一名45歲女性因職業關係，20年來菸、烈酒，吞嚥困難到連水都無法下胃，發現是食道癌腫瘤大到完全阻塞食道，沒有空隙，連水都無法通過食道，無法開刀治療。經光子刀放射治療，患者食道癌已縮小1/2，清出食道通路，讓患者嚥食喝水，維持生命養分。
腫瘤塞滿食道 喝水都有困難
澄清醫院中港院區放射腫瘤科主治醫師梁家郡表示，這麼晚期發現的食道癌很少見。這位女性患者起先發現自己吞嚥食物食有一點卡卡的，總以為是因喝烈酒刺激喉嚨而不以為意，後來竟嚴重到連喝水都有困難，還忍了3個月未就醫。因一次胃痛掛急診，被檢查出食道已完全阻塞，罹患第4期食道癌。
患者食道癌約2公分×10公分，塞滿食道的中上段，經病理切片化驗確診為鱗狀上皮細胞癌，癌腫瘤已局部侵犯到氣管，雖然癌細胞尚無遠端轉移情形，仍然無法開刀治療，選擇以光子刀放射治療讓癌腫瘤萎縮，再配合化療，對無法開刀的食道癌患者是比較理想的治療方法。
菸酒、亞硝胺或過熱食物 都可能刺激導致食道癌
梁家郡醫師強調，食道癌的形成大多是食道黏膜的鱗狀上皮細胞，被癌化病變而罹癌，依衛福部最近發佈的資料顯示，去年國人死於食道癌的人數為1797人，是國內十大癌症死亡率排名第9。食道癌初期無症狀，只有腫瘤大小佔據整個食道管腔的一半左右才會有吞嚥困難的症狀。食道癌發生率男性遠高於女性（15:1），好發年齡為60歲左右。
在台灣，大多數的食道癌是屬於鱗狀細胞癌。食道癌致病的原因可能與(1)抽菸、(2)喝酒、(3)含亞硝胺食物、(4)吃過熱飲食有關。酒精會對食道粘膜產生刺激甚至造成粘膜損傷；菸品含有很多致癌成份，當食道粘膜反覆受到刺激或損傷，很容易導致食道癌；同時呼籲不要吃過燙食物，以免燙傷食道粘膜上皮，使粘膜上皮發生破損、潰爛、出血等病變，甚至演變成可怕的食道癌。
吞嚥梗噎感等5徵兆 應儘速就醫
梁家郡醫師提醒，民眾如自覺有(1)吞咽梗噎感、(2)胸骨後疼痛、(3)食道內異物感、(4)食物通過緩慢並有滯留感、(5)咽喉部乾燥與緊縮感等情形，儘早就醫，早期發現、早期診斷、早期治療，提升食道癌的控制率與存活率。
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A 45-year-old woman has a career relationship. She has been smoking and spirits for 20 years. It is difficult to swallow even if she has difficulty swallowing. It is found that the esophageal cancer is so large that it completely blocks the esophagus. There is no gap, and even the water cannot pass through the esophagus. . After photon knife radiation therapy, the patient's esophageal cancer has been reduced by 1/2, clearing the esophageal pathway, allowing the patient to swallow and drink water to maintain life nutrients.
Tumors filled with esophagus, drinking water is difficult
The clarification of the hospital's Hong Kong hospital area radiation oncologist attending physician Liang Jiajun said that such late detection of esophageal cancer is rare. The female patient first discovered that she had swallowed food and had a little kaka. She always thought that she was not convinced by drinking spirits to stimulate her throat. Later, she was so serious that she could not even drink water. She also had no medical treatment for three months. Due to a stomachache, the esophagus was completely blocked and the fourth stage of esophageal cancer was diagnosed.
The patient's esophageal cancer is about 2 cm × 10 cm. It is filled with the upper middle segment of the esophagus. It is diagnosed as squamous cell carcinoma by pathological biopsy. The cancer tumor has partially invaded the trachea. Although the cancer has no distant metastasis, it still cannot be opened. Treatment, the choice of photon knife radiation therapy to atrophy cancer tumors, combined with chemotherapy, is an ideal treatment for patients with esophageal cancer who can not be operated.
Alcohol, nitrosamines or overheated foods may stimulate esophageal cancer
Liang Jiajun doctors stressed that the formation of esophageal cancer is mostly squamous epithelial cells of the esophageal mucosa, which is cancerous and cancerous. According to recent data released by the Department of Health and Welfare, the number of people who died of esophageal cancer last year was 1,797. The major cancer mortality rate is ranked 9th. Esophageal cancer is asymptomatic at the beginning, and only the tumor size accounts for about half of the entire esophageal lumen to have symptoms of difficulty swallowing. The incidence of esophageal cancer is much higher in men than in women (15:1), and the age of onset is about 60 years old.
In Taiwan, most esophageal cancers are squamous cell carcinomas. The cause of esophageal cancer may be related to (1) smoking, (2) drinking, (3) nitrosamine-containing food, and (4) eating an overheated diet. Alcohol can cause irritation or even mucosal damage to the esophageal mucosa; smoking products contain many carcinogenic components. When the esophageal mucosa is repeatedly stimulated or damaged, it can easily lead to esophageal cancer. At the same time, it is called for not to eat hot food, so as not to burn the esophageal mucosa and make the mucous membrane. The epithelium is damaged, ulcerated, hemorrhagic and other diseases, and even evolved into terrible esophageal cancer.
5 signs of swallowing sputum, etc. should seek medical attention as soon as possible
Liang Jiajun doctors reminded people that (1) swallowing sputum sensation, (2) post-sternal pain, (3) foreign body sensation in the esophagus, (4) slow and stagnant food, (5) throat dryness and deflation Sense of feeling, early medical treatment, early detection, early diagnosis, early treatment, improve the control rate and survival rate of esophageal cancer.
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