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Esophageal cancer

Cancer - esophagus

Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach.

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Causes

Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old.

There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope.

Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol.

Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese.

Symptoms

Symptoms may include any of the following:

Exams and Tests

Tests used to help diagnose esophageal cancer may include:

Stool testing may show small amounts of blood in the stool.

Treatment

Upper endoscopy (EGD) will be used to obtain a tissue sample from the esophagus to diagnose cancer.

When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using:

Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus.

Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform.

If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable.

Beside a change in diet, other treatments that may be used to help the patient swallow include:

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone

Outlook (Prognosis)

When the cancer has not spread outside the esophagus, surgery may improve the chance of survival.

When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your health care provider if you have difficulty swallowing with no known cause and it does not get better. Also call if you have other symptoms of esophageal cancer.

Prevention

To reduce your risk of cancer of the esophagus:

Related Information

Alcohol use and safe drinking
Barrett esophagus
Gastroesophageal reflux disease
Esophagectomy - minimally invasive
Esophagectomy - open
Gastrostomy feeding tube - bolus
Jejunostomy feeding tube
Esophagectomy - discharge

References

Kleinberg L, Kelly R, Yang S, et al. Cancer of the esophagus. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 74.

National Cancer Institute: PDQ Esophageal cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified 12/5/2014. www.cancer.gov/cancertopics/pdq/treatment/esophageal/HealthProfessional. Accessed January 22, 2014.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Esophageal and esophagogastric junction cancers. Version 1.2015. www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Accessed January 22, 2014.

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Review Date: 1/22/2015  

Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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