Esophageal cancer refers to a malignant tumor of the esophagus. The esophagus is the tube that connects the throat with the stomach.
This cancer is rare in the United States but more common in Asia and parts of Africa. In 2015, esophageal cancer made up
The two main subtypes of esophageal cancer are:
- Squamous cell carcinoma: This arises from the cells lining the upper part of the esophagus.
- Adenocarcinoma of the esophagus: This occurs due to changes in the glandular cells that exist at the junction of the esophagus and the stomach.
Rarer types include:
The treatment, symptoms, and prognosis are similar for both main types of esophageal cancer.
In this article, we look at the symptoms, causes, and treatments of esophageal cancer.
People often experience no symptoms during the initial stages of this cancer.
The majority of esophageal cancer diagnoses occur when the cancer has advanced.
When symptoms are present, they may include:
- Dysphagia: As the tumor narrows the passage in the esophagus, pushing food through becomes harder. This is usually the first noticeable symptom.
- Vomiting: A person vomits food after it gets stuck in the esophagus.
- Weight loss: Dramatic and sudden weight loss might occur.
- A cough: This becomes more common when trying to swallow. Sometimes, the individual wmay cough up blood.
- Voice changes: The voice may become hoarse.
- Pain and discomfort: These occur in the throat.
- Acid reflux: This can happen if cancer affects the lower part of the esophagus.
- Chest pain: This relates to acid reflux.
Cancer results from out-of-control cell growth. The disease harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors.
Tumors may grow and interfere with function. Some are benign and stay in one location without growing any bigger. Malignant cancer is dangerous as, without treatment, it can spread to other parts of the body, or metastasize.
If cancer enters the lymphatic system, it can reach other parts of the body more quickly, including vital organs.
Risk factors
The cause of esophageal cancer is not clear, but certain factors increase the risk.
These include:
- Achalasia: This is a type of esophageal motility disorder.
- Age: Esophageal cancer is more common after 60 years of age.
- Alcohol and smoking: Either or both of these increase the risk.
- Celiac disease: This may increase the risk of squamous cell carcinoma.
- Diet: Not consuming enough fruits and vegetables appears to increase the risk.
- Genetic factors: Having a family member with this condition increases the risk.
- Gastroesophageal reflux disease (GERD): Both this disease and its main symptom, acid reflux, can lead to Barrett’s esophagus. Barrett’s esophagus increases the risk of future malignancy.
- Human papillomavirus (HPV): HPV is a contagious, sexually transmitted virus.
- Long-term exposure to chemicals or irritants: These include soot, metal dust, exhaust fumes, lye, and silica dust.
- Sex: Males have a higher risk.
- Obesity: It is more common in people with obesity.
- Other cancers: Those who have had head and neck cancers in the past have a significantly higher risk of esophageal cancer§.
- Radiation therapy: When a doctor administers this treatment to the chest or head, they might increase the risk.
A doctor will examine the person presenting symptoms and ask for details. They may refer the individual to a specialist.
The doctor will order the following diagnostic tests:
- Gastroscopy, or endoscopy: The doctor passes a long, thin instrument called an endoscope through the mouth, into the esophagus, and toward the stomach. The endoscope has a light and camera at the end. The doctor sees the images on a screen and determines whether the presence of any tumors or abnormalities.
- Biopsy: The doctor may take a sample of tissue if the endoscopy shows unusual results. A pathologist then examines the sample under a microscope. They can determine whether or not there are any cancerous cells.
- Barium swallow test: The patient drinks a liquid containing barium. Barium shows up on x-rays. A technician takes several x-ray pictures at intervals. They will reveal wany obstructions that a tumor would cause.
- Endoscopic ultrasound: A small ultrasound probe fixes to an endoscope. The doctor then inserts it through the mouth into a targeted area. This usually takes place once the doctor has confirmed the cancer but wants to have a better look at the tumor on a monitor. This type of test may show whether the cancer has spread into nearby tissue.
- Other imaging scans: A CT scan can help determine the spread of the cancer.
Esophageal cancer develops in
- Stage 0: This stage refers to cells that have shown signs of cancerous activity without becoming cancerous.
- Stage 1: Cancer has formed in the wall of the esophagus. The location of the tumor may not be obvious.
- Stage 2: The cancer has spread to the muscular or connective tissue of the esophagus and one or two lymph nodes.
- Stage 3: The cancer has spread to the muscular or connective tissue of the esophagus, possibly as well as the diaphragm, the sac around the heart, or the protective tissue around the lungs, and between 3 and 6 lymph nodes.
- Stage 4: Cancer has spread to distant sites in the body.
The stage of a cancer will dictate how a doctor treats that cancer and the likelihood of successful treatment.
In 2014, the most recent year in which researchers collected data, the outlook for esophageal cancer was that
The outlook depends strongly on the stage of the cancer. If cancer has not spread from the esophagus, the survival rate increases to 43 percent. If the disease has spread to surrounding organs, the survival rate drops to 23 percent. Once the cancer reaches distant sites, the survival rate can be as low as 5 percent.
If you experience any symptoms at all, contact a doctor.
While these figures are an estimate, they indicate a low overall survival rate and therefore highlight the severity of esophageal cancer.