Esophageal Cancers Treatment in Delhi

The oesophagus, often referred to as the food pipe, is a vital part of our digestive system. It connects the throat (pharynx) to the stomach, facilitating the smooth passage of food. The oesophagus is categorised into upper, middle, and lower thirds, primarily based on its distance from the incisor tooth. A critical juncture in the oesophagus is the gastroesophageal junction, which unfortunately tends to be a common site for cancer.

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Unveiling the Culprits of Esophageal Cancers

The leading causes of esophageal cancers are well-documented, with smoking and alcohol consumption standing at the forefront. While some risk factors, such as the consumption of spicy foods and excessive coffee intake, are not conclusively proven, they have been implicated in the higher incidence of esophageal cancers in specific regions, notably in parts of Karnataka and Tamil Nadu in South India.

Reflux disease, triggered by various factors, can lead to changes at the gastroesophageal junction and lower oesophagus, ultimately culminating in cancer.

Symptoms of Esophageal Cancer

Meet Mr. Sampat (a hypothetical name), a 60-year-old gentleman who has been a regular smoker for the past 25 years, typically consuming 5 to 6 cigarettes daily. He occasionally enjoys a drink as well. Lately, he’s been grappling with the sensation of food getting stuck in his chest. This discomfort initially affected solid foods like chapattis, requiring water for digestion. However, the issue has escalated to include liquids too.

The hallmark symptom of esophageal cancer is difficulty in swallowing, known as dysphagia. This symptom is typically progressive, meaning it worsens over time. Some patients may experience coughing after eating, which is often linked to food entering the respiratory tract, a condition known as aspiration. Pain, though not a common feature, may occur in later stages when the cancer infiltrates surrounding nerves.

Diagnostic Journey for Esophageal Cancer

The foremost diagnostic test for esophageal cancer is an upper GI endoscopy, where a tube equipped with a camera is inserted through the mouth. This procedure allows for the visual inspection of any growth or ulcer in the oesophagus and facilitates biopsy collection if needed. Subsequent tests often include CT scans or PET scans, which help determine the extent of the disease.

Navigating Esophageal Cancer Treatment

The treatment approach for esophageal cancer hinges on several factors:

Stage of the cancer

Location within the oesophagus

Type of cancer (e.g., squamous carcinoma or adenocarcinoma)

The patient’s overall fitness for major medical procedures

Surgery, radiation therapy, and chemotherapy constitute the primary treatment options for esophageal cancer.

Esophageal cancer is rarely diagnosed at stage 1. It is typically detected at stages 2 or 3. In such cases, a multimodal approach is recommended, combining surgery, chemotherapy, and radiation. An interdisciplinary discussion involving surgical, medical, and radiation oncologists is vital for precise decision-making.

Prioritising Treatment

For patients diagnosed with stage 2 and 3 mid and lower esophageal cancers, an initial course of chemotherapy and radiation is often initiated. This treatment spans 4-6 weeks, followed by a 6-week waiting period to maximise the response. Subsequently, surgery and further chemotherapy are considered. This sequential approach has yielded promising outcomes in clinical trials.

In adenocarcinoma, some oncologists may opt to omit radiation, proceeding with chemotherapy and surgery.

Surgical Interventions for Esophageal Cancer

The choice of surgical procedure depends on the tumour’s location. Generally, in upper and middle esophageal cancer cases, it is challenging to remove only the affected portion. Hence, most often, the entire oesophagus must be resected, a procedure known as a total esophagectomy. This surgery involves the removal of nearby lymph nodes. In the reconstruction phase, the stomach is commonly used to create a new conduit, called a gastric pull-up.

Cancers in the upper third of the oesophagus are usually not considered for surgical intervention due to their proximity to the vocal cords. In cases of lower third and gastroesophageal junction cancers, the surgery involves removing the lower oesophagus and upper stomach and creating a connection between the remaining oesophagus and stomach.

Challenges in Esophageal Cancer Surgery

These surgeries are intricate and demand substantial expertise and training. The close proximity of the aorta and bronchus to the esophagus poses a risk of life-threatening complications in case of injury. Additionally, there is a significant risk of lower respiratory infections and potential leakage at the esophagus-stomach joint, leading to infections and sepsis.

Innovations in Esophageal Surgery

The introduction of robotic surgery marks a substantial advancement in the field of esophageal cancer treatment. Unlike traditional chest-opening surgeries, robotic-assisted procedures are minimally invasive and offer better postoperative outcomes, including reduced pain and respiratory complications. With robotics, surgeons can maintain the dexterity of manual surgery while working through smaller incisions.

Long-Term Effects of Esophageal Cancer Surgery

As with any major surgical intervention, long-term side effects are possible. Notably:

• Many patients experience weight loss due to a reduction in stomach size.
• Patients may encounter symptoms of bile reflux into the food pipe, leading to sensations of vomiting and a bitter taste in the mouth.
• In some cases, the newly constructed connection between the esophagus and stomach may narrow, necessitating endoscopic dilation.
• These challenges underline the importance of comprehensive pre-surgery discussions and follow-up care for patients.

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Dr. Ankur Bahl

Speciality:     Medical Oncologist & Hematologist
Experience: 15 years of experience
Hospital:       Fortis Memorial Research Institute

About Doctor:

• Dr. Ankur Bahl is a renowned Medical Oncologist with experience of over 15 years.
• He offers treatment for Multiple Myeloma, Lymphoma, Breast and Lung Cancer, Gastrointestinal tumors, Gynaecological Tumors, Head, Neck and Brain Tumors and Bone Marrow Transplantation.
• He was the recipient of Dr. Rehan Gold Medal for being the best Outgoing Post Graduate student of Internal Medicine in Delhi University.

Dr. Vedant Kabra

Specialist:      Surgical Oncologist
Experience:   23+ years of experience
Hospital:        Fortis Memorial Research Institute

About Doctor:

• Dr Vedant Kabra is the Head of the Department of Surgical Oncology at Fortis Memorial Research Institute (FMRI)
• He has a rich experience of 23+ years in the field of oncologist.
• Dr Vedant Kabra has successfully performed 12,000 cancer surgeries and various complex oncological procedures including robotic surgeries.

Dr. Vinod Raina

Specialist:       Medical Oncologist
Experience:   40+ years of experience
Hospital:        Fortis Memorial Research Institute

About Doctor:

• Vinod Raina is One of India’s foremost Medical Oncologists at Fortis Memorial Research Institute, Gurgaon.
• Having a vast 40+ years of experience in this field
• He performed the first high dose chemotherapy and peripheral blood stem cell transplant in India in 1994.

Dr. Niranjan Naik

Specialist :       Surgical Oncologist
Experience :    21 years of experience
Hospital :         Fortis Memorial Research Institute

About Doctor:

• Well-known and recognized Onco-Surgeon of India
• Performed more than 12000 cancer surgeries including Breast, Thoracic, Gastro-Intestinal & Hepatobiliary Surgeries
• Trained in Laparoscopic Cancer Surgeries

Dr. Nitesh Rohatgi

Specialist :       Medical Oncologist
Experience :    21 years of experience
Hospital :         Fortis Memorial Research Institute

About Doctor:

• Dr Nitesh Rohatgi is a Medical Oncologist with more than 20 years of expertise.
• Services provided by him include Cancer Treatment, Melanoma Treatment, Cancer Treatment, Cancer Surgery, Lung Cancer Treatment, Hormone Therapy For Breast Cancer, Thyroidectomy, Oral Cancer Treatment, and Chemotherapy.
• He earned his MBBS in 1998 from University of Delhi & DNB-Medical Oncology in 2000 from University of Delhi.

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We offers these Services

• Providing a doctor’s opinion and proper quotation
• Selecting the best hospital and doctor as per your case
• Arranging a call with the doctor (if the case required)
• Visa assistance, Providing Visa Invitation Letter (VIL)
• Providing full guidance how to get Visa from your country
• Providing total cost including treatment, air tickets, accommodation, and food
• Assitance to book flight ticket from your country
• Arranging airport pick up/ drop
• Providing professional language interpreter
• Booking accommodation and guest house as per your budget/ prefrence
• Providing help in money exchanging
• Providing local sim card
• Arranging video consultation with specialist doctor if case requires

Dr. Mukesh Patekar

Specialist:         Medical Oncologist
Experience:     9+ years of experience
Hospital:           Fortis Memorial Research Institute  

About Doctor:

• Dr. Mukesh Patekar is a medical oncologist with 9+ Experience.
• Well versed with solid tissue malignancies, haematological malignancies, stem cell transplant as well as paediatric malignancies.
• His expertise lies in chemotherapy, hormonal therapy, targeted therapy, immunotherapy and palliative care.

Dr. Suman S Karanth

Specialist:         Medical Oncologist
Experience:     8+ years of experience
Hospital:           Fortis Memorial Research Institute  

About Doctor:

• Dr. Suman S Karanth is a medical oncologist with 8+ experience.
• Her expertise lies in Solid malignancies, Lymphoma, Dendritic Cell therapy, and Immunotherapy, including the APECEDEN vaccine which is the only Dendritic cell therapy approved in India.

Dr. Sushil Kumar

Speciality:        Surgical Oncologist
Experience:      28+ Years of Experience
Hospital:           Fortis Memorial Research Institute

About Doctor:

• He is a renowned Surgical Oncologist and Robotic Onco Surgeon, presently working as senior consultant in Department of Surgical Oncology at Fortis Memorial Research Institute (FMRI) Gurugram.
• He is trained in Surgical Oncology from Dharamshila Cancer Hospital, New Delhi and Robotic Surgery training from Manipal Hospital, Bengaluru; Florida Hospital, USA; Yonsei university, Seoul (South Korea).
• He has successfully performed more than 4000 complex onco-surgical operations including open, laparoscopic and robotic procedures.

Dr. Alok T

Speciality:     Surgical Oncologist
Experience:  13+ Years of Experience
Hospital:        Fortis Memorial Research Institute

About Doctor:

• He is a well-known Surgical Oncologist with 10 years of experience.
• His vast areas of expertise in surgery include head & neck cancer, breast cancer, gynecological, oesophageal and thoracic malignancies.
• The doctor had worked in different parts of the country, he has holistic training in surgical oncology.

Get Opinion From India’s Best Doctors

We offers these Services

• Providing a doctor’s opinion and proper quotation
• Selecting the best hospital and doctor as per your case
• Arranging a call with the doctor (if the case required)
• Visa assistance, Providing Visa Invitation Letter (VIL)
• Providing full guidance how to get Visa from your country
• Providing total cost including treatment, air tickets, accommodation, and food
• Assitance to book flight ticket from your country
• Arranging airport pick up/ drop
• Providing professional language interpreter
• Booking accommodation and guest house as per your budget/ prefrence
• Providing help in money exchanging
• Providing local sim card
• Arranging video consultation with specialist doctor if case requires