Esophageal Cancer: Types, Causes, Symptoms, and More

Esophageal Cancer: Types, Causes, Symptoms, and More
Editor's Note: This article has been recently updated with latest information and research studies.
 

Introduction

Esophageal cancer is cancer that occurs in the long, hollow tube that runs from the throat to the stomach (esophagus). The function of the esophagus is to carry food swallowed to the stomach for digestion. It usually starts in the cells lining the inside of the esophagus but can occur anywhere along the esophagus. In the United States, it usually occurs in the lower part of the esophagus and more men get this type of cancer. It is not very common in the United States but it is more common in certain parts of the world like Asia and parts of Africa.

Signs and Symptoms

Signs and Symptoms

Early stages of esophageal cancer usually don’t cause noticeable symptoms. However, as it grows, the common symptoms include:

  • Food getting stuck in parts of the esophagus or the food comes back up
  • Moderate to severe pain, when swallowing
  • Pain in the chest or back
  • Heartburn
  • Weight loss*
  • Hoarseness of voice or persistent cough lasting more than 2 weeks.

Take note that these symptoms can also be caused by other health problems. If you are experiencing any of these symptoms, you should consult your doctor for a proper diagnosis.

Causes and Risk Factors

Esophageal cancer is primarily caused by a malignant mutation in the cells that make up the lining of the esophagus. Tumors in the esophagus usually invade the submucosa first then they eventually reach the muscular layer of the organ.

Age is a tops risk factor since it is a lot more common after the age of 50. The risk of developing this type of cancer is approximately 3 times higher in males. The other risk factors are:

  • Achalasia which is a rare disease that affects the muscles of the esophagus
  • Helicobacter pylori infection which is connected to gastritis and peptic ulcer disease
  • Human papillomavirus (HPV) infection increases* risk
  • Plummer-Vinson syndrome which usually causes esophageal irritation
  • Prior history of other neck and head cancers
  • Tylosis which is a rare genetic skin disorder that causes inflammation of the esophagus
  • Recent studies indicate that this type of cancer may have a genetic risk factor.
  • Smoking and drinking alcoholic beverages in excess

Types of Esophageal Cancer

Squamous cell carcinoma – this is when the cancer develops in the squamous cells along esophagus.

Squamous cell carcinoma

Adenocarcinoma – this type of cancer develops from gland cells. The squamous cells normally lining the esophagus are replaced by gland cells. It typically occurs in the lower esophagus and is believed to be related to acid exposure.

Adenocarcinoma

Tests and Diagnosis

If a patient’s symptoms suggest esophageal cancer, the physician needs to determine whether it is due to cancer or another cause. A physical exam will be performed then an interview regarding personal and family health history will be conducted. Blood tests may be conducted then other tests like:

Endoscopy – a thin, lighted, flexible tube is used to look down the esophagus. The tube is passed through the mouth or nose to the esophagus. This is a procedure called upper endoscopy.

Barium swallow – a barium solution is consumed then x-rays of the esophagus and stomach are done. The solution makes the esophagus clearer on the x-rays. The test is also referred to as an upper GI series.

Biopsy – the cancer usually begins in the inner layer of the esophagus. An endoscope is used to collect tissue from the esophagus. A pathologist then checks the tissue under a microscope looking for cancer cells. This is the only sure way to known if cancer cells are present in the esophageal tissue.

Biopsy

Image Source: https://gi.jhsps.org

Treatments and Medications

Like with any case of cancer different types of doctor work together to create a treatment plan for esophageal cancer. Different types of treatments are combined depending on several factors like the stage and type of cancer, health of the patient, preferences, and possible side effects.

For patients with a tumor that has not spread beyond the esophagus and lymph nodes, three types of treatments are usually combined: surgery, radiation therapy, and chemotherapy. The order of treatment varies from one case to another depending on the stage, type of cancer and other factors.

For squamous cell cancer, a combination of chemotherapy and radiation therapy is usually the first treatment followed by surgery depending on how effective the initial treatment is. Recent studies indicate that this treatment plan is more effective than surgery alone. For adenocarcinoma, the most common treatment in the United States is also chemotherapy and radiation therapy followed by surgery. However, for advanced cases of esophageal cancer, the treatment is usually a combination of chemotherapy and radiation therapy.

Related Video – Esophageal Cancer Treatment

Precautions and Self Care

Caring for esophageal cancer patients may include alternative therapies which are mostly for coping with the side effects of treatment. For instance, people with this type of cancer suffer from severe pain because of the growing tumor. The doctor can prescribe medication for this problem, but pain can still persist. This is where complementary and alternative therapies are useful. The options include acupuncture, guided imagery, massage and relaxation techniques. Take note that alternative therapies are not for treating the disease but for helping with pain management only. You need to consult your doctor whether the options mentioned are safe for you.

There are also ways to reduce* the risk of esophageal cancer which can also help prevent the disease from worsening. First, you need to quit smoking because it is a known risk factor not just for esophageal cancer but other types of cancer as well. Drink alcohol in moderation or completely avoid it especially if you already have esophageal cancer or you are suffering from gastritis, ulcer or other health problems linked to stomach acidity. Eat a diet rich in fruits, vegetables, and other unprocessed foods and avoid preserved, artificially flavoured food items. Last but not least, get plenty of rest which is important for recovery. If you have any problem like you are experiencing fever, vomiting, bleeding from the mouth/nose then you need to contact your doctor.

References:

  • Montgomery, EA et al. (2014). “Oesophageal Cancer”. In Stewart, BW; Wild, CP. World Cancer Report 2014. World Health Organization. pp. 528–543. ISBN 9283204298.
  • Ferri, FF, ed. (2012). “Esophageal Tumors”. Ferri’s clinical advisor 2013. Philadelphia, PA: Mosby (Elsevier). pp. 389–391. ISBN 9780323083737.
  • Whittemore, edited by David Schottenfeld, Joseph F. Fraumeni, Jr.; associate editors, Graham A. Colditz, Jonathan M. Samet, Alice S. (2006). Cancer epidemiology and prevention (3rd ed.). Oxford: Oxford University Press. p. 697. ISBN 9780199747979.

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Author

Expert Author : Dr. Ahmed Zayed (Consumer Health Digest)

Dr. Ahmed Zayed Helmy holds a baccalaureate of Medicine and Surgery. He has completed his degree in 2011 at the University of Alexandria, Egypt. Dr. Ahmed believes in providing knowledgeable information to readers. Other than his passion for writing, currently he is working as a Plastic surgeon and is doing his masters at Ain shams University.