Are you suffering from a cough following your esophageal cancer surgery?
This certainly can be scary to a patient who has no idea why this is happening.
Esophageal cancer is frightening enough without developing a nagging cough after the surgery.
“The cause of this coughing — which usually starts soon after the operation and resolves over the following weeks — is aspiration,” begins Alex Little, MD, a thoracic surgeon with special interests in esophageal and lung cancer.
Dr. Little explains, “Aspiration is the spillage of food or saliva from the pharynx (the back of the throat where both the esophagus and trachea originate in close proximity) into the trachea and irritating the vocal cords.
“The body responds by generating a cough to expel the aspirated material.”
Why does this happen in the first place?
“Two factors contribute to this development,” says Dr. Little.
“The surgeon replaces the removed esophagus with the stomach which is transferred from its usual location into the chest — or, less frequently, the neck where it is connected (technical word is anastomosed) to the remaining esophagus coming from above.
“Stomach contents can easily regurgitate back into the pharynx, as there is no longer the normal muscular sphincter which was located at the junction of the esophagus and stomach and removed by the operation.
“In addition, if the anastomosis is in the neck, the operation is near the pharynx and disturbs its coordination, so it functions less efficiently in swallowing — and this allows aspiration to occur.”
In short, this postsurgical issue of coughing is nothing to be alarmed about.
But if the coughing continues after a few weeks, you’ll want to bring this up to your surgeon.
More About Esophageal Cancer
The incidence of esophageal cancer varies significantly around the world.
It’s notably higher in countries like China and India, where certain risk factors such as tobacco use and dietary habits contribute to its prevalence.
In contrast, it’s less common in Western countries, though rates have been rising in recent years, possibly due to increased obesity and acid reflux issues.
The two main types are squamous cell carcinoma and adenocarcinoma.
Squamous cell carcinoma, which originates from the cells lining the esophagus, is more common in parts of Asia and Africa.
Adenocarcinoma, arising from glandular cells at the lower part of the esophagus, is more prevalent in Western countries and often associated with Barrett’s esophagus, a condition resulting from chronic acid reflux.
Symptoms like difficulty swallowing food once it’s cleared the throat, the sensation of something being “stuck” in the chest,” or unexplained weight loss usually do not appear until the disease has progressed. Coughing is not a symptom.
Alex Little, MD, trained in general and thoracic surgery at the Johns Hopkins University School of Medicine; has been active in national thoracic surgical societies as a speaker and participant, and served as president of the American College of Chest Physicians. He’s the author of “Cracking Chests: How Thoracic Surgery Got from Rocks to Sticks,” available on Amazon.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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