What you should know about esophageal cancer
Esophageal cancer is uncommon, accounting for only around 1 percent of all cancers diagnosed in the United States. Although the rate of esophageal cancer has increased slightly in recent years, the five-year survival rate has actually doubled over the past 30 years.
The most common risk factors for developing esophageal cancer are smoking, excessive alcohol use and chronic gastroesophageal reflux disease. Most esophageal cancers aren’t diagnosed until they’ve advanced, and they are typically discovered when patients seek medical attention after they have difficulty swallowing food or liquids.
A multidisciplinary team of experts is typically involved in treatment of esophageal cancer. The team may include an oncologist, gastroenterologist, radiation oncologist, surgical oncologist and dietitian.
What is esophageal cancer?
Esophageal cancer is cancer that develops in the 10-inch-long, muscular tube that connects the throat to the stomach. Cancer typically starts in the wall of the esophagus. Because two types of cells—squamous cells and gland cells—line the esophagus, esophageal cancer is characterized by two main types: squamous cell carcinoma and adenocarcinoma. Esophageal cancer generally grows outward and spreads through lymph nodes, eventually involving distant lymph nodes and organs such as the liver and lungs.
What are the main types of esophageal cancer?
The two main types of esophageal cancer are:
- Squamous cell carcinoma: This type of cancer begins in the flat squamous cells that line the esophagus. Although squamous cell carcinomas may occur anywhere in the esophagus, they most commonly develop in the upper part of the esophagus. Smoking and alcohol use are linked to an increased risk for squamous cell carcinoma of the esophagus. Squamous cell carcinoma was once the most common type of esophageal cancer in the United States, but it now makes up less than half of all esophageal cancers in the country.
- Adenocarcinoma: This type of cancer forms in gland cells and generally begins in the lower part of the esophagus. Adenocarcinomas occur when gland cells replace an area of squamous cells in the esophagus. This typically happens as a result of sustained reflux, which causes a condition known as Barrett’s esophagus. The longer the reflux persists, the higher the risk for developing Barrett’s esophagus, which carries a much higher risk for developing adenocarcinoma of the esophagus.
What are the most common risk factors for esophageal cancer?
Common risk factors for esophageal cancer include:
- Excessive smoking and alcohol use
- Gastroesophageal reflux disease (GERD), also known as reflux
- Gender, with men at higher risk
- Barrett’s esophagus
What are the symptoms of esophageal cancer?
Most esophageal cancers don’t cause symptoms in early stages. Because symptoms typically develop once they’ve grown and spread, these cancers are most commonly diagnosed after they’ve advanced. Rarely are esophageal cancers diagnosed before symptoms emerge.
Common esophageal cancer symptoms include:
- Painful or difficulty swallowing
- Chest pain
- Unexplained weight loss
- Heartburn and indigestion
- Persistent cough
How is esophageal cancer typically diagnosed?
A doctor will likely conduct several tests to diagnose esophageal cancer, including:
- A physical exam
- Imaging tests
- Endoscopic ultrasound
- Thoracoscopy and laparoscopy
- Endobronchial ultrasound
- Percutaneous biopsy
- Blood tests