About Esophageal Cancer

Types of esophageal cancer

There are two main types of esophageal cancer. The most common type, adenocarcinoma, develops in the lower part of the esophagus near the opening of the stomach. About 50 percent of people with esophageal cancer have adenocarcinoma.

The other type of esophageal cancer is squamous cell carcinoma, which grows in the cells that form the inner lining of the esophagus. These cells are called squamous cells. This type of cancer can grow anywhere in the esophagus. The treatment for both types of esophageal cancer is similar.

Symptoms of esophageal cancer

Often, there are no symptoms in the early stages of esophageal cancer. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer: 

  • Difficult or painful swallowing
  • Sensation of having food lodged in the chest (some people switch to softer foods with this problem)
  • Pain in the throat or back, behind the breastbone or between the shoulder blades
  • Severe weight loss (losing weight without trying)
  • Hoarseness or cough that does not go away within two weeks
  • Vomiting
  • Coughing up blood
  • Heartburn

Other medical conditions can also cause these symptoms, and you might have different symptoms. If you have any of these symptoms, talk to your doctor.

There is no routine screening examination for esophageal cancer. If you have Barrett's esophagus, you should be examined often because you have a higher risk of esophageal cancer.

Causes & Risk Factors for Esophageal Cancer

The exact cause of esophageal cancer is still unknown. There are multiple factors that can increase your risk of esophageal cancer. These risk factors include:

  • Age: Most people with esophageal cancer in the United States are 65 or older.
  • Obesity
  • Gender: Men are three times more likely to get esophageal cancer.
  • Tobacco use: Using any form of tobacco, but especially smoking, increases your risk of esophageal cancer. The longer you use tobacco, the greater your risk. The greatest risk is in people who have consumed alcohol for many years and have also smoked or used tobacco for a long time. Scientists believe alcohol and tobacco increase each other's harmful effects. People who smoke and drink are especially likely to get esophageal cancer.
  • Alcohol: Having more than three alcoholic drinks a day puts you at high risk for esophageal cancer.
  • Acid reflux: Long-term reflux (heartburn) changes the cells at the end of the esophagus. This can cause Barrett's esophagus, which is a precancerous condition that raises the risk of developing adenocarcinoma.
  • Diet: Diets low in fruits and vegetables and certain vitamins and minerals can increase the risk of esophageal cancer.
  • Other irritants: Swallowing caustic irritants such as lye and other substances can burn and destroy cells in the esophagus. The scarring and damage can raise your risk of getting esophageal cancer many years later.
  • Medical history: Certain diseases, such as achalasia, a disease in which the bottom of the esophagus does not open to release food into the stomach, and tylosis, a rare inherited disease, increase the risk of esophageal cancer. If you have had other head and neck cancers, you have a  higher risk of developing includes esophageal cancer.

Diagnosing esophageal cancer

In addition to a complete medical history and physical examination, your doctor may perform the following tests to diagnose your esophageal cancer:
  • Chest X-ray: A test that uses invisible energy beams to produce images of internal tissues, bones and organs on film.
  • Upper GI (gastrointestinal) series, also called barium swallow: A test that examines the organs of the upper part of the digestive system. You swallow a chalky-tasting liquid called barium that makes these organs show up on X-ray film. Next, a technician takes X-rays so doctors can examine your digestive organs.
  • Esophagogastroduodenoscopy (EGD or upper endoscopy): A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube called an endoscope, is guided into your mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope lets the doctor see inside this area and use instruments to take a small tissue sample if necessary.
  • Computed tomography scan (CT or CAT scan): An imaging procedure that uses X-rays and computer technology to produce images. CT scans are more detailed than general x-rays.
  • Endoscopic ultrasound: A technique that uses sound waves to create a computer image of the inside of the esophagus and stomach. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. This lets the doctor see inside of this area and use instruments to take a small tissue sample if necessary.
  • Thoracoscopy/laparoscopy : A procedure that uses a hollow, lighted tube to look at the lymph nodes inside the chest or abdomen and remove them for further testing.

Treatments for Esophageal Cancer

At OHSU Knight Cancer Institute, we work together to develop an individualized treatment plan for each patient. Your treatment plan for your esophageal cancer may include:

  • Surgery
  • Chemotherapy
  • Radiation therapy

Learn more about treatment options for esophageal cancer