Esophageal (ih-SOF-oh-JEE-uhl) cancer is a disease where cancer cells form in your esophagus. Esophageal cancer starts in the inner lining of your esophagus and spreads outward through the other layers as it grows. There are two main kinds of esophageal cancer:
- Squamous (SKWAH-miss) cell carcinoma (KAR-sihn-OH-muh). In this form of cancer, the disease starts in the flat cells that line your esophagus. This cancer is most common in the upper and middle part of your esophagus but can happen in other areas of the esophagus as well.
- Adenocarcinoma (ah-DEE-no-KAR-sihn-OH-muh). This form of esophageal cancer starts in the cells that make and release mucus and other fluids in your esophagus. This form of cancer often starts in the lower part of your esophagus, near the stomach.
The esophagus (ih-SOF-uh-giss) is part of your digestive system. It is a tube that moves food and liquid from your throat to your stomach. The walls of this tube have several layers of tissue, including an inner lining, muscle, and connective tissue that keeps the esophagus attached to other parts of your body.
Men are about three times more likely than women to develop esophageal cancer. Older people are also more likely to get this kind of cancer, and it is more common in black people than in people of other races.
Risk factors for esophageal cancer include:
- Alcohol use
- Gastric reflux (gah-STRIK REE-fluhks) (heartburn)
- Being overweight
- Not getting enough exercise
- Avoiding smoking and not drinking.
- Exercising more.
- Losing weight.
- Chemoprevention (kee-MOH-prih-VEHN-shun). This is the use of drugs, vitamins, or other medicines that can reduce the risk of cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can lower the risk of certain kinds of cancer. On the other hand, these medicines also have side effects, so you should talk to your doctor about whether this kind of prevention is right for you.
What are the Stages of Esophageal Cancer?
Esophageal cancer is described in stages. There are five stages of this disease:
- Stage 0. In this stage, abnormal cells are found in the esophagus wall. These cells are not cancer but can turn into cancer and move into nearby tissue.
- Stage I. In this stage, your doctor finds cancer cells in the esophagus, but they grow more slowly than other kinds of cancer cells.
- Stage II. In this stage, the cancer cells spread into the muscles, connective tissues, or lymph nodes in and near your esophagus.
- Stage III. In this stage, cancer cells have spread to the mucosal, muscle layer, connective tissue, or lymph nodes in and near the esophagus. The cancer might also have spread to your diaphragm or the sac around your heart. Stage III cancer can be removed with surgery.
- Stage IV. In this stage, the cancer spreads to other parts of your body, like the lungs, liver, kidneys, or bones.
In the early stages of esophageal cancer, you might not notice any symptoms. If the cancer has grown, you might notice symptoms like:
- Painful or difficult swallowing
- Weight loss
- A hoarse voice or cough that does not go away
Because there are no early signs or symptoms of this disease, esophageal cancer is sometimes not diagnosed until it is at an advanced stage.
You should see a doctor if you have any of the symptoms of esophageal cancer, or if you are at risk for developing this disease.
Your doctor may test you for esophageal cancer if:
- You are having the symptoms of esophageal cancer
- You have one or more risk factors for this disease
- Your doctor thinks you might have esophageal cancer for some other reason
Diagnosing Esophageal Cancer
There is no standard screening test for esophageal cancer, but there are a number of tests that can help your doctor diagnose this disease:
- Esophagoscopy (ih-SOF-uh-GO-sko-PEE). During this test, your doctor puts a thin tube down your nose or throat so that they can look at your esophagus. This tube has a camera that lets the doctor take pictures or video of your esophagus. It might also have a small tool that can remove tissue samples that can be tested for cancer.
- Biopsy (BY-op-see). During a biopsy, your doctor removes a small piece of tissue from your esophagus and sends it to a lab to check for signs of cancer.
- Brush cytology (siy-TAH-low-GEE). During this test, cells are brushed from your esophagus and checked for cancer and other diseases.
- Balloon cytology. In this test, you swallow a small, deflated balloon. This balloon is inflated and pulled out of the esophagus. As it is pulled out, the balloon collects cells that can be sent to a lab to study.
Diagnostic tests can help your doctor diagnose esophageal cancer, but they also have some risks, including:
- The test can give a false negative: this happens when a test says you don’t have cancer, but you actually do.
- The test can give a false positive: this happens when a test says you do have cancer, but you don’t.
- The test can cause side effects, like an allergic reaction to the dye used or damage to the esophagus from the tube used for an esophagoscopy.
- Even if your doctor finds that you have cancer, it might not help you live longer.
There are six common kinds of treatment for esophageal cancer. These include:
- Surgery. If you have cancer in your esophagus, surgery is the most common form of treatment. Your doctor removes the part of the esophagus with cancer in an operation called and esophagectomy (ih-SOF-oh-GEK-tuh-mee).
- Radiation therapy. This treatment uses high-energy x-rays or radioactive particles to kill the cancer cells in your body.
- Chemotherapy (KEE-mo-THER-up-ee). This treatment uses anticancer drugs that are injected into your veins or given to you by mouth.
- Chemoradiation (KEE-mo-ray-dee-AY-shun) therapy. This treatment combines chemotherapy and radiation therapy to increase the effects of both.
- Laser therapy. A focused laser beam is used to burn away cancer cells or remove a small piece of tissue for study.
- Electrocoagulation (ee-LEK-tro-coh-AHG-you-LAY-shun). This treatment uses electricity to kill cancer cells.
Only your doctor can decide which esophageal cancer treatment is right for you. This depends on the stage of the cancer, where the cancer is in your esophagus, and other factors that your doctor can talk to you about.