Esophageal cancer
Cancer - esophagusEsophageal cancer is cancer that starts in the esophagus. This is the tube through which food moves from the mouth to the stomach.
Causes
Esophageal cancer is not common in the United States. It occurs most often in men over age 50 years.
There are two main types of esophageal cancer, squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope.
Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol.
Drinking too much alcohol.
Alcohol use involves drinking beer, wine, or hard liquor.
Read Article Now Book Mark ArticleAdenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk for this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese.
Barrett esophagus
Barrett esophagus (BE) is a disorder in which the lining of the esophagus is damaged by stomach acid leading to changes in the cells of the lining. ...
Read Article Now Book Mark ArticleGastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backward from the stomach into the esophagus (food pipe). F...
Read Article Now Book Mark ArticleSymptoms
Symptoms may include any of the following:
- Backward movement of food through the esophagus and possibly mouth (regurgitation)
- Chest pain not related to eating
- Difficulty swallowing solids or liquids
- Heartburn
Heartburn
Heartburn is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in ...
Read Article Now Book Mark Article - Vomiting blood
Vomiting blood
Vomiting blood is regurgitating (throwing up) contents of the stomach that contains blood. Vomited blood may appear bright red, dark red, or look lik...
Read Article Now Book Mark Article - Weight loss
Exams and Tests
Tests used to help diagnose esophageal cancer may include:
-
Series of x-rays taken to examine the esophagus (barium swallow)
Barium swallow
An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...
Read Article Now Book Mark Article - Chest MRI or thoracic CT (usually used to help determine the stage of the disease)
Chest MRI
A chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...
Read Article Now Book Mark ArticleThoracic CT
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
Read Article Now Book Mark Article - Endoscopic ultrasound (also sometimes used to determine the stage of disease)
Endoscopic
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
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Test to examine and remove a sample of the lining of the esophagus (esophagogastroduodenoscopy, EGD)
Esophagogastroduodenoscopy
Esophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine (the duodenum)....
Read Article Now Book Mark Article - PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible)
PET scan
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
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Stool testing may show small amounts of blood in the stool.
Treatment
EGD will be used to obtain a tissue sample from the esophagus to diagnose cancer.
When the cancer is only in the esophagus and has not spread, surgery may be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using:
- Open surgery, during which 1 or 2 larger incisions are made.
Open surgery
Open esophagectomy is surgery to remove part or all of the esophagus. This is the tube that moves food from your throat to your stomach. After it i...
Read Article Now Book Mark Article - Minimally invasive surgery, during which 2 to 4 small incisions are made in the belly. A laparoscope with a tiny camera is inserted into the belly through one of the incisions.
Minimally invasive surgery
Minimally invasive esophagectomy is surgery to remove part or all of the esophagus. This is the tube that moves food from your throat to your stomac...
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Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus.
Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform.
If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable.
Besides a change in diet, other treatments that may be used to help the patient swallow include:
- Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open.
Stent
A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a vein, or another structure, such as the tube ...
Read Article Now Book Mark Article - A feeding tube into the stomach.
- Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor.
Support Groups
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Read Article Now Book Mark ArticleOutlook (Prognosis)
When the cancer has not spread outside the esophagus, surgery may improve the chance of survival.
When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms.
Possible Complications
Complications may include:
- Pneumonia
- Severe weight loss from not eating enough
When to Contact a Medical Professional
Contact your health care provider if you have difficulty swallowing with no known cause and it does not get better. Also contact your provider if you have other symptoms of esophageal cancer.
Prevention
To reduce your risk of cancer of the esophagus:
- Do not smoke.
- Limit or do not drink alcoholic beverages.
- Get checked by your doctor if you have severe GERD.
- Get regular checkups if you have Barrett esophagus.
References
Ajani JA, D'Amico TA, Bentrem DJ. Esophageal and esophagogastric junction cancers, version 2.2023, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2023;21(4): 393-422. PMID: 37015332 pubmed.ncbi.nlm.nih.gov/37015332/.
Ku GY, Ilson DH. Cancer of the esophagus. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 71.
National Cancer Institute website. Esophageal cancer treatment (PDQ) - health professional version. www.cancer.gov/types/esophageal/hp/esophageal-treatment-pdq. Updated May 11, 2023. Accessed August 9, 2023.
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
Heartburn prevention - illustration
Heartburn is a condition where the acidic stomach contents back up into the esophagus causing pain in the chest area. This reflux usually occurs because the sphincter muscle between the esophagus and stomach is weakened. Standing or sitting after a meal can help reduce the reflux which causes heartburn. Continuous irritation of the esophagus lining as in gastroesophageal reflux disease is a risk factor for the development of adenocarcinoma.
Heartburn prevention
illustration
Esophageal cancer - illustration
Esophageal cancer is cancer that starts in the esophagus. This is the tube through which food moves from the mouth to the stomach. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma.
Esophageal cancer
illustration
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
Heartburn prevention - illustration
Heartburn is a condition where the acidic stomach contents back up into the esophagus causing pain in the chest area. This reflux usually occurs because the sphincter muscle between the esophagus and stomach is weakened. Standing or sitting after a meal can help reduce the reflux which causes heartburn. Continuous irritation of the esophagus lining as in gastroesophageal reflux disease is a risk factor for the development of adenocarcinoma.
Heartburn prevention
illustration
Esophageal cancer - illustration
Esophageal cancer is cancer that starts in the esophagus. This is the tube through which food moves from the mouth to the stomach. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma.
Esophageal cancer
illustration
Review Date: 8/7/2023
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.