Esophageal Cancer

What is Esophageal Cancer?

Cancer of the esophagus usually occurs in the cells lining the lowest part of a patient’s esophagus, although it can show up anywhere between the throat and stomach. As with any with cancer, esophageal cancer develops when cells lining the esophagus begin to grow uncontrollably as a result of mutated DNA and malignant cells. The cells usually create a tumor that spreads quickly and may block the esophagus, causing problematic symptoms for the affected patient.

In the United States, getting cancer in the esophagus is not all that common. Most cases of esophageal cancer are concentrated in Asia and some parts of Africa. However, statistics do show that among Americans, esophageal cancer affects men more often than it affects women.

Are There Different Types of Esophageal Cancer?

Depending on which types of cells are mutated in your esophagus, you may or may not have one of several types of esophageal cancer. Rarer forms include lymphoma, sarcoma, choriocarinoma and small cell cancer—but the two most common types of esophageal cancer are:

 

Do I Have Esophageal Cancer?

If you have usually experiencing feelings of pain, burning or increased pressure in your chest area— or is you have difficulty swallowing food, drink or saliva—it maybe be possible that you have esophageal cancer. Many patients who are diagnosed with esophageal cancer report unexplained weight loss, fatigue, frequent coughing, choking, heartburn and indigestion. This is usually only after the cancer has already developed and has been detected during a medical screening test. Unfortunately esophageal cancer is quite difficult to detect merely be noticing the symptoms. Scheduling a medical procedure such as upper endoscopy or EGD to treat these symptoms may lead to a proper diagnosis—although, since esophageal cancer is not very common, these invasive and semi-risky tests are rarely scheduled as a precaution or routine screening test.

Patients who have already been diagnosed with precancerous conditions such as Barrett’s esophagus have an increased risk of getting esophageal cancer. Such patients should work with their medical providers to routinely monitor the body to ensure early detection, if cancer does develop and start spreading.

How Do I Treat Esophageal Cancer?

Leaving esophageal cancer untreated puts you at risk for esophageal obstruction (blockage), pain, gastrointestinal bleeding (bleeding along the GI tract) and bad fits of coughing as the cancer eats away and creates holes in trachea (or windpipe). If the cancer is detected at an early enough stage, surgery may be successful in removing the tumor and all cancerous tissue. Surgery to remove small tumors may be done during upper endoscopy procedures by inflating the esophagus with an endoscope first and then guiding long, flexible surgical tools into the throat through the endoscope.

However, if the cancer is further along, biopsy alone will not suffice. A surgeon may need to cut out large sections of the diseased esophagus with a procedure called esophagectomy. The leftover parts of the esophagus will then be surgically attached to the stomach (or sometimes the colon) in order to maintain digestive functionality. He or she may also have to remove part of the stomach in addition to the lower part of your esophagus during a procedure called esophagogastrectomy if the cancer has spread. In general, invasive surgery to treat esophageal cancer carries a significant risk of bleeding, leakage and infection. Chemotherapy and radiation therapy are other options to treat esophageal cancer.

 

Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014