with chronic irritation of the inside lining and spreads outward through the layers of surrounding tissues as it grows and transforms the cells and changes the DNA. It can be difficult to diagnose in the early stages because it can resemble normal everyday digestive issues, such as heartburn, acid indigestion, reflux, and abdominal pain. Other possible symptoms are; painful swallowing or choking, weight loss, vomiting, hoarseness and coughing, pain behind the breastbone and fatigue. If the cancerous tumor is large enough to cause painful swallowing of food and not moving down the esophagus, inserting a feeding tube is the best option to provide the body with nutrients to get through the treatment process and recovery.
There are two types of esophageal cancer: squamous cell carcinoma or epidermoid carcinoma of the esophagus. Researchers believe smoking tobacco and excessive alcohol intake contributes to the irritation of the mucosal tissue that forms this type of cancer. This type of cancer is located in the layer of tissue that forms the skin surface and organs of the respiratory and digestive tract. A malignant cancer forms in the thin flat cells that line the upper and middle part of the esophagus. “Carcinoma develops from the squamous epithelium having cuboid cells characterized by keratinization, which is initially localized and later metastasis into other organs or parts of the body through lymph vessels or the bloodstream” (Jobe, Thomas, Hunter & Ebrary 2009) Adenocarcinoma cancer is more common in the United States than other countries due to obesity and gastroesophageal reflux disease (GERD). This cancer begins in the glandular cells that secrete mucus in the lining of the esophagus and typically begins in the lower part of the esophagus near the stomach in which the stomach contents come back up into the esophagus and irritate the lining. Over time, homeostasis of GERD can turn into Barrett’s esophagus due to the acid in the stomach weakens the esophagus sphincter and the acid backs up into the esophagus and damages the lining. The cells change and replace normal cells with abnormal cells (gland-like adenomatous cells) that lead to adenocarcinoma (Torpy & Burke 2010)
There are four stages to classify esophageal cancer: Stage I – the cancer is small and located in the lining, Stage II – the cancer is deep in the layers and not in nearby lymph vessels, Stage III, the cancer is deep in the wall of the esophagus including other tissues and organs. Stage IV – the cancer has grown beyond the esophagus wall, into lymph vessels and spread to other parts of the body. When cancer cells of the esophagus metastasis to other areas of the body, the cell breaks away from the tumor and travels through one of four ways; the blood stream, lymph vessels, or surrounding tissue and then attaches to another area and grows a new tumor. This type of cancer will remain the same. For example, the esophageal cancer cell metastasis to the lungs, the cancer cells in the lungs will remain as esophageal cancer, not lung cancer. Metastatic cancer cells generally look the same as the original cancer cells, except for some molecular features such as certain proteins or the presence of specific chromosome changes (mayoclinic.com)
After several tests such as x-rays, MRI’s, PET scans, and blood work, the stage of cancer and treatments are considered. Depending upon the location and size of the tumor, surgery is an option. If a tumor is small, a procedure of inserting an endoscope down the throat into the esophagus is available to remove tumors that have not spread to other areas. A large tumor may need an esophagectomy surgery, which is removing part of the esophagus and lymph nodes nearby and replacing the section with a portion of the stomach. Another treatment option is chemotherapy drugs to stop the growth of cancer cells, by killing the cells or preventing them from dividing. Chemotherapy drugs given intravenously lowers the level of healthy blood cells that make a person susceptible to get infections, bruise or bleed easily and feel weak and tired. The treatments may cause hair loss, decreased appetite, and nausea and vomiting, diarrhea, mouth sores, joint pain and swelling of the feet and legs. There is also, radiation treatment that kills cancer that has spread from its original area but still localized. Radiation reduces the size of the tumor, which makes swallowing easier. The downside to radiation treatment is that it does not distinguish between cancer cells and healthy cells, but there is medications to help build up healthy cells and the immunity. The side effects from the radiation cause burning of the skin, sore throat, cough, and shortness of breath.
Smoking tobacco and alcohol is a possible risk factor in developing esophageal cancer. Research shows that alcoholic beverages may contain a variety of carcinogenic contaminants, which occurs during fermentation and production, such as nitrosamines, asbestos fibers, phenols, and hydrocarbons. Metabolizing alcoholic drinks, which contains ethanol, turns into acetaldehyde, which is a toxic and can damage DNA and proteins that result in squamous cell carcinoma. In addition, a person who inherits a deficiency in an enzyme that metabolizes alcohol is at an increased risk of alcohol-related esophageal squamous cell carcinoma.
In conclusion, there is no vaccine or cure for some types of cancers. To decrease the risk of esophageal cancer quit smoking tobacco, drinking excessive alcohol. Include a diet high in fruits and vegetables, schedule regular medical checkups especially if there is a diagnosis of GERD, and be sure to get the necessary nutrients to promote healthy cell growth, for the immune system to fight off unhealthy cells that die to protect the body.
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