Esophageal Cancer

What is esophageal cancer?

Esophageal cancer begins in the inner layer of cells that line the esophagus, which is the long tube that connects the throat to the stomach. The esophagus moves swallowed food from the back of the throat to the stomach for digestion.

Esophageal cancer makes up 1% of all cancers diagnosed in the U.S., according to the American Cancer Society. The lifetime risk of developing esophageal cancer in men is about 1 in 132 and about 1 in 455 in women.

What are the different types of esophageal cancer?

There are two main types of esophageal cancer:

  • Squamous cell carcinoma: This type can occur anywhere along the esophagus. It is most common in the neck and upper chest cavity. It makes up less than half of esophageal cancers diagnosed in the U.S.
  • Adenocarcinoma: These cancers start in gland cells that make mucus. This type of cancer typically starts in the lower part of the esophagus.

Though rare, melanomas, lymphomas, and sarcomas can also start in the esophagus.

What are the symptoms of esophageal cancer?

Esophageal cancers usually cause symptoms that lead to a diagnosis. However, most esophageal cancers cause no symptoms until they reach an advanced stage.

Early diagnosis in people without symptoms is rare, as the cancer is usually found during tests for other medical purposes. Common esophageal cancer symptoms can include the following:

Trouble swallowing

The most common symptom of esophagus cancer, trouble swallowing is mild when it starts and gets worse over time. As the cancer grows larger, the opening of the esophagus shrinks.

Foods like bread and meat may get stuck in the throat, and the body will produce more saliva to help pass food through the esophagus to the stomach. If the cancer continues to spread, liquids may become hard to swallow.

Weight loss

Fifty percent of people with esophagus cancer lose weight unintentionally due to swallowing problems. They typically do not eat enough to maintain a healthy weight.

Chest pain

Discomfort in the chest may point to esophageal cancer, but it is more common in patients with heartburn and seldom viewed as an indication of esophagus cancer. Chest pain while swallowing is common in cases where a tumor has grown large enough to block the passage of food.

Additional symptoms

Experiencing one or more of the following symptoms does not mean you have esophageal cancer. However, it’s important to have these symptoms checked by your doctor:

  • Chronic cough
  • Hiccups
  • Hoarse throat
  • Vomiting
  • Esophageal bleeding

What are the causes and risk factors of esophageal cancer?

Several factors can affect your risk of developing esophageal cancer. However, some people who have one or more risk factors never develop the disease, while others who get the disease may not have any risk factors. Esophageal cancer risk factors include:

  • Age
  • Gender
  • Gastroesophageal reflux disease
  • Barrett’s esophagus
  • Tobacco use
  • Alcohol use
  • Obesity
  • Diet
  • History of other cancers
  • HPV infection
  • Achalasia (a condition in which the lower esophagus does not relax properly)
  • Tylosis (an inherited disease that causes excess skin growth on the hands and feet)
  • Plummer-Vinson syndrome
  • Workplace exposure to chemical fumes and dry-cleaning solvents
  • Injury to the esophagus 

How is esophageal cancer diagnosed and treated?

If your doctor suspects you may have esophageal cancer, he or she will perform a variety of exams and tests to confirm the diagnosis. These tests may include:

  • Medical history exam
  • Physical exam
  • Imaging tests
  • Barium swallow
  • CT, MRI, and PET scans
  • Bronchoscopy
  • Thoracoscopy and laparoscopy
  • Endoscopy or upper endoscopy
  • Endoscopic ultrasound
  • Biopsy lab tests (including HER2 testing)
  • Blood tests (including complete blood count and liver enzymes)

Treatment for esophageal cancer depends on the type and stage of the cancer. Doctors and specialists often use local therapy for early-stage esophageal cancer treatment, including surgery, radiation therapy, and endoscopic treatments.

Systemic therapies, or treatments that travel throughout the body, use oral drugs to destroy cancer cells. Chemotherapy, targeted therapy, and immunotherapy are common systemic therapies used to treat esophageal cancer. Doctors recommend palliative care and life planning in cases when the cancer cannot be removed.

Esophageal Cancer Treatment at Baptist Cancer Center

Baptist Cancer Center is dedicated to the research, prevention, and treatment of all forms of gastrointestinal cancer. Led by Dr. Stephen Berhman, the Baptist Cancer Center gastrointestinal program provides patients with a one-stop experience.

Most patients receive treatment plans within two days of testing with Baptist specialists. Our multidisciplinary team of doctors, surgeons, and radiation and medical oncologists strive to provide personalized, close-to-home care and guidance to esophageal cancer patients and their families.

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