2010年8月8日星期日

Esophageal cancer

Esophageal cancer




Abstract correcting edit summary

Esophagus (shidaoai) also known as esophageal cancer (shiguanai), is one of common malignant tumors in humans. About 30 million people worldwide die from cancer each year. China is a high incidence area of esophageal cancer, esophageal cancer deaths every year about 15 million people, accounting for nearly a quarter of all cancer deaths. Esophageal cancer mortality rates vary greatly all over the country, according to survey data in China Review of Cancer Mortality statistics, mortality adjusted esophageal cancer population in Yunnan lowest level (105/10 million), with the difference of 14 times the national level, and mortality Henan Province, the highest difference of 31 times. The incidence of esophageal cancer have significant regional differences, China has high incidence of esophageal cancer: high incidence of Taihang: Linn County, including Henan, Hebei Cixian, Shanxi Yangcheng a dozen cities and counties. Age of onset was higher in high age group, aged 70, then decreased gradually. Esophageal cancer in China the average age of death of men and women together was 63.49 years, the proportion of different age, the highest percentage to 55-74 years of age. Thus, esophageal cancer is common disease in the elderly.

Esophagus - common symptoms

Esophageal cancer

Early symptoms:



1. Swallow stem choking sense: the most common, can choose the disappearance and recurrence, no effect on swallowing. Often occurs in patients with mood swings, it is often mistaken for functional symptoms.

2. Retrosternal pain and xiphoid under: more common. After the sternum when swallowing or xiphoid of the pain, was burning like nature can, like acupuncture or traction like to swallow rough, hot or spicy food as a.

3. Food stranded infection and foreign body sensation: when ingesting food or water, some food and stay slow down the feeling, and chest tightening after the flu or food adhesion to the wall so fresh feeling of complete disappearance of food.

4. Throat dry and tight feeling: to swallow food especially dry, rough, the symptoms were often related to the patient's mood swings.

Late symptoms:



1. Dysphagia: Progressive dysphagia is when the vast majority of visits were the main symptoms, but late expression of this disease.

2. Food reactions: often when dysphagia aggravated, anti-throughput, containing food and mucus, with blood and pus can be.

3. Other symptoms: When the cancer can cause hoarseness in recurrent laryngeal nerve compression; violations of the phrenic nerve can cause hiccups or phrenic nerve paralysis; compression of the trachea or bronchus, there may be shortness of breath and dry cough; erosion aorta can produce fatal hemorrhage.

Esophageal cancer - etiology and pathology

Esophageal lesions, the diverse parts of China, but are in the middle of the most (52.69% ~ 63.33%), followed by lower segment (24.95% ~ 38.92%), at least the upper (2.80% ~ 14.10%). In 622 patients, accounted for 68.90% middle, lower segment accounted for 36.40%, accounted for 4.70% the previous paragraph.

(A) clinical staging and classification

1. Clinical staging of esophageal cancer clinical staging, and treatment options and assessment of treatment is important. 1976 established the National Working Conference esophageal cancer clinical staging criteria in Table 18-7.

Table 18-7 Clinical staging of esophageal cancer

Stage 01234

Lesion length does not require <3cm 3 ~ 5cm> 5cm> 5cm

Lesions limited to the mucosal layer of muscle invasive submucosal invasive part of the invasion through the muscle layer or outer layer of significant foreign invasion

Metastasis metastasis metastasis metastasis without regional lymph node metastasis, lymph node or distant organ metastasis



2. Pathologic classification

(1) Early pathological changes of esophageal cancer type:



Esophageal cancer

Early esophageal cancer can be divided according to their shape hidden erosive, plaque and papillary. Which the plaque is the most common, accounting for early esophageal cancer in about 1 / 2, this type of cancer cells were well differentiated. Erosive accounted 1 / 3, poorly differentiated cancer cells. The first hidden lesions, both carcinoma in situ, but only early esophageal cancer 1 / 10. Papillary lesions of late, though generally well differentiated cancer cells, but the operative findings are rarely seen in situ.

(2) in advanced esophageal pathological type:

Can be divided into medullary type, fungating, ulcerative, narrow type, cavity type and not stereotypes. In which the highest degree of medullary-type malignant, and accounted for in advanced esophageal cancer 1 / 2. This type of cancer can involve layers of esophageal wall to the cavity expansion within and outside the esophageal circumference of all or most of, and connective tissue around the esophagus may be involved, with varying degrees of cell differentiation. Fungating about in advanced esophageal cancer 1 / 6 ~ 1 / 5, carcinoid tumors were round or oval mass, the esophagus was protruding mushroom umbrella, most esophageal wall can be involved. Ulceration and narrowing of each type in advanced esophageal cancer 1 / 10. Ulceration over the surface of a deep ulcer, bleeding and early metastasis, which occurred late obstruction. Growth ring type was narrow, and mostly involved the week esophagus and esophageal mucosa showed concentric contraction, it appears early obstruction, and bleeding and late metastasis. Cavity type is rare, carcinoid tumor protruding into the esophageal lumen, were round or oval bulge, there pedicle wall is connected with water, erosion or ulceration of the surface often. Tumor can invade the muscle, but lower than the above type is shallow. Few in advanced esophageal cancer can not be classified in the various types of persons, not as stereotypes.

3. Histological type

(1) squamous cell carcinoma: the most common.

(2) adenocarcinoma: rare, can be divided into pure adenocarcinoma, adenosquamous carcinoma, mucoepidermoid carcinoma and adenoid cystic carcinoma.

(3) undifferentiated carcinoma: rare but highly malignant.

Esophagus, the middle majority of squamous cell carcinoma cancer, esophageal cancer is mostly adenocarcinoma. 622 patients with esophageal cancer in our hospital, 441 cases were made by pathological examination, which accounted for 87.3% of squamous cell carcinoma, adenocarcinoma 10.6%, undifferentiated carcinoma 1.5%, 0.6% other cancers.

(B) of esophageal cancer proliferation and metastasis method

1. Proliferation of esophageal cancer in esophageal wall near the bottom of epithelial cells into cancer or carcinoma in situ, carcinoma of the surface diffusion is one of the ways. Esophageal cancer is also often along the lamina propria or submucosa lymphatic invasion.

2. Direct infiltration of adjacent organs upper esophageal carcinoma can invade the larynx, trachea and neck soft tissue, and even penetrated the thyroid. Bronchial carcinoma can invade the middle to form a bronchial - esophageal fistula; also can invade the thoracic duct, azygos vein, hilar and lung tissue, part of the esophagus can invade the aorta to form - aortic fistula, caused massive hemorrhage and death. Can often involve the lower esophageal cardiac and pericardial. Total direct involvement of adjacent organs and esophagus were about 1 / 2, involved organs were the lung and pleura, trachea and bronchi, spine, heart and pericardium, aorta, thyroid and pharynx.

3. Lymph node metastasis are more common, accounting for cases 2 / 3. Often transferred to a middle esophageal paraesophageal or mediastinal lymph nodes can also be transferred to the neck, around the door and the responsibility the left gastric artery lymph nodes. Lower esophageal cancer often can be transferred to the next adjacent cardia, left gastric artery adjacent tissues such as abdominal lymph nodes, even to first mediastinal and cervical lymph nodes. Sites were mediastinal lymph node, stomach, trachea and paratracheal, hilar and bronchial side.

4. Metastatic more common in patients with advanced. The most common metastasis to the liver (about 1 / 4) and lung (about 1 / 5), and other organs were bone, kidney, adrenal gland, pleura, omentum, pancreas, heart, lung, thyroid and brain.

Esophageal cancer - diagnostic criteria

Esophageal cancer

(A) of the barium meal, pull all negative net

1  no swallowing discomfort, but more than 40 years of age, from esophageal cancer positive family history of high incidence or every six months to review a second drawing in the net cytology.

2  have swallowing symptoms and risk factors associated with the above-mentioned persons, each drawing in the net after 3 months a time, and can apply checks and swallowing water Occult Blood Bead tone diagram (see later).

3  If symptoms continue or swallowing Occult Blood Bead, swallowing water sound plan positive fibers Esophagoscopy should be carried out, such as still unable to diagnose the disease should be closely observed, every 1 to 2 months was 1.

(B) barium-negative, drawing in the net positive

1  chest CT or chest radiograph examination, excluding upper respiratory tract tumors.

2  double contrast barium-line, multi-dimensional observation of the esophagus, watch for mucosal changes.

3  network will pull away from the incisors catheter was sent to 25 cm, 35 cm, 35 cm for the following sub-office drawing in the net, to help locate, help to develop treatment programs.

4  esophageal endoscopy can often show more clearly the lesion, to further clarify its scope, depth, size and shape. If the disease is difficult to qualitatively, the preferred biopsy cytology line.

(C) barium positive, drawing in the net negative

1  repeat cytology, and pull in the net bag to the lesion volume when inflated due to increase capsule to reduce misdiagnosis.

2  Esophagoscopy under direct vision to obtain cytology and histology diagnosis, certain lesions, except for benign disease, as an important basis for the design of treatment programs.

3  small number of atypical cases, symptoms persist, still not confirmed by the inspection should promptly line thoracotomy.

(D) of the barium meal, netting or esophagoscopy were positive

Is the range of patients, mostly in advanced esophageal cancer, symptoms and barium meal than the typical, generally do not need to cytology. However, in order accurate preoperative staging and prognosis, according to the conditions for the following checks to make preoperative preparation.

1  even advanced patients, esophageal endoscopy is still necessary in order to understand cancer, the extent of foreign invasion, endoscopic and histological type. In recent years an increased incidence of esophageal adenocarcinoma, esophageal small cell carcinoma and multiple primary cancers have frequently reported, these findings with preoperative TNM staging and treatment of tumor is closely related.

2  tracheal bifurcation is a division of the tumor, lymph node metastasis to understand an important sign. Tracheal bifurcation in more than cancer, lymph node metastasis up to the main direction of the neck and upper mediastinum area, otherwise the major downward shift. Thus, in the tracheal bifurcation, the thoracic esophageal cancer preoperative neck ultrasound and chest CT scan B, help to determine the extent of the operation, and according to whether the mediastinum was observed by barium meal, the trachea changes necessary for bronchoscopy in Large airway involvement were distinguished.

3  endoscopic ultrasound, thoracoscopy, B ultrasonic examination of the invasive depth and lymph node metastasis will also be prompted.

Esophageal cancer - conventional therapy (1) Surgical treatment of esophageal cancer

(1) surgical indications: body in good condition, major organ function to tolerate surgery; no distant metastasis; partial resection of lesions may be estimated; no persistent pain in chest and back; without hoarseness, and irritating cough.



(2) contraindication for surgery: the apparent tumor invasion, there are signs of wear were adjacent organs and distant metastases; have serious heart and lung failure, can not afford surgery; cachexia.



(3) estimate the possibility of surgical resection: disease sooner, the higher the removal rate; medulla fungating type and resection rate and the ulceration than narrowing the type of high; lower rate of esophageal cancer resection, followed by middle, upper lower ; lesions of soft tissue around the soft tissue shadow than the shadow without removal rate; esophageal axis changes were lower than those without change. Comprehensive analysis of these factors, the possibility of preoperative tumor resection of great help to judge.



(4), esophageal cancer resection: a non-surgical procedure commonly used in chest and thoracic surgery two categories. Non-thoracotomy esophagectomy include: ① pull off esophageal inversion technique, mainly applicable to hypopharynx and cervical esophagus; ② blunt dissection of esophageal resection and can be used within the thoracic esophageal cancer, cancer had no cases of foreign invasion ; ③ sternal part of the split neck incision (Figure 39-1) for the aortic arch above the lower edge of the upper thoracic esophageal cancer. These types of surgical removal of the tumor and the esophagus, stomach or colon with the bed raised to the neck and esophageal or pharyngeal and esophageal anastomosis. Such surgery with less trauma and cardiopulmonary function Liu, etc, but not OK mediastinal lymph node dissection. Thoracic surgery are mainly: ① posterolateral left chest cut l: 3, suitable for middle and lower esophagus; ② right anterolateral cut El, suitable for medium and upper esophageal carcinoma, tumor resection, the stomach and abdominal sword mentioned by the hole to the right chest tube and esophageal anastomosis, the length of esophageal resection from the tumor margin at least 5-7cm; ③ If the lesion high enough for the smell of urine evidence of esophageal resection length, possible neck cut l3, stomach and sent to the neck and esophageal anastomosis, the right chest, upper abdomen and neck three incisions, before I head over the middle of esophageal cancer have favored a three-way cut 1:3. Lymph node dissection should also be OK.



Common after esophagectomy stomach, colon reconstruction of the esophagus, stomach being the most commonly used, because of its blood supply and healing ability, simple operation, only one anastomosis, consistent with available equipment or by hand. Stomach may be due a raise to the neck, can be used for the esophageal resection and reconstruction. Sufficient length of the colon can be excised with the pharynx or cervical esophagus anastomosis, can be used for unresectable tumors of patients with gastric bypass surgery or subtotal esophageal reconstruction. Hypopharynx and the cervical esophagus after resection of cervical esophagus with the stomach than defect, correction of intestinal reconstruction, can still use the free jejunal graft or muscle flap reconstruction.



(5) palliative surgery: swallowing difficulties with serious cancer cases could not be removed, based on the patient to choose the following palliative surgery, to address the patient feeding. Commonly used methods are: ① gastric or jejunostomy; ② esophagus catheter technique, currently used with a film shape memory alloy stent, the tube method is simple and can lift the patient feeding obstruction; ③ esophageal shunt surgery exploring the tumor can not be removed, the patient severe obstructive symptoms, can be used in the thoracic stomach and esophageal cancer at the top of line shunt side to side anastomosis. If the preoperative estimation of tumor resection difficult, can be used non-thoracotomy substernal colon bypass surgery, this method has been rarely used.



(6) postoperative complications and treatment: ① anastomotic leak: cervical anastomotic fistula patients do not pose a threat to life, more able to heal after drainage; intrathoracic anastomotic leakage on a patient at risk, and high mortality , intrathoracic anastomotic fistula occurred in 5 to 10 days after surgery, the patient breathing difficulty and chest pain, X-ray signs of pneumothorax with fluid, oral iodine contrast agents out of the water shows esophagus, should be placed immediately closed thoracic drainage, fasting the use of effective antibiotics and supportive treatment; early fistula patients, surgical repair can be tried and used omentum or intercostal muscle flap to strengthen.



② pulmonary complications include: pneumonia, atelectasis, pulmonary edema and acute respiratory distress syndrome, to more common lung infection, should pay close attention; patients to encourage patients to cough, sputum, strengthening respiratory tract in order to reduce postoperative pulmonary complications.



③ chylothorax: thoracic duct injury was caused by surgery, more than occurred in patients 2 to 10 days, the patient felt chest tightness, shortness of breath, flustered. Chylous pleural effusion test positive; once diagnosed, should be placed closed thoracic drainage, close observation of drainage, less traffic, could give low-fat diet, maintaining water and electrolyte balance and nutritional supplements, some patients may be healed. Large flow of patients on the chyle should promptly thoracotomy ligation of the thoracic duct.



④ Other complications include hemothorax, pneumothorax, chest infection, according to the processing condition accordingly.



(7) results of operations: surgical treatment of esophageal cancer in China is better, surgical resection rate was 56.3% -80%, 5-year survival rate of 30%; early esophageal cancer resection rate of l00%, 5-year survival rate of 90%.



(B) of esophageal cancer radiotherapy



Esophageal cancer

Radiotherapy indication wide, in addition to the formation of esophageal perforation, esophageal fistula, distant metastasis, significantly cachexia, severe heart, lung, liver and other diseases, radiation therapy may be OK.

1) Indications:

(1) patients over the general situation in the middle;

(2) lesion length of not more than 8cm suitable;

(3) No supraclavicular lymph node metastasis, silent with paralysis, no distant metastasis;

(4) can be into the semi-liquid food or the normal diet;

(5) no signs of perforation before ※, no significant thoracodorsal pain;

(6) should cytology or pathology diagnosis, especially in superficial esophageal cancer.

※ Note: The signs of esophageal perforation ago: ① spikes stand out: the lesion, spike-like prominence, small in size as burr, as powerful as the wedge; ② Kanying form: a large ulcer; ③ diverticulum degeneration: the formation and general similar to esophageal diverticulum, mostly occurs in radiotherapy; ④ distorted angle: loss of normal wall of moving water, it seems as long bone fracture dislocation; ⑤ mediastinitis: mediastinal widening shadow, patient body temperature, pulse speed, thoracodorsal pain. After perforation of poor prognosis, most patients die within a few months.

2) radiation dose and time: Usually irradiated tumor volume was 60Gy ~ 70Gy / 6 ~ 7 周.

3) The response to external exposure

(1) esophageal response: exposure to tumor volume of 10 ~ 20Gy / 1 ~ 2 weeks, the esophageal mucosal edema, may increase dysphagia, usually for treatment from time, exposure volume of 30 ~ 40Gy / 3 ~ 4 weeks, can produce swallow pain and retrosternal pain, appropriate symptomatic treatment.

(2) tracheal response: cough, mostly dry cough, phlegm less.



4) complications

(1) hemorrhage: incidence of about 1%. Should select patients, those with significant ulcers, in particular, there is a burr-like prominence of the deep ulcer, should be particularly careful to reduce the dose each time, extending the total treatment time, the radiation process, should always be observed X-ray barium meal .

(2) perforation: incidence rate is about 3%, which may penetrate the trachea, esophageal fistula formation or penetration mediastinum, causing mediastinal inflammation.

(3) radiation myelopathy: spinal cord disease is radiation head, neck, chest, severe complications of cancer radiotherapy is one. The incubation period after irradiation more than 1 to 2 years.



(C) chemotherapy

Commonly used drugs are cisplatin, BLM, etc., although about 50% efficient, but its efficacy is not satisfactory.

Advanced esophageal cancer treatment

The treatment of advanced esophageal cancer treated with Chinese herbs is the best choice. Advanced esophageal cancer are treated with radiation therapy and do not use chemotherapy. Surgical treatment of advanced esophageal cancer proliferation should be read to determine the site of metastasis.

The treatment of advanced esophageal cancer treatment using traditional Chinese medicine is very good. Late recurrence of esophageal cancer is very easy to transfer, Western treatment less effective. At this point do not significantly effect of radiotherapy and chemotherapy, chemotherapy side effects were large, weak, too old, damaged heart liver and kidney dysfunction, bone marrow suppression were not applied. And Chinese medicine can not only use of esophageal cancer early, middle and late, but also before and after use and operation, radiotherapy and chemotherapy treatment, significantly improved patient outcomes. Reduce the adverse reactions after chemotherapy, radiotherapy and chemotherapy are reduced to bring the Sun Shang patients, to improve their own immunity, and enhance patient outcomes.

Esophageal cancer in Chinese medicine are of "Ye Ge," "choke" category. The incidence of esophageal cancer with spleen and kidney deficiency, phlegm silt Finding the TCM treatment to enrich yin and blood, spleen Qi, Chu Tan Stasis treatment start. According to Chinese medicine principles, the Chinese Herb, Chinese medicine with modern science and technology to process uranium concentrate made from the appropriate forms. All of the patients used medication.

Late treatment of esophageal cancer esophagus through oral solution containing of XAP pill Xiaoaiping paste, esophagus through particles results have been positive effects. Esophagus through oral solution of XAP with pills, taken orally Xiaoaiping stickers affixed outside the "Trinity therapy" used in the clinic with a wide range of applications have been hit more than 97% efficiency.

ZXC take the essence of Chinese medicine in China, selected three dozen non-toxic taste of luxury with modern science and technology concentrated Chinese herbal extract is refined. No toxic prescription drugs blindly to Qingrejiedu Xiaotansanjie, blood circulation, vital essence for the treatment of the principle to treat cancer, is the drug of choice for the treatment of esophageal cancer. ZXC can inhibit tumor cell proliferation, metastasis, effectively shrink the tumor lesions, improving the symptoms caused by cancer. Is a non-toxic anti-cancer drugs.

XAP film is made of pure Chinese traditional medicine extraction, treatment on a significant tract cancers. The period of treatment for esophageal cancer. Is a broad-spectrum anti-cancer drugs. With the vital essence, removing heat from blood and pain relief, the efficacy of Endometriosis, can directly kill a variety of cancer cells, inhibition of cancer metastasis, but also enhance the body's immunity.

Chinese medicine treatment of advanced esophageal cancer is not a substitute for any treatment, and Chinese medicine therapy in the treatment of esophageal cancer in Chinese occupied an important position. The treatment of esophageal cancer in Chinese medicine will eventually rule the break. Establish confidence in the struggle with the disease, do not despair

Data indicate that the incidence of mental state and disease development and prognosis of very closely related. The treatment of suspected loss of confidence, pessimism, depression, disappointments, poor efficacy, and ease of tumor recurrence and survival time than the cheerful, brave struggle with the disease, many patients short. In particular, some patients, the treatment for some reason, mental state deteriorated, the condition often also nosedive.

Esophageal cancer - prevention

Esophageal cancer

The results show that:

① cancer can not be formed in weak alkaline body;

② cancer only in the formation of acid in the body;

③ If you have cancer, indicating the body is acidic;

④ cancer can only be extended in an acidic body;

⑤ If your body is weak alkaline, cancer can not be extended;

⑥ If you can balance the PH value of your body, let your body into weak alkaline, no matter what you have to have change and be cured of cancer;

⑦ no matter how bad your situation, even if only live 6 months, if you can change your body into weak alkaline PH value, you will not be extended to cancer, will be good;

⑧ Do not worry your family, your mom, dad or anyone else has cancer, as long as your body is alkaline, you will not have to, if you already have, it will change;

⑨ are acidic body fluids of cancer survival, nothing else. If your body is acidic, you will get cancer. If it is weak base, and you will not get cancer. If you already have cancer, as long as you can adjust your body's PH value to weak alkaline, cancer will leave you.

Cancer prevention tips are very simple things as basic food in order to prevent the accumulation of acid waste, because the acidification of the fluid environment is fertile ground for normal cell cancerous, adjust the pH balance of body fluids is an effective way to prevent cancer.

A) to develop good habits, smoking cessation alcohol limit. Smoking, the World Health Organization predicts that if people are not smoking, five years later, the world's cancer will be reduced 1 / 3; Second, do not drink. Tobacco and alcohol are very acid acid, long-term smokers who drink, easily lead to acidic.

B) Do not eat too much salty and spicy food, do not eat heat, cold, late and bad food; frail or have a disease genes are appropriate to eat a number of anti-cancer foods and high alkali content alkaline food, maintain a good mental state.

C) have a good mentality to cope with stress, work and rest, do not fatigue. Shows that pressure is an important incentive cancer, Chinese medicine practitioners believe that stress caused by fatigue physically weak and thus lead to decreased immune function, endocrine disorders, metabolic disorders, resulting in the deposition of acid substances; pressure can lead to stagnation of qi and blood stasis caused by mental stress, toxic fire retraction so.

D) to enhance physical activity, physical fitness, sports and more in the sun, sweating more acid the body can be excreted with the sweat and avoid the formation of acidic.

E) to the law of life, habits are not regular people, such as through the night singing karaoke OK, play mahjong, night out and other living without law, will increase the acidic, prone to cancer. Should develop good habits to maintain alkaline body, so far from various types of cancer diseases.

F) not to eat contaminated food, such as contaminated water, crops, poultry, fish balls, moldy food, eat green organic food, to prevent the disease from the mouth.

Diet is one of the main reason for esophageal cancer, esophageal cancer prevention diet is the key. Prevention of esophageal cancer which should be on diet? Study found that long-term lack of micronutrients such as zinc, molybdenum, selenium and vitamins A, B2, C, E, etc. in the pathogenesis of esophageal cancer play a role. Therefore, the prevention of esophageal cancer can start from the diet. From the food perspective, esophageal cancer prevention and health care approach has the following aspects:

1 diet of eating nutritious food, and to the diversity of plant food-based diet, rich in a variety of fruit and vegetable choices, beans vegetable meals, but that does not mean to be vegetarian, but should be allowed to plant foods accounted for cooking 2 / 3. 2, restriction of salt: the daily adult salt intake from all sources should not exceed 6 grams, including a variety of salted food. 3, eat more vegetables and fruits, to provide heat to reach 7% of the total energy of the year to eat a variety of vegetables and fruits a day, every day up to 400-800 grams.

4 Do not drink alcohol, especially excessive drinking should not be.

5, red meat in meat products (defined as cattle, sheep, pork and their products) in total energy intake should be below 10% should be less than 80 grams per day, the best choice for fish and poultry.

6, total fat and oils provide energy to be 15% of total energy to 30% higher fat content restrictions, especially more animal fat, vegetable oil should also be appropriate, and should be selected with monounsaturated fat hydrogenated vegetable oil and less. 7, to minimize fungal contamination of foods should avoid eating contaminated by mycotoxins or long-term storage at room temperature food.

Esophageal cancer prevention diet is an integral part of, but not only in the diet, also need to pay attention to the positive treatment of esophageal diseases such as esophagitis, leukoplakia, polyps, diverticula, achalasia psychosis, because of organizational changes of the functional variation local irritation, the formation of cancer progression risk.

Esophageal cancer - risk factors

(1) genetic factors: a significant cancer family aggregation, high-incidence area for more than three generations or three generations of family illness common, but certainly there is no genetic cancer, but the family has a close link between eating habits.

(2) nitrosamines: Nitrosamines compounds is a strong carcinogen, studies show that eating sauerkraut Linxian esophageal high-incidence area residents, gastric juice and urine of esophageal cancer induced by the existence of methyl benzyl nitrosamine, nitroso pyrrolidine, NTG Ding. And found that consumption of sauerkraut is proportional to the amount and the incidence of esophageal cancer.

(3), trace elements and malnutrition: esophageal cancer among serum high incidence of molybdenum, molybdenum hair, urine molybdenum and molybdenum in esophageal cancer are lower than normal. Linxian esophageal cancer in high-incidence area lack of water and soil molybdenum, molybdenum tumor suppressor role has been confirmed that the majority of scholars. Malnutrition, inadequate intake of animal protein and vitamin AB2C residents lack a high esophageal cancer diet, but most of the common features of esophageal cancer in high incidence of malnutrition is not high so it can not be a dominant factor

(4) esophageal mucosal injury: Long-term hi into the hot food and eating, drinking tea, eating more peppers and other spicy food can cause esophageal mucosal damage, caused by changes in esophageal mucosal hyperplasia, one of the factors may be carcinogenic. Smoking, drinking alcohol and cancer have a certain relationship. Various long-term healing of the esophagitis may be precancerous lesions of esophageal cancer.

(5) a factor in causing mold: moldy food can be induced in mice with esophageal and gastric precancerous lesions or squamous cell carcinoma. Proliferative type of mold and synergistic effect of N-nitrosamines.

Esophageal cancer - effects drugs

Esophageal cancer

The following drugs from Chinese esophageal cancer in Henan Province and Zhengzhou, China Institute of Traditional Chinese Medicine Esophageal Cancer Hospital Institute of Health jointly developed a series of pure traditional Chinese medicine, the main treatment in the series of pure Chinese esophageal, gastric cardia, gastric cancer caused by choking down food food phlegm constantly, into food that is spit, food regurgitation, dysphagia, cough, hoarseness, weight loss, constipation, indigestion and pain and other symptoms of reflex lesions have good results. On eating problems, pain or drop of water does not enter general medicine patients 3 - 7 days to water consumption, reduce pain. Cure for the treatment of esophageal cancer, cardiac cure for cancer specific drugs.

1, esophagus through oral

Effect: Food obstruction; phlegm; qi stasis; enhance immunity; kill cancer cells; inhibit cancer cell development;

2 Xiaoaiping of pills containing

Effect: Open the esophagus; discharge mucus; softening tumor; adjust the spleen and stomach;

3, XAP Posts

Effectiveness: Traditional; Consumer cancer pain; Poyu by water; skin penetration to kill cancer cells; inhibit cancer cell growth, proliferation, transfer.

4, removal of cancer Pills

Efficacy: Qingrejiedu; Sanyu pain; remove lumps; enhance immunity; Endometriosis; dehumidification spleen.

5, removal of cancer through Granules

Effects: anti-cancer anti-inflammatory; kill cancer cells; inhibition of cancer cell, proliferation, transfer; improve immunity.

6, esophagus Granules

Effects: anti-inflammatory swelling; analgesic; opening of the esophagus; microcirculation; enhance immunity; kill cancer cells; inhibition of cancer cell, proliferation, transfer; improve immunity.

7, elimination cured cancer tumor capsule

Effects: Cancer of tumor, pain swelling, Po Yu by water, vital essence, improve immunity.

8, cured cancer medicine Tang Xiao Liu

Efficacy: Qingrejiedu; righting accompany this; Qi Po Yu; detoxification Sanjie; kill cancer cells; inhibited cancer cell, diffusion, transfer; improve immunity.

9, Xiao Liu remove tumor thrombus

Effect: clearing and detoxifying, promoting blood circulation, anti-inflammatory pain, cancer suppressor.

10, Esophagus Ping San

Efficacy: Qi Po Yu, detoxification Sanjie. Used in advanced esophageal cancer Erzhi esophageal stricture and obstruction, dysphagia, pain, Ye Ge anti-saliva and other illnesses.

11, reference Dan dissolving capsule

Effectiveness: Qi Sun, solid table antiperspirant, but also benefit the water swelling, drug myogenic care, "added the five internal organs weakness and inadequate", "added strength, fully Cou management, governance injured workers, long muscles." Compatibility with ginseng, complementary, beneficial effect of increasing, to Qi Fu Zheng, and rule the present, enhance the body resistance to disease. [1]

Esophageal cancer - esophageal cancer treatment

The treatment of early esophageal cancer should be using surgery, radiotherapy and chemotherapy, the combination of Chinese medicine treatment of combined modality therapy, we should adopt Chinese for advanced conservative treatment.

1, surgical treatment

1. Major surgery: Surgery is the preferred method of treatment of early esophageal cancer. Once diagnosed esophageal cancer patients, physical condition permits that should be taken to surgery. The condition of patients can be divided into two kinds of palliative surgery and radical surgery. Palliative surgery for advanced primary or radiotherapy can not cure patients, to resolve the difficulties with eating esophagogastric bypass, gastrostomy, esophageal lumen catheter technique and so on. Radical surgery patients according to lesion site and the specific circumstances. The majority principle, be removed esophagus, esophageal resection should be at least 5cm away from the tumor over. Lower cancer resection rate of 90%, 50% carcinoma of the middle, upper rate of tumor resection in 56.3% to 92.9%. ① surgery contraindications to clinical x lines confirmed as extensive esophageal lesions and involved adjacent organs, such as the trachea, lung, mediastinum, aorta and so on. ② severe cardiopulmonary or renal dysfunction or cachexia can not tolerate surgery. 2. Minor surgery: clinical recommendations for patients with advanced general (almost can not swallow the patients) were placed stents, this a small operation to a small bracket into the lesion site, expanding the expanded esophagus (ps: momentary distraction will hurt), to allow patients to eat to achieve, but this can only be short-term continuation of life for patients has been unable to do surgery to remove the price probably about 1W, where different prices are not the same, if the family economic conditions permit, This approach can extend the life of a certain period.

Second, radiation therapy

Radiotherapy indication wide, in addition to the formation of esophageal perforation, esophageal fistula, distant metastasis, significantly cachexia, severe heart, lung, liver and other diseases, radiation therapy may be OK. 1) Indications: (1) patients generally above the average; (2) lesion length of not more than 8cm is appropriate; (3) No supraclavicular lymph node metastasis, silent with paralysis, no distant metastasis; (4) can be into the semi- stream water or common food; (5) no signs of perforation before ※, no significant thoracodorsal pain; (6) should cytology or pathology diagnosis, especially in superficial esophageal cancer. ※ Note: The signs of esophageal perforation ago: ① spikes stand out: the lesion, spike-like prominence, small in size as burr, as powerful as the wedge; ② Kanying form: a large ulcer; ③ diverticulum degeneration: the formation and general similar to esophageal diverticulum, mostly occurs in radiotherapy; ④ distorted angle: loss of normal wall of moving water, it seems as long bone fracture dislocation; ⑤ mediastinitis: mediastinal widening shadow, patient body temperature, pulse speed, thoracodorsal pain. After perforation of poor prognosis, most patients die within a few months. 2) radiation dose and time: Usually irradiated tumor volume was 60Gy ~ 70Gy / 6 ~ 7 周. 3) external exposure of the reaction (1) esophageal response: exposure to tumor volume of 10 ~ 20Gy / 1 ~ 2 weeks, the esophageal mucosal edema, may increase dysphagia, usually for treatment from time, exposure volume of 30 ~ 40Gy / 3 ~ After 4 weeks, can produce pain in swallowing, and substernal pain, appropriate symptomatic treatment. (2) tracheal response: cough, mostly dry cough, phlegm less. 4) complications (1) hemorrhage: incidence of about 1%. Should select patients, those with Mingxian ulcers, especially those with burr-like prominence of the deep ulcer, shall take special care to reduce the radiation dose each time, extending the total treatment time, the radiation process, should always be observed X-ray barium meal . (2) perforation: incidence rate is about 3%, which may penetrate the trachea, esophageal fistula formation or penetration mediastinum, causing mediastinal inflammation. (3) radiation myelopathy: spinal cord disease is radiation head, neck, chest, severe complications of cancer radiotherapy is one. The incubation period after irradiation more than 1 to 2 years.

Third, Chinese medicine treatment of esophageal cancer

TCM believes that the fundamental pathogenesis of esophageal cancer as yang weakness, body function decline, the main strength treatment should yang qi, strengthening the body, improve body function, so treatment should reflect the main square principles of Chinese medicine. On esophageal cancer in different sub-license, the legislature has also come to the different drugs. But the government has stored in liver and gas law, Jiangni stasis, Treating Endometriosis, training of the righting, raw body fluid, clearing and detoxifying, anti-cancer pain, yang qi and so on. (A) proprietary cancer treatment should be surgery, chemotherapy and combined therapy. Chinese medicine is a very important part of Chinese patent medicine of which a dose ingredients stability, easy to take advantage of effective and convenient. (B) BRC 1. Qi stagnation, the primary evidence: the performance of early esophageal cancer, no significant dysphagia, only a sense of the esophagus when swallowing block choking, foreign body sensation or burning sensation, chest discomfort and back, depressed sense of Shen tight , when the sink when the hidden sense of swallowing negative. X-rays are mainly early esophageal cancer lesions. Light dark tongue, thin white tongue coating, wiry pulse. Therapeutic: Liver qi, yang qi, Fuzhengyiliu. 2. Terrier choke Principal Certificate: When a simple, mild adverse stem choking or swallowing. X-rays are mostly early and mid-medullary type, fungating esophageal cancer. Tongue is dark blue, yellow and white fur, thin pulse string. Governing Law: cancer Sanjie, Jiangni qi, yang righting. 3. Yin Yang withered master card bad: sick of late, dysphagia, close to obstruction, Oue gas counter, emaciation, shortness of breath, fatigue, vexed hot, dry lips, dry stool, such as dung, tongue dark Jiang, thin and small, less lack subsidized or no moss moss, moss and black, also dry and crack those small weak pulse breakdown or Shen. Governing Law: AIDS yin and invigorating, BNI. After years of painstaking research and clinical trials, co-developed the series of effects of pure anti-cancer medicine. A "trinity of therapy," the main treatment esophageal, gastric cardia, gastric cancer caused by choking on food down food, phlegm constantly, into food that is spit, food regurgitation, dysphagia, weight loss, hoarseness, chest tightness, fatigue, pain reflex lesions various symptoms have good results.

Esophageal cancer - esophageal cancer nursing

A, preoperative care

1. Psychological care of patients with progressive dysphagia, increased weight loss, poor tolerance of the procedure, lack of confidence in treatment, while there is a degree of surgery fear. Therefore, should address the patient's mental state to explain, to comfort and encourage the establishment of fully trusted by the nursing patient relationship, in which patients Renshi to surgery, a complete treatment, it Leyu surgery. 2. To strengthen nutrition still capable of consuming them, should be given high-calorie, high protein, high vitamin liquid or semi-liquid diet. Can not eat, shall intravenous hydration, electrolytes and calories. Hypoproteinemia patients should be given to correct blood or plasma proteins. 3. ① gastrointestinal oral hygiene preparations; ② preoperative placement stomach and duodenal drip tube; ③ preoperative fasting, those who have food retention, intraoperative transesophageal night before washing with isotonic saline, help reduce edema, postoperative infection and reduce the incidence of anastomotic leakage; ④ were scheduled for colon esophagus, preoperative care shall colon surgery preparation, see colorectal cancer preoperative preparation. 4. Preoperative patients with deep breathing exercises Church, effective cough, expectoration, defecation and other activities in bed.



Second, postoperative care

In addition to observation of vital signs and other routine care, should be: 1. To maintain smooth operation for gastrointestinal decompression tube drainage of 24 ~ 48h a small amount of blood, should be regarded as normal, such as a large number of blood leads to medical treatment should be immediately reported. Gastrointestinal decompression tube should be retained in 3 to 5 days to reduce anastomotic tension to facilitate healing. Note tube connecting accurate, stable fixation, to prevent the prolapse, the drainage was adequate.

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