Esophageal Cancer

What Is Esophageal Cancer?

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus, the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue including mucous membrane, muscle, and connective tissue. Esophageal cancer starts on the inside lining of the esophagus and spreads outward through the other layers as it grows.

The two most common forms of esophageal cancer are named for the type of cells that become malignant (cancerous):

• Squamous cell carcinoma: Cancer that forms in the thin, flat cells lining the inside of the esophagus.
• Adenocarcinoma: Cancer that begins in glandular cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus.

Risk Factors

• Health History
• Tobacco use.
• Heavy alcohol use.
• Barrett esophagus: A condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to cancer of the esophagus. Gastric reflux (heartburn) is the most common cause of Barrett esophagus.
• Older age

Signs and Symptoms

• Painful or difficult swallowing
• Weight loss
• Pain behind the breastbone
• Hoarseness and cough
• Indigestion and heartburn
• A lump under the skin

Testing

Providers use tests and procedures that examine the esophagus to diagnose esophageal cancer, including the following:

• Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual.
• Chest X-ray: An X-ray is a type of energy beam that can go through the body and onto film making a picture of areas inside the body.
• Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. In this procedure, providers insert an esophagoscope through the mouth or nose and down the throat into the esophagus.
• Biopsy: The removal of cells or tissues, so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Prognosis

The prognosis and treatment options depend on the following:

• The stage of the cancer (whether it affects part of the esophagus, involves the whole esophagus, or has spread to other places in the body).
• Whether the tumor can be completely removed by surgery.
• The patient's general health.

Download our booklet to learn more about staging and potential spreading of esophageal cancer.

Treatment Options

Six types of standard treatments are used:

• Surgery - Surgery is the most common treatment for cancer of the esophagus. Part of the esophagus may be removed in an operation called an esophagectomy.
• Radiation therapy - Uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing.
• Chemotherapy - Uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.
• Chemoradiation therapy - Combines chemotherapy and radiation therapy to increase the effects of both.
• Laser therapy - uses a laser beam (a narrow beam of intense light) to kill cancer cells.
• Electrocoagulation - uses an electric current to kill cancer cells.
• Targeted Therapy such as Monoclonal Antibodies - uses drugs or other substances to identify and attack specific cancer cells.

Clinical Trials

Our specialists are continuously testing new types of treatments in clinical trials such as targeted therapy. Patients may want to think about taking part in a clinical trial, entering before, during, or after starting their cancer treatment.

This content was last medically reviewed in May 2022 by Sharlotte Manley, MSN, FNP, Erlanger Gastroenterology.