Esophageal Cancer | Cancer | Loyola Medicine

Esophageal Cancer

Overview and Facts about Esophageal Cancer

Esophageal cancer is the presence of an abnormal tumor in the esophagus of the gastrointestinal tract. In 2018, esophageal cancer was responsible for around 2-3% of all cancer-related deaths in the United States. It affects both men and women. Nearly 0.5% of all individuals will be diagnosed with esophageal cancer in their lifetimes. There are two common forms of esophageal cancer: adenocarcinoma and squamous cell carcinoma. African-Americans are two times more likely than Caucasian-Americans to develop the squamous cell form of esophageal cancer.

The formation of esophageal tumors is primarily driven by genetic changes within the tissue cells of the esophagus, which is a tube above your stomach and below your throat. Your esophagus performs a key function in your digestive health because it is responsible for carrying solid food and liquid from your mouth to your stomach for further digestion. As the location of esophageal tumors may vary, individuals with esophageal cancer may experience problems in the transport of food from their throats to their stomachs.

Signs and Symptoms of Esophageal Cancer

During early stages of esophageal cancer, those affected may experience little to no symptoms. However, during later stages of the disease, those affected may experience one or more of the following symptoms:

  • A persistent cough
  • Unexplained weight loss
  • A persistently hoarse or dry-sounding voice
  • Difficulty swallowing solid food, such as raw vegetable, meats, and bread
  • Vomiting
  • Choking
  • Throat pain
  • Pain or a burning sensation in the chest, resembling heartburn or indigestion

Since many of these symptoms are shared with other diseases, it is important to consult with a doctor to determine if these symptoms are attributable to esophageal cancer.  

Causes and Risk Factors of Esophageal Cancer

Lifestyle factors, such as tobacco smoking, alcohol abuse, and poor nutrition can lead to an increased risk of esophageal cancer. Risk is also associated with age, as esophageal cancer is often diagnosed in individuals between the ages of 45-70. Children are more likely to develop esophageal cancer if they ingest lye, a chemical often found in household drain cleaners. Gender also plays a role in esophageal cancer; men are diagnosed with the disease at 4 times the rate of women.

Some health conditions may also increase an individual’s risk of esophageal cancer. These conditions include achalasia and Barrett’s esophagus. Achalasia is a condition where the lower muscular ring, or sphincter, of the esophagus fails to relax to allow food to easily pass to the stomach while eating. Individuals with Barrett’s esophagus, caused by chronic gastroesophageal reflux disease (GERD) and/or chronic inflammation in their esophagus, have an increased risk of developing esophageal cancer.

Tests and Diagnosis of Esophageal Cancer

Esophageal cancer is diagnosed in a variety of ways that include the use of imaging technology, such as X-rays and ultrasounds, and tumor tissue sampling (biopsy). An endoscopy, which involves the use of very thin tubes with lights and a camera, may be performed to more closely identify abnormal tissue growths or tumors within the esophagus. Computed tomography (CT or CAT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans may also be performed to observe soft esophageal tissue and screen for any abnormal tumor tissue in the esophagus.

Molecular tests may also be performed to screen for cancer biomarkers in the blood. 

Treatment and Care for Esophageal Cancer

Esophageal cancer is a treatable condition, especially when it is diagnosed at early stages of the disease. Treatment mechanisms include surgery to remove the tumor tissue and radiation and chemotherapy to directly destroy cancer cells. Targeted therapies may also be used to make the tumor’s living environment less hospitable.

There are several ways to treat unwanted symptoms and side effects of esophageal cancer. Such treatments fall under the term “endoscopic therapy.” Endoscopic therapy is often used to open or widen the esophagus, which permits more comfortable food passage to the stomach. Endoscopic therapies include endoscopy with stent placement, endoscopy with dilation, cryotherapy, and photodynamic therapy.