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What is esophageal cancer?

Definition: Esophageal cancer is a malignant tumor of the esophagus (the muscular tube that propels food from the mouth to the stomach).

Causes, incidence, and risk factors: Esophageal cancer is relatively uncommon in the United States, and occurs most often in men over 50 years old. It affects less than 5 in 100,000 people. There are two main types of esophageal cancer, distinguished by the way they look under the microscope: squamous cell carcinoma and adenocarcinoma.

Squamous cell cancer is associated with smoking and alcohol consumption. The incidence of this disease in the United States has remained relatively constant, while the incidence of adenocarcinoma of the esophagus has risen dramatically.

Barrett's esophagus, a complication of gastroesophageal reflux disease (GERD), is a risk factor for the development of adenocarcinoma of the esophagus.

Prevention of esophageal cancer:

Avoiding smoking and reducing or eliminating alcohol consumption can help prevent of squamous cell cancer of the esophagus.

Surveillance EGD (esophagogastroduodenoscopy) and biopsy in people with Barrett's esophagus may lead to early detection and improved survival. People with symptoms of severe reflux should seek medical attention.

People diagnosed with Barrett's esophagus should see a gastroenterologist (gastrointestinal specialist) at least every year.

Symptoms of esophageal cancer:

Tests:

  • Barium swallow
  • EGD (esophagogastroduodenoscopy) and biopsy
  • Chest MRI or thoracic CT (usually used for helping to determine the stage of the disease)
  • PET scan (sometimes useful for determine stage of disease and whether surgery is possible)
  • Evidence of occult blood in stool

Expectations (prognosis): Esophageal cancer is a very difficult disease to treat, but it can be cured in patients whose disease is confined to the esophagus. In circumstances in which surgery can be performed, cure rates are in the range of 25%.

In some circumstances in which the cancer is localized to the esophagus and radiation therapy is used instead of surgery, cure is possible but is less likely than with surgery.

For patients whose cancer has spread outside the esophagus, cure is generally not possible and treatment is directed toward relief of symptoms.

digestivesystem

The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

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