Esophageal Cancer

The esophagus is a hollow muscular tube that connects the mouth to the stomach. Each time you swallow food or liquid, the esophagus transports it to the digestive system.

Esophageal cancer can develop when cells in the soft tissues lining this tube begin to grow and divide abnormally, forming a tumor. Tumors typically start in the innermost layer of the esophagus and then spread outward. The spread of cancer from the esophagus to the lymph nodes and other organs is called metastasis.

Esophageal cancer is considered rare compared with cancers of the breast, lung, or prostate. Nevertheless, the number of diagnoses for one of the two main types of esophageal cancer, adenocarcinoma, has risen dramatically in the past few decades.

Types of Esophageal Cancer

Most esophageal tumors can be classified as one of two types — adenocarcinoma or squamous cell carcinoma. A third type of esophageal cancer, called small cell carcinoma, is very rare. Because different types of cancer begin in different kinds of cells, they develop in different ways and call for different approaches to treatment.

  • Adenocarcinoma
  • Squamous cell carcinoma
  • Small cell carcinoma

Gastroesophageal Reflux Disease and Esophageal Cancer

Normally, a sphincter muscle at the end of the esophagus opens to allow food to enter the stomach and closes to prevent harmful digestive acids from bubbling back up into the esophagus. When this sphincter muscle does not function normally, however, it can lead to a condition known as GERD. Studies have shown that having severe GERD over the course of many years increases the chance of developing gastroesophageal adenocarcinoma.

Symptoms of Esophageal Cancer

In many cases, esophageal cancer is diagnosed after a person begins to experience symptoms. Some of the most common symptoms of esophageal cancer include:

  • Difficulty swallowing. As the tumor grows, it can narrow the tube through which food and liquids move to the stomach.
  • Pain or discomfort in the chest. Some people with esophageal cancer feel pressure or a burning sensation.
  • Weight loss and lack of appetite. As swallowing becomes more difficult, many people begin to eat less, leading to involuntary weight loss.
  • Other symptoms. Some patients with esophageal cancer experience other symptoms such as hoarseness, a persistent cough, hiccups, pneumonia, bone pain, and bleeding in the esophagus.

Because many of these symptoms are also associated with other medical conditions, having any of them does not necessarily mean that you have esophageal cancer. If you experience any of these symptoms, speak with your doctor. The earlier you are evaluated, the better the chance of detecting esophageal cancer at an earlier stage, when treatment can be more effective.

Risk, Prevention & Screening

A variety of physiological, lifestyle, and environmental factors can make some individuals more likely to develop esophageal cancer than others. Although there is no sure way to prevent esophageal cancer, there are things you can do to reduce your risk.

Risk Factors

The following are the most common risk factors for esophageal cancer.

  • Age
  • Male
  • Smoking and alcohol use
  • Barrett’s esophagus
  • Race
  • Obesity
  • Ingestion of lye
  • Vitamin deficiency

Preventing Esophageal Cancer

There is no sure way to prevent esophageal cancer, but doctors recommend certain behaviors and warn against others to lower risk. Most of them are also ways to preserve your overall health:

  • Quit smoking. The habit is a known risk factor for esophageal cancer and other malignancies.
  • Stop drinking alcohol, or try to cut back.
  • Consult a doctor if you experience persistent heartburn that may be a sign of gastroesophageal reflux disease (GERD).
  • Commit to a regular exercise program and avoid becoming overweight.
    Also consider risk factors and screening for conditions that can set the stage for certain types of esophageal cancer such as GERD, Barrett’s Esophagus & Achalasia.


Screening refers to any test that is given to detect disease before it begins to cause symptoms.

Screening for esophageal cancer is not recommended for most people. However, your doctor may recommend regular endoscopic screening for adenocarcinoma if you have been diagnosed with Barrett’s esophagus or are at high risk of esophageal cancer for other reasons.

Patients with Barrett’s esophagus shall undergo endoscopic screening for esophageal cancer every three years.

Because the symptoms of esophageal cancer only tend to arise when the disease is advanced, screening may enable your doctor to identify the disease earlier, when treatment can be more effective.

Diagnosis & Staging

Getting an accurate diagnosis is the first step toward getting the best cancer care.

Most patients who come for the treatment of esophageal cancer first meet with a surgeon. He or she will work together with gastroenterologists, pathologists, radiologists, and other esophageal cancer experts to determine the specific type of cancer you have and how advanced it is. These findings help your esophageal cancer disease management team to develop the treatment plan that will be most successful for you.