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