Esophageal cancer develops in the esophagus, the tube that connects the throat (pharynx) to the stomach and propels food to the stomach through muscular contractions. The American Cancer Society estimates that there will be about 20,000 new esophageal cancer cases in 2021 and about 15,000 deaths from esophageal cancer. The 5-year survival rate for people with esophageal cancer is about 20%.
There are two types of esophageal cancer:
Adenocarcinoma: Adenocarcinoma esophageal cancer starts in gland cells at the base of the esophagus. This type of cancer is the most common esophageal cancer and makes up more than half of all new cases. Acid reflux, Gastroesophageal reflux disease (GERD) and Barrett’s Esophagus increase the chance of developing adenocarcinoma esophageal cancer. Barrett’s Esophagus is a condition in which the lining of the esophagus changes to lining similar to that of the small intestine. In some patients, such modification is precancerous and carries an increased risk of developing esophageal cancer. Treating acid reflux and Barrett’s Esophagus (BE) reduces the risk of esophageal cancer (learn more about BE here.)
Squamous Cell Carcinoma: This type of esophageal cancer arises from squamous cells that are primarily in the upper esophagus. Squamous cell carcinoma of the esophagus is strongly associated with heavy smoking and alcohol consumption.
What causes esophageal cancer?
Factors that can increase your risk of esophageal cancer include:
- Heavy alcohol consumption
- Chronic heartburn or acid reflux
- Gastroesophageal reflux disease (GERD)
- Barrett’s Esophagus
- Achalasia, a rare disorder of esophageal muscles
- Age 55+
- Male (men are more prone to developing esophageal cancer than women)
What are the symptoms of esophageal cancer?
If you experience of the following symptoms, it’s crucial to seek treatment from a board-certified gastroenterologist as soon as possible.
- Trouble swallowing (feeling of food is stuck in the chest)
- Chronic heartburn or GERD (burning sensation in the middle of the chest after swallowing)
- Unintended weight
- Persistent coughing
How is esophageal cancer diagnosed?
There are several types of tests to diagnose esophageal cancer. The most common tests are:
- Endoscopy with biopsy: A doctor uses an endoscope (a flexible tube with a small, attached camera) to take tissue samples (this is called a biopsy).
- Endoscopic ultrasonography (EUS): Endoscopic ultrasound is a medical procedure in which endoscopy is combined with ultrasound to obtain images of affected areas.
- PET scan: A PET scan can help to determine if the cancer has spread to areas beyond the esophagus.
How is esophageal cancer treated?
Most treatment plans for esophageal cancer involve a combined approach, which is when you receive a mix of radiation, chemotherapy or surgical treatments, instead of just one type of treatment.
For patients with chronic acid reflux, it’s crucial to receive treatment early – before it has the chance to develop into Barrett’s Esophagus and potentially into esophageal cancer. Learn more about treating Barrett’s Esophagus here.
Is esophageal cancer preventable?
The most effective ways to prevent esophageal cancer are to improve your overall health by:
- Avoiding tobacco and alcohol
- Maintaining a healthy weight
- Eating a healthy, nutrient-rich diet
- Seeking treatment for reflux and heartburn