Esophagus

Esophageal cancer is cancer that occurs in the esophagus – a long, hollow tube that runs from your throat to your stomach. Your esophagus helps transport the food you swallow down the back of your throat into your stomach to be digested.

Esophageal cancer usually begins in the cells lining the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women develop esophageal cancer.

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary in different geographic locations. In some regions, high esophageal cancer rates can be attributed to tobacco and alcohol use or certain dietary habits and obesity.

 

The symptoms

Signs and symptoms of esophageal cancer include:

  • Difficulty swallowing (dysphagia)
  • Losing weight without trying
  • Chest pain, pressure, or burning
  • Indigestion or heartburn
  • Cough or hoarseness
  • Early esophageal cancer typically causes no signs or symptoms.

 

When to see a doctor

Make an appointment with your doctor if you have persistent signs and symptoms that worry you.

If you’ve been diagnosed with Barrett’s esophagus, a pre-cancerous condition caused by chronic acid reflux, your risk of esophageal cancer is higher. Ask your doctor what signs and symptoms you should watch for that might indicate that your condition is getting worse.

Esophageal cancer screening may be an option for people with Barrett’s esophagus. If you have Barrett’s esophagus, discuss the pros and cons of screening with your doctor.

 

Reasons

It’s unclear exactly what causes esophageal cancer.

Esophageal cancer occurs when cells in the esophagus develop changes (mutations) in their DNA. The changes cause cells to grow and get out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

 

Esophageal cancer types

Esophageal cancer is classified according to the type of cells involved. The type of esophageal cancer you have helps determine your treatment options. Esophageal cancer types include:

  • Adenocarcinoma. Adenocarcinoma begins in the cells of the glands that secrete mucus in the esophagus. Adenocarcinoma is most common in the lower esophagus. Adenocarcinoma is the most common type of esophageal cancer in the United States and primarily affects white men.
  • Squamous cell carcinoma. Squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma is most common in the upper and middle parts of the esophagus. Squamous cell carcinoma is the most common esophageal cancer worldwide.
  • Other rare species. Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma, and choriocarcinoma.

 

Risk factors

It is thought that chronic irritation of your esophagus may contribute to the changes that cause cancer of the esophagus. Factors that cause irritation to cells in your esophagus and increase your risk of esophageal cancer include:

  • Having gastroesophageal reflux disease (GERD)
  • To smoke
  • Pre-cancerous changes in esophagus cells (Barrett’s esophagus)
  • Being obese
  • To drink alcohol
  • Having bile reflux
  • Difficulty swallowing due to the esophageal sphincter not being relaxed (achalasia)
  • Having the habit of constantly drinking very hot liquids
  • Not eating enough fruits and vegetables
  • Radiation therapy is applied to the chest or upper abdomen.

 

Complications

As esophageal cancer progresses, it can cause complications such as:

  • Obstruction of the esophagus. Cancer can make it difficult for food and fluid to pass through your esophagus.
  • Ache. Advanced esophageal cancer can cause pain.
  • Bleeding in the esophagus. Esophageal cancer can cause bleeding. Although the bleeding is usually gradual, it can be sudden and severe at times.

 

Prevention

You can take steps to reduce your risk of esophageal cancer. For example:

  • Quitting smoking. If you smoke, talk to your doctor about quitting strategies. Medications and counseling are available to help you quit. If you don’t use tobacco, don’t start.
  • If nothing else, drink alcohol in moderation. If you choose to drink alcohol, do so in moderation. For healthy adults, this means one drink a day for women and two glasses a day for men.
  • eat more fruits and vegetables. Include a variety of colorful fruits and vegetables in your diet.
  • Maintain your healthy weight. If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.