Esophageal cancer is a malignant tumor of the esophagus (the muscular tube that propels food from the mouth to the stomach).

Alternative Names

Cancer - esophagus

Causes, incidence, and risk factors

Esophageal cancer is relatively uncommon in the United States, and occurs most often in men over 50 years old. It affects less than 5 in 100,000 people. There are two main types of esophageal cancer, distinguished by the way they look under the microscope: squamous cell carcinoma and adenocarcinoma. Squamous cell cancer is associated with smoking and alcohol consumption . The incidence of this disease in the United States has remained relatively constant, while the incidence of adenocarcinoma of the esophagus has risen dramatically. Barrett's esophagus , a complication of gastroesophageal reflux disease (GERD), is a risk factor for the development of adenocarcinoma of the esophagus.

Signs and tests

Treatment

When esophageal cancer is localized to the esophagus and has not spread elsewhere (metastasized), surgery is the treatment of choice. The goal of surgery, in most cases, is to cure the patient. In some circumstances chemotherapy, radiation, or a combination of the two will be used to make surgery easier to perform. In patients who cannot tolerate surgery, or in situations where the cancer has spread to other organs (metastatic disease), chemotherapy or radiation may be used to help alleviate symptoms (palliative therapy). In such circumstances, however, the disease is usually not curable. Other treatments that may be used to improve a patient's ability to swallow include endoscopic dilation of the esophagus (sometimes with placement of a stent ) or photodynamic therapy.

Support groups

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .

Expectations (prognosis)

Esophageal cancer is a very difficult disease to treat, but it can be cured in patients whose disease is confined to the esophagus. In circumstances in which surgery can be performed, cure rates are in the range of 25%. In some circumstances in which the cancer is localized to the esophagus and radiation therapy is used instead of surgery, cure is possible but is less likely than with surgery. For patients whose cancer has spread outside the esophagus, cure is generally not possible and treatment is directed toward relief of symptoms.

Complications

Calling your health care provider

Call your health care provider if difficulty with swallowing persists that is not attributed to other causes or if other symptoms develop that may indicate esophageal cancer.

Prevention

Avoiding smoking and reducing or eliminating alcohol consumption can help prevent of squamous cell cancer of the esophagus. Surveillance EGD (esophagogastroduodenoscopy) and biopsy in people with Barrett's esophagus may lead to early detection and improved survival. People with symptoms of severe reflux should seek medical attention. People diagnosed with Barrett's esophagus should see a gastroenterologist (gastrointestinal specialist) at least every year.