Esophageal Cancer

What is esophageal cancer?

Esophageal cancer occurs in the tissues of the esophagus, which is a long, hollow tube that runs from the throat to the stomach. It helps move the food you swallow from the back of the throat to the stomach to be digested. The wall of the esophagus is made up of several layers of tissue. Esophageal cancer usually begins in the cells that line the inside of the esophagus, and then spreads outward through the other layers as it grows. There are various types of esophageal cancer, which affect a patient’s treatment options. The type of esophageal cancer is determined based on the type of cells that are involved. Types of esophageal cancer include:

• Adenocarcinoma: This type begins in cells that make and secrete mucus, and is usually found in the lower portion of the esophagus. It is the most common form of esophageal cancer in the United States.
• Squamous cell carcinoma: This occurs in the squamous cells of the esophagus, which are flat and thin cells that line its surface. It is usually found in the upper and middle parts of the esophagus. It is the most common esophageal cancer found worldwide.
• Rare types: sarcoma, small cell carcinoma, lymphoma, melanoma, choriocarcinoma

It is estimated that esophageal cancer affects about 4 in 100,000 people per year. Men are more likely to get it than women. There is also a regional factor, as mentioned above. The risk of getting esophageal cancer may increase if a patient has or partakes in: smoking, excessive alcohol consumption, gastroesophageal reflux disease, Barrett’s esophagus, acid reflux, and obesity.

What are the symptoms of esophageal cancer?

Early stages of esophageal cancer usually show no symptoms. Later on, symptoms include, but are not limited to:

• Painful or difficult swallowing
• Unintentional weight loss
• Chest pain, pressure or burning
• Poor indigestion
• Heartburn
• Chronic coughing
• Hoarseness
• Bone pain
• Obstruction of the esophagus

What causes esophageal cancer?

Normal, healthy cells grow at a steady rate, and die at a set time. However, sometimes healthy cells develop abnormalities; they grow and multiply at an out of control rate, and take much longer to die. When this happens to cells in the esophagus, they accumulate into a tumor there. However, the exact cause of the cell mutations that lead to esophageal cancer is unknown. At times, the tumor can grow to invade other body parts.

How is esophageal cancer diagnosed?

Esophageal cancer is diagnosed using the following procedures:

• Physical exam
• Recording of medical history
• Endoscopy
• Biopsy
• Chest X-ray
• Barium Swallow
• Blood tests

After diagnosis, various imaging tests (CT scans, MRIs, X-rays) are used to find out if the cancer cells have spread to other parts of the body. This is called staging.

What are the stages of esophageal cancer?

Doctors use the information obtained during diagnosis to assign a patient’s cancer a stage. Esophageal cancer stages are:

• Stage in situ: Cancer cells are visible through a microscope on the lining of the esophagus but have not spread to the deeper parts of the esophagus’s inner lining
• Stage I: Cancer is in the superficial layers of the esophagus and has started to invade the first layers of the inner lining. It may have spread to nearby lymph nodes.
• Stage II: Cancer has spread to deeper muscular layers of the esophagus. It may have spread to nearby lymph nodes.
• Stage III: Cancer has spread past the muscle layers and invaded the deepest layers of the wall of the esophagus. It has also spread to nearby tissues and lymph nodes.
• Stage IV: Cancer has spread to other body parts.

What are the treatments for esophageal cancer?

Treatment for esophageal cancer depends on the stage of the cancer, the type of cells involved in the cancer, the patient’s health, and the patient’s personal preferences. Treatment includes:

• Surgery
• Chemotherapy
• Radiation therapy
• Targeted therapy

Where can I find out more about esophageal cancer?

• Mayo Clinic
• American Cancer Society
• National Cancer Institute