[Verse 1]
Up where the smoke curls, high in the throat,
squamous cells rally where cigarettes float,
whiskey and ember carved out this lane—
upper, mid esophagus, catching the flame.
Down at the bottom where stomach acid creeps,
adenocarcinoma's the shadow it keeps,
Barrett's is the lining that turned and betrayed,
GERD and extra weight paved the way it stayed.
[Chorus]
Squamous up high, smoke and rye,
adeno down low where the reflux runs dry,
learn the border, learn the cause,
esophagus teaches its own set of laws,
CROSS trial whispers: shrink it first,
chemo and radiation quench that thirst,
then we cut—Ivor Lewis, McKeown's call,
watch the leak, the dreaded wall.
[Verse 2]
Before any blade, we hit it with a beam,
chemo-radiation, the CROSS trial's scheme,
shrinking the tumor, cleaning the field,
better margins become the eventual yield.
Ivor Lewis joins chest and belly as one,
McKeown adds a neck stitch once the chest work's done,
transhiatal skips the ribs, avoids that strain,
but every route can spring an anastomotic rain.
Leak's the demon lurking under the drain,
a contrast swallow tells you what to reclaim.
[Chorus]
Squamous up high, smoke and rye,
adeno down low where the reflux runs dry,
learn the border, learn the cause,
esophagus teaches its own set of laws,
CROSS trial whispers: shrink it first,
chemo and radiation quench that thirst,
then we cut—Ivor Lewis, McKeown's call,
watch the leak, the dreaded wall.
[Verse 3]
Now travel further, to the stomach's own wall,
H. pylori's the tenant who starts the fall,
Lauren split this cancer in two designs:
intestinal builds glands in a tidy line,
diffuse scatters cells like shattered glass,
signet rings shove nuclei off to the side as they pass,
linitis plastica—a leather bottle squeeze,
the stomach turns rigid, forgets how to ease.
[Bridge]
First we peek before we leap in—
laparoscopy scans the peritoneal skin,
hunting for seeds dropped far and wide,
if they've already spread, we step aside.
FLOT wraps around both edges of the fight,
four drugs working morning and night,
gastrectomy clears the stomach's old estate,
D2 dissection takes the nodes off the plate.
[Chorus]
Squamous up high, smoke and rye,
adeno down low where the reflux runs dry,
H. pylori digs the diffuse and the straight,
signet rings whisper, leather bottle fate,
scope before you cut, FLOT before you sew,
D2 clears the nodes that the surgeons must know,
esophagus, stomach—both telling their tale,
know the type, know the plan, and you won't fail.
[Outro]
Squamous, adeno, diffuse, and the line,
every border whispers a different sign,
chemo first, scope first, then steady the knife—
that's the map that carries the patient through life.