About Esophageal Cancer

What causes esophageal cancer? 

No one knows exactly what causes esophageal cancer. At the top of the esophagus is a muscle, called the sphincter,  lets food or liquid through. The lower part of the esophagus is connected to the stomach, where another muscle allows food to enter the stomach. This muscle also works to keep food and juices from the stomach from backing up into the esophagus. When these juices do back up, reflux (heartburn) occurs.

Having reflux (heartburn) for a long time can change the cells at the lower end of the esophagus. This condition is called Barrett's esophagus. If these cells are not treated, you have a higher risk of 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.
Squamous cell carcinoma 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.
Treatment for both types of esophageal cancer is similar.

What are the 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.

What are the risk factors for esophageal cancer?

Some things that can increase your risk of esophageal cancer:

• Age
  Most people with esophageal cancer in the United States are 65 or older.
• 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 drunk 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. Drinking alcohol.
  Having more than three alcoholic drinks a day puts you at high risk for esophageal cancer.
• Barrett's esophagus
  Long-term reflux (heartburn) changes the cells at the end of the esophagus. This 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.
• Obesity Being very overweight
• Having acid reflux

This condition can cause Barrett’s esophagus, which raises your risk of getting esophageal cancer.

Diagnosing 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: the esophagus, stomach and duodenum (the first section of the small intestine). You will 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 seeinside 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 produceimages. 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 seeinside of this area and use instruments to take a small tissue sample if necessary.
• Thoracoscopy and laparoscopy – your doctor uses a hollow, lighted tube to look at the lymph nodes inside the chest or abdomen and remove themfor further testing.