Esophageal Cancer

Overview

Esophageal cancer is cancer that occurs in the esophagus, the long, hollow tube that runs from your throat to your stomach. Your esophagus carries food you swallow to your stomach to be digested. Esophageal cancer begins in the cells that line the inside of the esophagus and can occur anywhere in the esophagus. In the United States, it occurs most often in the lower portion of the esophagus. The Esophageal Cancer Action Network can offer more information about esophageal cancer and ways to promote awareness.

While this disease is rare, esophageal cancer is one of the deadliest forms of cancer. In the localized stage, meaning it is only growing in the esophagus, this cancer has only a 38 percent five-year survival rate. In the regional stage, the cancer has spread to nearby lymph nodes or tissues. This stage has only a 20 percent survival rate. The distant stage, when the cancer has spread to other organs, has a 3 percent survival rate.

The cause of esophageal cancer is unknown. Esophageal cancer occurs when the cells in your esophagus develop mutations, or errors, in their DNA. These errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow and invade nearby structures, spreading to other parts of the body.

Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options.

Types of Esophageal Cancer

Adenocarcinoma- begins in the cells of mucus-secreting glands in the esophagus. This type of esophageal cancer occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the U.S., and it affects primarily white men.
Squamous cell carcinoma- flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the middle of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
Other rare forms of esophageal cancer- choriocarcinoma, lymphoma, melanoma, sarcoma and small cell cancer.

Symptoms of Esophageal Cancer

Difficulty swallowing (dysphagia)
Weight loss without trying
Chest pain, pressure or burning
Fatigue
Frequent choking while eating
Indigestion or heartburn
Coughing or hoarseness

Early esophageal cancer typically causes no signs or symptoms

Certain factors can cause chronic irritation to your esophagus. Chronic irritation of your esophagus may contribute to the DNA changes that cause esophageal cancer.

Risk factors for Esophageal Cancer

Drinking alcohol
Having bile reflux
Chewing tobacco
Having difficulty swallowing because of an esophageal sphincter that won’t relax (achalasia)
Drinking very hot liquids
Eating few fruits and vegetables
Eating foods preserved in lye, such as lutefisk, a Nordic recipe made from whitefish and some olive recipes
Having gastroesophageal reflux disease (GERD)
Being obese
Having Barrett’s esophagus
Undergoing radiation treatment to the chest or upper abdomen
Smoking

Other risk factors include being male and being between the ages of 45 and 70. Men are three to four times more likely to develop esophageal cancer than women.

Four stages of Esophageal Cancer

Stage I- occurs only in the top layer of cells lining your esophagus
Stage II- occurs when the cancer has invaded deeper layers of your esophagus lining and may have spread to nearby lymph nodes
Stage III- occurs when the cancer has spread to the deepest layers of the wall of your esophagus and to nearby tissue or lymph nodes
Stage IV- occurs when the cancer has spread to other parts of your body

Tests to Diagnose Esophageal Cancer

Upper endoscopy
Barium esophagram
Biopsy- passing an endoscope down your throat into your esophagus to collect a tissue sample to look for cancer cells

Complications of Esophageal Cancer

Obstruction of the esophagus making it difficult or impossible for food and liquid to pass through your esophagus
Cancer pain
Bleeding in the esophagus
Severe weight loss
Coughing

Treatments for Esophageal Cancer

Surgery to remove very small tumors
Esophagectomy/ Esophagogastrectomy – surgery to remove a portion or all of you esophagus as well as a portion of your stomach

There are also surgeries that can help relieve symptoms and allow you to eat and relieve esophageal obstruction.

Radiation therapy and chemotherapy can also be used either before or after surgery to help relieve the signs, symptoms and complications of esophageal cancer.

Preventing Esophageal Cancer

Quit smoking or chewing tobacco
Drink alcohol in moderation, if at all
Eat more fruits and vegetables
Maintain a healthy weight