Esophageal Cancer: Problems and Challenges in Early Detection

Abstract

Cancer of the esophagus is a distressing disease to treat as most patients present late and the overall results are poor worldwide, save a very few stray series published (Akiyama et al. 1981, Mathisen et al. 1988). There is little doubt that apart from the generally rapid spread of this cancer, due to the rich lymphatic plexus within the organ and its ramifications in the thorax, abdomen, and neck, the poor results are due to a delayed diagnosis as the disease is asymptomatic in its early stages. Results collected for early T1N0M0 cases show impressive cure rates ranging from 50% to 80% (Yamashita et al. 1972). This clearly indicates that inherently squamous cell carcinoma of the esophagus is not a biologically lethal disease and that concerted attempts to make an early diagnosis may be worthwhile in selected settings.