Esophageal Cancer

Esophageal Cancer

Esophageal cancer, also called esophagus cancer, is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach. The esophagus, located just behind the trachea, is about 10 to 13 inches in length and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.

Esophageal Cancer

The American Cancer Society (ACS) estimates that 18,170 Americans will be newly diagnosed with esophageal cancer during 2014. About 15,450 people will die from this disease each year. Learn about the causes of esophageal cancer. Other facts about esophageal cancer include the following:

  • Esophageal cancer is three times more common among men than among women.
  • Esophagus cancer is three times more common among African-Americans than among Caucasians.
  • Some countries such as Iran, northern China, India, and southern Africa have rates that are 10 to 100 times greater than that in the United States.

What Are the Symptoms of Esophageal Cancer?

Often, an early stage of esophageal cancer has no symptoms. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • Difficult or painful swallowing: A condition known as dysphagia, this is the most common symptom of esophageal cancer. This gives a sensation of having food lodged in the chest, and persons with dysphagia often switch to softer foods to help with swallowing.
  • Pain in the throat or back, behind the breastbone or between the shoulder blades
  • Severe weight loss: Many persons with esophageal cancer lose weight unintentionally because they are not getting enough food.
  • Hoarseness or chronic cough
  • Vomiting
  • Coughing up blood
  • Indigestion and heartburn

The symptoms of esophageal cancer may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

There is no routine screening examination for esophageal cancer, however, persons with Barrett’s esophagus should be examined often since they are at greater risk for developing the disease.

What Are the Different Types of Esophageal Cancer?

There are two main types of esophageal cancer:

Squamous cell carcinoma

Squamous cell carcniomas, which accounts for about half of all esophageal cancers, grow in the cells that form the top layer of the lining of the esophagus, known as squamous cells. This type of cancer can grow anywhere along the esophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.

Adenocarcinoma

Adenocarcinoma develops in the glandular (secretory) tissue cells in the lower part of the esophagus, near the opening of the stomach. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.

Treatment for both types of esophageal cancer is similar.

How Is Esophageal Cancer Diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for esophageal cancer may include the following:

Barium swallow

Also called an upper gastrointestinal (GI) series, this is a diagnostic test that examines the organs of the upper part of the digestive system

Biopsy

The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy is usually done during an esophagoscopy. Sometimes a biopsy shows changes in the esophagus that are not cancer but may lead to cancer.

CT scan (computed axial tomography or CAT scan)

A noninvasive medical test that uses special X-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body.

Chest X-ray

A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

Endoscopic ultrasound

An imaging technique that uses sound waves to create a computer image of the inside of the esophagus and stomach.

Esophagogastroduodenoscopy

Also called EGD or upper endoscopy, it is a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum.

Thoracoscopy and laparoscopy

These methods allow the doctor to examine the lymph nodes inside the chest or abdomen with a hollow, lighted tube, and remove these nodes for further testing.

What Are the Stages of Esophageal Cancer?

When you receive an esophageal cancer diagnosis, tests will be performed to determine how much cancer is present, and if the cancer has spread from the colon to other parts of the body. This is called staging and is an important step toward planning a treatment program.

The National Cancer Institute defines the following stages for esophageal cancer:

Stage 0 esophageal cancer

In stage 0, abnormal cells are found in the innermost layer of tissue lining the esophagus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage 1 esophageal cancer

Stage I: The cancer is detected only in the top layers of cells lining the esophagus.

In stage I, cancer has formed and spread beyond the innermost layer of tissue to the next layer of tissue in the wall of the esop

Stage 2 esophageal cancer

Stage II: The cancer involves deeper layers of the lining of the esophagus or it has spread to nearby lymph nodes. However, the cancer has not spread to other parts of the body.

Stage II esophageal cancer is divided into stage IIA and stage IIB, depending on where the cancer has spread.

  • Stage IIA: Cancer has spread to the layer of esophageal muscle or to the outer wall of the esophagus.
  • Stage IIB: Cancer may have spread to any of the first three layers of the esophagus and to nearby lymph nodes.

Stage 3 esophageal cancer

Stage III: The cancer has spread into the wall of the esophagus or has spread to tissues or lymph nodes near the esophagus. However, it has not spread to other parts of the body.

In stage III, cancer has spread to the outer wall of the esophagus and may have spread to tissues or lymph nodes near the esophagus.

Stage 4 esophageal cancer

Stage IV: The cancer has spread to other parts of the body, such as the liver or lungs.

Stage IV esophageal cancer is divided into stage IVA and stage IVB, depending on where the cancer has spread.

  • Stage IVA: Cancer has spread to nearby or distant lymph nodes.
  • Stage IVB: Cancer has spread to distant lymph nodes and/or organs in other parts of the body.

Recurrent esophageal cancer

Recurrent esophageal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the esophagus or in other parts of the body.

Prognosis for esophageal cancer

When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed.

At later stages, esophageal cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered.

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