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Esophageal Cancer

What is esophageal cancer?

Esophageal cancer is a type of rare cancer that grows in the esophagus. The esophagus is the hollow tube that connects your throat to your stomach and moves food and liquids from your mouth to the stomach. It is part of the digestive system. The two most common types of esophageal cancer are adenocarcinoma and squamous cell carcinoma.

Esophageal adenocarcinoma forms in the glandular cells. These cells are in the lining of the esophagus and make fluids, such as mucus. Esophageal squamous cell carcinoma forms in the squamous cells in the esophagus.

How common is esophageal cancer?

Esophageal cancer is a rare type of cancer, making up about 1% of cancer cases in the United States. The rate of new cases per year is about 4 for every 100,000 people. In other parts of the world, esophageal cancer is more common. In the United States, esophageal adenocarcinoma is more common than esophageal squamous cell carcinoma and makes up about 80% of esophageal cancer cases.

Esophageal cancer is more common in men than women.

How is esophageal cancer diagnosed?

Many people with esophageal cancer do not have symptoms when the cancer first starts. Later, when the tumor gets larger, symptoms can include:

  • Trouble swallowing
  • Weight loss for no known reason
  • Hiccups
  • Throwing up with streaks of blood
  • Streaks of blood in mucus coughed up from the lungs

Imaging: If you have symptoms of esophageal cancer, your doctor will use imaging scans such as a Barium Swallow, CT, PET, and ultrasound to see where the tumor is and how big it is. They will also check for signs that the tumor has spread to other parts of the body.

Other types of imaging tests that doctors might use include esophagoscopy, bronchoscopy, and thoracoscopy. Esophagoscopy and bronchoscopy tests use a long, tube like tool that contains a light and lens. It is inserted into the throat to see inside the esophagus and nearby parts of the body. A thoracoscopy is like these other tools but requires surgery to place it inside the chest.

Biopsy: To check if the tumor is esophageal cancer, your doctor will do a biopsy, taking a small sample from the tumor. The sample is usually taken during the esophagoscopy test. An expert, called a pathologist, then studies cells from the sample under the microscope to see what kind of tumor it is.

How is esophageal cancer treated?

Treatment for each patient is unique. You should go to an expert in esophageal cancer treatment to decide the best approach for your tumor. You can contact MyPART for help finding experts near you.

Treatment options to discuss with your doctor include:

Surgery: Surgery is used to remove as much of the esophageal cancer as possible.

Radiation therapy: Radiation therapy uses high energy x-rays or other types of radiation to kill the cancer cells.

Chemotherapy: Chemotherapy uses anti-cancer drugs to kill the cancer cells. Chemotherapy is used when the cancer cells have spread to other parts of the body.

Targeted therapy: Targeted therapy is aimed at the changes in cancer cells that help them grow, divide, and spread.

Does esophageal cancer run in families?

Yes, esophageal cancer can run in families. Recent research found that 9% of cases of esophageal adenocarcinoma are linked to a family history of Barrett’s Esophagus, which is a condition that is known to cause esophageal adenocarcinoma. A recent study found that mutations in the gene VSIG10L may lead to cases of Barrett’s Esophagus and esophageal cancer that run in families.

How does esophageal cancer form?

We know that esophageal adenocarcinoma is linked to a condition called Barrett’s Esophagus, which is caused by gastroesophageal reflux disease (GERD).  People with Barrett’s Esophagus are much more likely to develop esophageal adenocarcinoma than people without it, with some studies showing 25 times higher risk.

Esophageal squamous cell carcinoma is often linked to smoking and drinking alcohol.

What is the prognosis for someone with esophageal cancer?

The estimate of how a disease will affect you long-term is called prognosis. Each person is different and prognosis will depend on many factors, such as:

  • Where the tumor is in your body
  • If the cancer has spread to other parts of your body
  • How much of the tumor is taken out during surgery

If you want information on your prognosis, it is important to talk to your doctor. Also, NCI has resources to help you understand cancer prognosis.

Doctors estimate esophageal cancer survival rates by how groups of people with esophageal cancer have done in the past. The overall five-year survival rate for esophageal cancer is about 20%, but survival rates can range from 5% to 47%. When esophageal cancer is found early and when it is small, the five-year survival rate is higher. When it is already large or has spread to other parts of the body, treatment is more difficult and the five-year survival rate is lower.