“Goodbye, my beloved friend. A Great Voice falls silent. A Great Heart Stops!”~ Salman Rushdie.
This post is dedicated to Mr. Hitchens. How did we lose this voice? He was a known case of Esophageal Carcinoma.
Esophagus is a tube which connects the mouth with the stomach. Its function is to pass food. Just imagine a tube, this tube has several layers. The layer that immediately surrounds the inner side of the tube is called mucus layer. This mucus layer is covered by one type of cell called squamous cell.
When people smoke tobacco and drink alcohol chronically, this squamous epithelium can’t stand this insult so that’s why they adapt. They transform themselves in other type of cells, most commonly into columnar cells. This is known as Metaplasia.
Cancer can take place due to rapid proliferation of both the squamous epithelium or columnar. When this cancer proliferates, it starts symptoms like dysphagia. Dysphagia means a subjective awareness of food sticking in your mouth and you are unable to swallow which is the primary cause of weight loss. In 20% cases progressive loss of appetite also takes place.
When this cancer has proliferated to a certain extent, it tries to travel to different parts of the body by three ways, directly to other organs nearby, by blood or by some channels called lymphatic system.
When this cancer progresses to different parts of the body then other symptoms like cervical lymphadenopthy takes place followed by hoarseness of voice. The tumor compresses nerves called recurrent laryngeal nerves that cause changes in the voice.
Doing a routine endoscopic test to check your esophagus is the best way to avoid further complications by the cancer, provided that you have symptoms of dysphagia. Obesity is also know be involved in the etiology of this cancer.
In China, esophageal cancer is endemic in places like Linxian in Henan Province. It is suspected to arise due to nutritional deficiencies and fungal infections, so the government has added supplements of diet with some vitamins like B and E and selenium.
In the west and mostly probably Mr. Hitchens suffered from Adenocarcinoma of the esophagus, as it is common in the western world. Esophageal Carcinoma is the 6th most common cancer in this world. With a survival rate of 5-10 % of those diagnosed with five year survival chances.
It’s the smoking and drinking that predisposes to it. So why take chance? Do you want to live your life in limitations?
Depending on the extent of the cancer the patient is treated. A surgery is performed in the early cases called oesophagectomy. If the cancer has progressed to a larger extent then palliative treatment is suggested.
RIP Mr.Hitchens!
