An esophageal cancer affects the esophagus, a long muscular tube that connects the throat and stomach. It carries food and liquids from the mouth to the digestive system. There are a number of symptoms associated with esophageal cancer, including difficulty swallowing, chest pain, weight loss, and spread to other tissues and organs.
The exact cause of esophageal cancer is not known, but some factors may increase the risk of developing it. These include:
Age: Esophageal cancer is more common in people over 60 years old.
Gender: Esophageal cancer is more common in men than in women.
Race: Esophageal cancer is more common in people who are Black or Asian than in people who are white.
Tobacco use: Smoking cigarettes, cigars, pipes, or chewing tobacco can damage the cells that line the esophagus and increase the risk of esophageal cancer.
Alcohol use: Drinking alcohol can irritate the esophagus and increase the risk of esophageal cancer, especially when combined with tobacco use.
Gastroesophageal reflux disease (GERD): GERD is a condition where stomach acid flows back into the esophagus, causing heartburn and inflammation. Over time, this can damage the esophageal lining and increase the risk of esophageal cancer.
Barrett’s esophagus: Barrett’s esophagus is a complication of GERD where the normal cells of the esophagus are replaced by abnormal cells that are more resistant to acid. These cells have a higher chance of becoming cancerous than normal cells.
Obesity: Being overweight or obese can increase the pressure on the stomach and cause acid reflux, which can lead to GERD and Barrett’s esophagus.
Diet: Eating a diet that is low in fruits and vegetables and high in processed meats, salt, and pickled foods can increase the risk of esophageal cancer.
Family history: Having a close relative who has had esophageal cancer may increase the risk of developing it.
Esophageal cancer may not cause any symptoms in its early stages. As it grows and spreads, it may cause:
Difficulty swallowing (dysphagia): This is one of the most common symptoms of esophageal cancer. It may feel like food or liquids get stuck in the throat or chest, or cause pain or discomfort when swallowing.
Weight loss: This may occur due to difficulty swallowing or reduced appetite.
Chest pain, pressure, or burning: This may occur when the tumor presses on nerves or other structures in the chest.
Worsening indigestion or heartburn: This may occur due to acid reflux or tumor growth.
Coughing or hoarseness: This may occur due to irritation of the throat or vocal cords by the tumor or acid reflux.
Bleeding: This may occur when the tumor erodes into blood vessels or causes ulcers in the esophagus. It may cause vomiting blood, black stools, or anemia (low red blood cell count).
In order to diagnose esophageal cancer, a healthcare provider will ask about symptoms, medical history, and risk factors. They will also perform a physical exam and order some tests.
The endoscope is a thin flexible tube with a camera and light that is inserted into the esophagus through the mouth. As a result of the endoscope, healthcare providers can see inside the esophagus and look for abnormalities. An examination under a microscope may also result in the removal of a biopsy (small sample of tissue) from suspicious areas.
A barium swallow is a test in which you swallow a liquid containing barium (a contrast agent), and then the esophagus and stomach are X-rayed. The barium coats the inside of the digestive tract, making it easier to see any tumors or blockages.
It uses X-rays and a computer to produce detailed images of the inside of the body. A CT scan can show the size and location of any tumors in the esophagus or nearby organs. The test can also be used to determine if the cancer has spread to the lungs, liver, or bones.
Using a radioactive substance (tracer), a PET scan measures the amount of tracer absorbed by certain cells by measuring how active they are by injecting it into a vein. The PET scan can help determine the extent and aggressiveness of the cancer as well as whether it has spread to other parts of the body. Cancer cells tend to absorb more tracer than normal cells.
In blood tests, certain substances, such as blood cells, enzymes, hormones, or tumor markers, are measured in the blood. Using blood tests, you can check for infections, inflammation, anemia, liver or kidney problems, and check for signs of anemia, inflammation, and anemia. In addition to monitoring the response to treatment, blood tests can also detect cancer recurrences.
Several factors determine the treatment of esophageal cancer, such as the type, stage, location, and size of the tumor, the overall health and preferences of the patient, and the availability of resources.
During surgery, part or all of the esophagus, as well as nearby lymph nodes, are removed. The remaining part of the esophagus is reconnected to the stomach or part of the intestine. It can be performed alone or in combination with other treatments. By inserting a stent (a metal or plastic tube) inside the esophagus, surgery can also relieve symptoms, such as difficulty swallowing or bleeding.
Cancer cells are killed or stopped from growing with drugs in chemotherapy. When advanced or metastatic cancer cannot be removed by surgery, chemotherapy may be given before surgery (neoadjuvant) to shrink the tumor and make it easier to remove, after surgery (adjuvant) to kill any remaining cancer cells and reduce the risk of recurrence, or as a main treatment. Also, chemotherapy can relieve symptoms and improve quality of life.
In radiation therapy, high-energy rays or particles are used to destroy or stop cancer cells from growing. During surgery (neoadjuvant), radiation therapy shrinks the tumor and makes removal easier, after surgery (adjuvant) to kill remaining cancer cells and reduce recurrence risk, or as the primary treatment for advanced or metastatic cancer that cannot be removed through surgery. In addition to relieving symptoms and improving quality of life, radiation therapy may also be used.
It involves using drugs to stimulate the immune system to recognize cancer cells and attack them. Advanced or metastatic cancers that do not respond to chemotherapy or radiation therapy may be treated with immunotherapy alone or in combination with other treatments. Furthermore, immunotherapy may be used to relieve symptoms and improve quality of life.
There is no sure way to prevent esophageal cancer, but some steps may help reduce the risk. These include:
Avoiding tobacco use: Quitting smoking or chewing tobacco can lower the risk of esophageal cancer. If you need help quitting, talk to your healthcare provider about nicotine replacement products, medications, counseling, or other resources.
Limiting alcohol use: Drinking less alcohol or avoiding it altogether can lower the risk of esophageal cancer. If you choose to drink alcohol, do so in moderation. The recommended limit is no more than one drink per day for women and people DFAB and no more than two drinks per day for men and people DMAB.
Managing GERD: Treating GERD with medications, lifestyle changes, or surgery can lower the risk of developing Barrett’s esophagus and esophageal cancer. If you have GERD, talk to your healthcare provider about your treatment options and follow their advice.
Maintaining a healthy weight: Losing weight if you are overweight or obese can lower the pressure on your stomach and reduce acid reflux, which can lower the risk of GERD and esophageal cancer. If you need help losing weight, talk to your healthcare provider about a healthy diet and exercise plan that suits your needs.
Eating a balanced diet: Eating a diet that is rich in fruits and vegetables and low in processed meats, salt, and pickled foods can lower the risk of esophageal cancer. Fruits and vegetables contain antioxidants, vitamins, minerals, and fiber that can protect against cell damage and inflammation. Processed meats, salt, and pickled foods contain chemicals that can damage the cells that line the esophagus.
Screening for Barrett’s esophagus: If you have chronic GERD or a family history of Barrett’s esophagus or esophageal cancer, you may benefit from screening for Barrett’s esophagus. Screening involves having an endoscopy every few years to check for any abnormal changes in the esophageal lining. If Barrett’s esophagus is detected, it can be monitored closely and treated if needed to prevent it from progressing to esophageal cancer.
As the name suggests, esophageal cancer affects the long muscular tube that connects the throat to the stomach, causing difficulty swallowing, chest pains, weight loss, and other symptoms. It can also spread to other organs and tissues, such as the liver.
