Esophageal Cancer

Signs and symptoms of esophageal cancer include:

• Difficulty swallowing (dysphagia)
• Weight loss without trying
• Chest pain, pressure or burning
• Worsening indigestion or heartburn
• Coughing or hoarseness
• Early esophageal cancer typically causes no signs or symptoms.

When to Call

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

If you’ve been diagnosed with Barrett’s esophagus, a precancerous condition caused by chronic acid reflux, your risk of esophageal cancer is higher. Ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening.

Screening for esophageal cancer may be an option for people with Barrett’s esophagus. If you have Barrett’s esophagus, discuss the pros and cons of screening with your doctor.

Causes

It’s not exactly clear what causes esophageal cancer.

Esophageal cancer occurs when cells in the esophagus develop changes (mutations) in their DNA. The changes make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

Types of esophageal cancer

Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

• Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.
• Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
• Other rare types. Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.

Risk Factors

It’s thought that chronic irritation of your esophagus may contribute to the changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

• Having gastroesophageal reflux disease (GERD)
• Smoking
• Having precancerous changes in the cells of the esophagus (Barrett’s esophagus)
• Being obese
• Drinking alcohol
• Having bile reflux
• Having difficulty swallowing because of an esophageal sphincter that won’t relax (achalasia)
• Having a steady habit of drinking very hot liquids
• Not eating enough fruits and vegetables
• Undergoing radiation treatment to the chest or upper abdomen

Complications

As esophageal cancer advances, it can cause complications, such as:

• Obstruction of the esophagus. Cancer may make it difficult for food and liquid to pass through your esophagus.
• Pain. Advanced esophageal cancer can cause pain.
• Bleeding in the esophagus. Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.

Prevention

You can take steps to reduce your risk of esophageal cancer. For instance:

• Quit smoking. If you smoke, talk to your doctor about strategies for quitting. Medications and counseling are available to help you quit. If you don’t use tobacco, don’t start.
• Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
• Eat more fruits and vegetables. Add a variety of colorful fruits and vegetables to your diet.
• Maintain a healthy weight. If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.