Esophageal Cancer

Esophageal cancer forms in the tissue lining of the muscular tube within the neck connecting the throat and stomach known as the esophagus. The esophagus has several layers, and esophageal cancers start in the innermost layer (the mucosa) and spread outward (through the submucosa and the muscle layer). Growths within the walls of the esophagus may be benign (non-cancerous) or malignant (cancerous). This cancer is 3-4 times more common among men than among women1.

Credit: American Cancer Society

What are the different types of esophageal cancer?

There are several types of esophageal cancer that affect the different cells of this organ. Read more about the types of esophageal cancer at:

What are the symptoms of esophageal cancer?

As esophageal cancer grows, the common symptoms are:

  • Food getting stuck in the pathway of the esophagus and food coming back up
  • Pain when swallowing
  • Pain in the chest or back
  • Weight loss
  • Heartburn
  • A hoarse voice or cough that doesn’t go away within 2 weeks

How is esophageal cancer diagnosed?

Physical exams will particularly focus on the neck and chest area to check for any abnormalities.

Imaging tests use x-rays, magnetic fields, or sound waves to create pictures of the inside of your body. For esophageal cancer, these tests will include barium swallow x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emissions tomography (PET) scans.

Endoscopic tests are the examination of the esophagus using instruments that are inserted into the throat via the mouth. For esophageal cancer, these tests include upper endoscopy, endoscopic ultrasound, and bronchoscopy.

Biopsy is the removal of tissue from the esophagus from its inner layer for examination under the microscope. Biopsy is the only way to make an esophageal cancer diagnosis and determine its type.

What are the different stages of esophageal cancer?

The most common system used to stage esophageal cancer is the TNM system of the American Joint Committee on Cancer (AJCC).

The TNM system describes 4 key pieces of information:

  • T refers to how far the primary tumor has grown into the wall of the esophagus and into nearby organs.
  • N refers to cancer spread to nearby lymph nodes.
  • M indicates whether the cancer has metastasized (spread to distant organs).
  • G describes the grade of the cancer, which is based on how the patterns of cancer cells look under a microscope.

What are the treatments for esophageal cancer?

This esophageal cancer treatment information does not outline the particular treatment(s) a patient will receive. Rather, it provides general information about the typical treatments used for this type of cancer.

Primary treatment options:

Surgery is commonly used to treat cases of esophageal cancer that have not metastasized (spread) past the esophagus and nearby lymph nodes. The goal of this surgery, called an esophagectomy, is to remove the cancer and nearby tissue that may be affected. During this procedure, the surgeon removes the cancerous part of the esophagus, nearby lymph nodes, and part of the stomach if necessary. After the removal, the remaining healthy portion of the esophagus is attached to the stomach.

Chemotherapy is the use of drugs to treat cancer. Patients with non-metastatic, but advanced case of cancer may receive chemotherapy and radiation therapy prior to surgery to shrink an esophageal tumor and kill esophageal cancer cells that are not visible. If esophageal cancer has spread to other organs, chemotherapy is given to lessen present symptoms, such as difficulty swallowing and pain.

Radiation therapy uses high-energy rays or particles to kill cancer cells. In combination with chemotherapy, radiation therapy is frequently used to shrink esophageal cancer before an esophagectomy. Radiation therapy is also used to lessen present symptoms, such as swallowing problems.

Secondary treatment options:

Endoscopic Mucosal Resection (EMR) is a new and effective treatment for esophageal cancer in its early stages. It is generally used as an alternative treatment for those who cannot have surgery. Using special tools, surgeons lift and cut tumors from the outer mucosal and submuscosal layers of the esophagus.

What are the risk factors of esophageal cancer?

  • Acid Reflux Disease: is correlated to higher incidences of esophageal cancer.
  • Hiatal Hernia: may lead to acid reflux disease, a contributing factor to esophageal cancer
  • Obesity: is linked to higher rates of acid reflux disease, a contributing factor to esophageal cancer
  • Smoking and alcohol abuse: may cause esophageal cancer development.
  • Chronic heartburn: is linked to higher rates of esophageal cancer.

How is esophageal cancer prevented?

  • Avoiding smoking
  • Limiting consumption of alcohol
  • If you have severe heartburn, more than twice a week, contact your healthcare provider so that precancerous esophageal conditions may be detected early 
Mikayla D. Williams , BS student, Nursing , The University of Arizona
Michael Principe, MA, Information Resources and Library Science
Works Cited: 
American Cancer Society (2014). Esophagus cancer.
Works Consulted: 
National Cancer Institute (2014). Esophageal cancer.
American Society of Clinical Oncology (2014). Esophageal cancer.