Overview

Esophageal Cancer

The esophagus is the muscular tube extending from the neck to the abdomen, connecting the mouth to the stomach. Esophageal cancer is the uncontrolled growth of cells in the esophagus. The lining of the esophagus is the most common region for cancers of the esophagus to start to grow.

The esophagus is mostly lined with squamous cells; malignant cancer cells in the esophagus is known as squamous cell carcinoma. When cells at the bottom of the esophagus, near the stomach, become cancerous, they are referred to as adenocarcinomas. Other, rarer forms of esophageal cancer include sarcoma and small cell cancer.

Risk factors

There are different causes for esophageal cancer, depending on the type. Certain factors increase your risk for developing squamous cell cancer, including:

Risk factors for development of adenocarcinoma are less well-understood, although individuals with the following conditions are at increased risk of developing it:

Signs and symptoms

Difficulty swallowing is the most common symptom of esophageal cancer, or the sensation of food being stuck in the throat before reaching the stomach. As a progressive disease, it will advance to the point where even liquids won't go down easily. Other symptoms may include:

  • Weight loss
  • Pain when swallowing
  • Regurgitation of undigested food
  • Vomiting blood
  • Black or tarry stool

Diagnoses

If you experience difficulty swallowing or unexplained weight loss, contact your physician about doing tests to determine whether there is a growth (tumor) in the esophagus that is causing the swallowing difficulty. If a growth found, your physician will perform a biopsy to confirm the diagnosis. Diagnostic tests may include:
  • Endoscopy: A common early step for diagnosis, this outpatient procedure uses a thin, flexible tube topped with a camera to allow your physician to examine the esophagus and, if necessary, collect a biopsy sample for analysis.
  • X-ray of the esophagus and stomach (barium swallow test): This test reveals the condition of the lining of the esophagus.
  • Computed tomography (CT) scan: This detailed view of the chest and abdomen offers a picture of the lungs, liver and other organs surrounding the esophagus.
  • Endoscopic ultrasonography (EUS): Using ultrasound waves to create an image, and EUS allows your physician to examine the tumor and adjacent lymph nodes.
  • Positron emission tomography (PET): This nuclear test may be used to measure activity in the cells and find information about the possible locations of cancer.

Staging and treatment

If you are diagnosed with esophageal cancer, your physician will then stage the cancer, which is the determination of how advanced the cancer is and whether it has spread to other parts of the body. Esophageal cancer may commonly spread to:

  • Lymph nodes
  • Lungs
  • Liver
  • Adrenal glands
  • Kidneys
  • Bones
  • Lining of the chest and abdomen

Treatment depends on the stage of the esophageal cancer at the time of diagnosis, as well as your overall condition and what symptoms you are having. Because esophageal cancer may be asymptomatic at early stages, it is often only found at later stages, when causing swallowing difficulty.

If the esophageal cancer has not spread to other organs, esophagectomy surgery is the primary treatment, sometimes used in combination with chemotherapy or radiotherapy.

If the cancer has spread to other organs, or if surgery is not an option, combination therapy is the most common treatment.

Prognosis for patients with esophageal cancer depends on the stage of the cancer at time of diagnosis, with 80 percent to 90 percent of patients recovering if the cancer is discovered early enough. Overall success rates for patients with later stage esophageal cancer are far lower.



The Thoracic Surgery Program at Northwestern Memorial Hospital offers the latest surgical procedures for benign and malignant diseases of the chest, including the tracheobronchial tree (airways), lungs, pleura, esophagus, diaphragm, chest wall and mediastinum. Our program comprises a highly specialized team that provides integrated care and practices medicine centered on each patient’s unique circumstances, including:

  • Comprehensive and seamlessly coordinated care across multiple physician disciplines, with team members from:
    • Medical oncology
    • Radiation oncology
    • Interventional pulmonology
    • Thoracic pathology
    • Thoracic radiology
  • A highly specialized team of nurses, anesthesiologists and support personnel
  • Advanced diagnostic technologies
  • Minimally invasive surgical techniques
  • Convenient and customized patient and family services
  • Significant expertise in minimally invasive surgical techniques
  • Nationally recognized clinical experts
  • Demonstrated quality outcomes
  • Access to novel therapies and clinical trials
  • Commitment to collaboration with referring physicians
  • Collaboration with pharmaceutical, device and biotechnology companies in clinical trials to improve patient care and advance thoracic science

Esophageal cancer teams provide access to leading-edge cancer treatments coupled with compassionate care. Your cancer treatment team1 may include:

  • Surgical oncologist
  • Medical oncologist
  • Radiation oncologist
  • Gastroenterologist
  • Palliative medicine physician
  • Pathologist
  • Nutritionist
  • Social worker
  • Interventional radiologist
  • Advanced practice nurses
  • Geneticist
  • Rehabilitation therapist

Your physician and other care providers collaborate weekly in multidisciplinary cancer conferences that are specific to gastrointestinal cancer(s), bringing together expertise from a variety of disciplines to develop the best treatment plans for you.

We offer a comprehensive minimally invasive surgical program, including robotics-assisted surgery, available to qualified patients. The team of specialized interventional radiologists offer targeted therapies to treat esophageal cancer and our surgeons specialize in treating advanced, complex cases.

Legal Information
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In the spirit of keeping you well-informed, the physician(s) identified are neither agents nor employees of Northwestern Memorial HealthCare or any of its affiliate organizations. They have selected our facilities as places where they want to treat and care for their private patients.