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Esophageal Cancer

Did you know that every 36 minutes someone in the U.S. dies of esophageal cancer? Learn more about esophageal cancer and how we can help.

 

About

Esophageal cancer is cancer that occurs in the esophagus —a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic-locations. In some regions, higher rates of esophageal cancer may be attributed to tobacco and alcohol use or nutritional habits and obesity.

 

Statistics

  • About 20,640 new esophageal cancer cases diagnosed (16,510 in men and 4,130 in women)
  • About 16,410 deaths from esophageal cancer (13,250 in men and 3,160 in women)
  • Esophageal cancer is more common among men than among women. The lifetime risk of esophageal cancer in the United States is about 1 in 125 in men and about 1 in 417 in women. (See Esophageal Cancer Risk Factors to learn about factors that can affect these chances.)
  • Adenocarcinoma is the most common type of cancer of the esophagus among caucasians, while squamous cell carcinoma is more common in African Americans. American Indian/Alaska Natives and Hispanics have lower rates of esophageal cancer, followed by Asians/Pacific Islanders.
  • Although many people with esophageal cancer will go on to die from this disease, treatment has improved, and survival rates are getting better. During the 1960s and 1970s, only about 5% of patients survived at least 5 years after being diagnosed. Now, about 20% of patients survive at least 5 years after diagnosis. This number includes patients with all stages of esophageal cancer. Survival rates for people with early-stage cancer are higher.

Symptoms

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.

Diagnosis

Tests and procedures used to diagnose esophageal cancer include:

  • Barium swallow study. During this study, you swallow a liquid that includes barium and then undergo X-rays. The barium coats the inside of your esophagus, which then shows any changes to the tissue on the X-ray.
  • Using a scope to examine your esophagus (endoscopy). During endoscopy, your doctor passes a flexible tube equipped with a video lens (video endoscope) down your throat and into your esophagus. Using the endoscope, your doctor examines your esophagus, looking for cancer or areas of irritation.
  • Collecting a sample of tissue for testing (biopsy). Your doctor may use a special scope passed down your throat into your esophagus (endoscope) to collect a sample of suspicious tissue (biopsy). The tissue sample is sent to a laboratory to look for cancer cells.

Determining the extent of the cancer

Once a diagnosis of esophageal cancer is confirmed, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body. Tests may include:

  • Bronchoscopy
  • Endoscopic ultrasound (EUS)

Treatment

Surgery to remove the cancer can be used alone or in combination with other treatments. Operations used to treat esophageal cancer include:

  • Surgery to remove very small tumors. If your cancer is very small, confined to the superficial layers of your esophagus and hasn’t spread, your surgeon may recommend removing the cancer and margin of healthy tissue that surrounds it. Surgery can be done using an endoscope passed down your throat and into your esophagus.
  • Surgery to remove a portion of the esophagus (esophagectomy). During esophagectomy, the surgeon removes the portion of your esophagus that contains the cancer, along with a portion of the upper part of your stomach, and nearby lymph nodes. The remaining esophagus is reconnected to your stomach. Usually this is done by pulling the stomach up to meet the remaining esophagus.
  • Surgery to remove part of your esophagus and the upper portion of your stomach (esophagogastrectomy). During esophagogastrectomy, the surgeon removes part of your esophagus, nearby lymph nodes and a larger part of your stomach. The remainder of your stomach is then pulled up and reattached to your esophagus. If necessary, part of your colon is used to help join the two.
  • Esophageal cancer surgery carries a risk of serious complications, such as infection, bleeding and leakage from the area where the remaining esophagus is reattached to the stomach.

Treatments for complications

Treatments for esophageal obstruction and difficulty swallowing (dysphagia) can include:

  • Relieving esophageal obstruction. If your esophageal cancer has narrowed your esophagus, a surgeon may use an endoscope and special tools to place a metal tube (stent) to hold the esophagus open. Other options include surgery, radiation therapy, chemotherapy, laser therapy and photodynamic therapy.
  • Providing nutrition. Your doctor may recommend a feeding tube if you’re having trouble swallowing or if you’re having esophagus surgery. A feeding tube allows nutrition to be delivered directly to your stomach or small intestine, giving your esophagus time to heal after cancer treatment.

Resources

Providers

The Surgeons at Northwest Institute for Digestive Surgery are trained in the entire spectrum of benign and malignant digestive diseases. Our specialists have completed accredited fellowship training programs. Fellowship training is beyond what is required in standard residency training and is the highest level of surgical training attainable. Our surgeons have completed this rigorous training in order to become the highest-level experts in the medical and surgical aspects of gastrointestinal diseases.

Contact Us

Northwest Institute for Digestive Surgery

750 N. Syringa Street, Suite 204
Post Falls, ID 83854

DIRECTIONS

(208) 457 –0945 | Phone
(208) 415 –0150 | Fax 

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