Esophageal cancer is not very common in the United States. It occurs most often in men over 50 years old.
Two main types of esophageal cancer exist: 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 alcohol consumption.
Barrett's esophagus, a complication of gastroesophageal reflux disease (GERD), increases the risk for adenocarcinoma of the esophagus. This is the more common type of esophageal cancer. Other risk factors for adenocarcinoma of the esophagus include:
Male gender
Obesity
Smoking
Symptoms
Backwards movement of food through the esophagus and possibly mouth (regurgitation)
Sometimes chemotherapy, radiation, or a combination of the two may be used instead of surgery, or to make surgery easier to perform.
If the patient 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.
Other treatments that may be used to help the patient swallow include:
Endoscopic dilation of the esophagus (sometimes with placement of a stent to keep the esophagus dilated).
Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor.
Support Groups
Patients can often ease the stress of illness by joining a support group of people who share common experiences and problems. See cancer - support group.
Expectations (prognosis)
Esophageal cancer is usually not curable. When the cancer has not spread outside the esophagus, surgery may improve the chances of survival.
Radiation therapy is used instead of surgery in some cases where the cancer has not spread outside the esophagus.
For patients whose cancer has spread, a cure is generally not possible. Treatment is directed toward relieving symptoms.
Complications
Difficulty swallowing
Pneumonia
Severe weight loss from not eating enough
Spread of the tumor to other areas of the body
Calling your health care provider
Call your health care provider if you have difficulty swallowing with no known cause and it does not get better, or if you have other symptoms of esophageal cancer.
Prevention
The following may help reduce your risk of squamous cell cancer of the esophagus:
Avoid smoking
Limit or do not drink alcoholic beverages
People with symptoms of severe gastroesophageal reflux should seek medical attention.
Screening with EGD and biopsy in people with Barrett's esophagus may lead to early detection and improved survival. People who are diagnosed with Barrett's esophagus should consider getting regular checkups for esophageal cancer.
References
Das A. Tumors of the esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 46.
National Cancer Institute. Esophageal Cancer Treatment PDQ. Updated July 20, 2010.
Review Date:
1/31/2011
Reviewed By:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
