Esophageal Cancer
Information, Symptoms, Treatments and Resources
Esophageal cancer is a malignant (cancerous) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach.
See also: Barrett's esophagus
Esophageal cancer is relatively uncommon in the United States, and occurs most often in men over 50 years old. It affects less than 5 in 100,000 people. 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 associated with smoking and alcohol consumption. The rate of this disease in the United States has remained mostly the same, while the rate of adenocarcinoma of the esophagus has risen dramatically.
Barrett's esophagus, a complication of gastroesophageal reflux disease (GERD), is a risk factor for the development of adenocarcinoma of the esophagus.
Risk factors for adenocarcinoma of the esophagus include male gender, obesity, poor nutrition, and smoking.
- Backwards movement of food through the esophagus and possibly mouth (regurgitation)
- Chest pain unrelated to eating
- Difficulty swallowing solids or liquids
- Heartburn
- Vomiting blood
- Weight loss
Tests used to help diagnose esophageal cancer may include:
- Barium swallow
- Esophagogastroduodenoscopy (EGD) and biopsy
- Chest MRI or thoracic CT (usually used for helping to determine the stage of the disease)
- PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible)
Stool sample testing may show signs of hidden (occult) blood in the stool.
When esophageal cancer is only in the esophagus and has not spread elsewhere, surgery is the treatment of choice. The goal of surgery, in most cases, is to cure the patient. In some circumstances chemotherapy, radiation, or a combination of the two will be used instead of surgery, or to make surgery easier to perform.
If the patient cannot tolerate 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 circumstances, however, the disease is usually not curable.
Other treatments that may be used to improve a patient's ability to swallow include endoscopic dilation of the esophagus (sometimes with placement of a stent), or photodynamic therapy. In photodynamic therapy, a special drug is injected into the tumor, which is then exposed to light. The light activates the medicine that attacks the tumor.
Esophageal cancer is a very difficult disease to treat, but it can be cured when it has not spread outside the esophagus. Cure rates are in the range of 25% for those who can have surgery.
Radiation therapy is used instead of surgery in some cases where the cancer has not spread outside the esophagus.
For patients whose cancer has spread, cure is generally not possible and treatment is directed toward relief of symptoms.
- Difficulty swallowing
- Pneumonia
- Severe weight loss resulting from not eating enough
- Spread of the tumor to other areas of the body
Call your health care provider if you have difficulty swallowing with no known cause and it does not get better, or if you have other symptoms of esophageal cancer.
The following may help reduce your risk of squamous cell cancer of the esophagus:
- Avoid smoking
- Limit or eliminate alcoholic drinks
People with symptoms of severe reflux should seek medical attention.
Screening with EGD and biopsy in people with Barrett's esophagus may lead to early detection and improved survival. People diagnosed with Barrett's esophagus should see a gastroenterologist (digestive system specialist) at least every year.
Kleinberg LR, Forastier AA, Heitmiller RF. Cancer of the esophagus. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 3rd ed. Orlando, Fl: Churchill Livingstone; 2004; chapt 77.
Esophageal Cancer. NCCN Clinical Practice Guidelines in Oncology (Version 1.2008). Copyright 2008 National Comprehensive Cancer Network, Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. � 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
