Esophageal Cancer

Overview

The esophagus is the long, hollow tube that runs between your throat and your stomach. Food passes through the esophagus to be digested. Esophageal cancer is cancer that occurs in the esophagus.

Esophageal cancer can be broadly classified into the following two types:

• Adenocarcinoma – this type begins in the mucus-secreting glands of the esophagus. It is the most common type of esophageal cancer in the United States.
• Squamous cell carcinoma – this type begins in the cells that line the surface of the esophagus. It is the most common type of esophageal cancer worldwide.

Esophageal cancer causes

Esophageal cancer is caused when mutations (changes) occur in the cells of the esophagus, and then those cells grow and multiply quickly.

Esophageal cancer risk factors

The following factors may increase your risk for developing esophageal cancer:

• Being a smoker
• Being obese
• Drinking excessive amounts of alcohol
• Drinking very hot liquids regularly
• Having achalasia (trouble swallowing due to an esophageal sphincter that won’t relax)
• Having Barrett’s esophagus (precancerous changes in the esophagus cells)
• Having bile reflux
• Having gastroesophageal reflux disease, or GERD
• Having undergone radiation therapy to the chest or upper abdomen
• Not eating enough fruits and vegetables

Esophageal cancer symptoms

Signs and symptoms of esophageal cancer can include:

• Chest pain, burning or pressure
• Coughing
• Hoarseness
• Indigestion or heartburn
• Trouble swallowing (dysphagia)
• Unintentional weight loss

Esophageal cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors.
• Barium swallow study – during this test, you swallow a liquid that includes barium. You then undergo X-rays; the barium coats the inside of your esophagus and creates a better, more contrasted X-ray image.
• Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer.
• Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine the size and location of the cancer.
• Endoscopy – during this imaging test, your doctor passes a thin, flexible tube with a camera on the end of it through your mouth and into your esophagus. Your doctor then takes images of the inside of your body to check for anomalies.

Esophageal cancer treatments

Depending on your personal health history, the extent of the esophageal cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible.
• Chemotherapy – you may need to also undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Immunotherapy – this treatment works with your body’s immune system to fight the cancer.
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically.
• Targeted drug therapy – this treatment involves taking medications that target specific weaknesses of the cancerous cells, working to destroy them.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.