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Esophageal cancer

About esophageal cancer

The esophagus is the hollow tube that connects the throat to the stomach, allowing food to pass. It sits behind the trachea, or windpipe, and in front of the spine. Esophageal cancer develops when the tissue that lines the esophagus becomes malignant.

What causes esophageal cancer?

Researchers believe esophageal cancer may develop from damaged DNA in the cells that line the esophagus. The DNA damage is frequently caused by long-term irritants, such as chronic tobacco or alcohol use. 

Other factors that may lead to esophageal cancer include:

  • Obesity
  • Conditions like gastroesophageal reflux disease (GERD), Barrett's esophagus and achalasia
  • A diet low in fruits, vegetables and certain vitamins and minerals

Learn more about risk factors for esophageal cancer

Who gets esophageal cancer?

The risk for developing esophageal cancer increases with age, and men are three to four times more likely than women to be diagnosed with the disease. People who are obese or who drink or smoke excessively, especially in combination, are also more likely to develop esophageal cancer.

People with certain conditions are also at higher risk. These conditions include:

  • GERD
  • Barrett's esophagus
  • Achalasia
  • Tylosis
  • Esophageal webs

Esophageal cancer is rare, accounting for 1 percent of all cancers diagnosed in the United States. According to the American Society of Clinical Oncology, an estimated 17,650 Americans will be diagnosed with esophageal cancer in 2019. The disease accounts for more than 2 percent (nearly 16,000) of cancer deaths each year in the United States.

Esophageal cancer types

Esophageal cancers are classified depending on the type of cell in which they form, either as:

  • Adenocarcinomas, which are the most common type of esophageal cancer in the United States and form in the mucus-forming gland cells of the esophageal lining
  • Squamous cell carcinomas, which are linked to heavy alcohol and tobacco use and develop in the thin, flat cells of the outermost layer of skin

Learn more about esophageal cancer types

Esophageal cancer symptoms

In its early stages, esophageal cancer typically doesn't cause signs or symptoms. Once the disease has advanced, the most common symptom is often trouble swallowing, or dysphagia, caused when the opening to the esophagus contracts and becomes smaller. This symptom generally worsens over time.

Other symptoms of esophageal cancer include:

Learn more about esophageal cancer symptoms

Diagnosing esophageal cancer

A diagnosis of esophageal cancer is usually determined after several tests have been performed. People with conditions that increase their risk of developing esophageal cancer, such as Barrett's esophagus, may be advised to have regular endoscopic exams to look for changes in tissue.

Diagnostic tests may include:

Learn more about diagnosing esophageal cancer

Treating esophageal cancer

Depending on the type and stage of the disease, treatment for esophageal cancer may include therapies delivered either alone or in combination. These treatments may include:

Learn more about treatments for esophageal cancer

Next topic: What are the risk factors for esophageal cancer?