The esophagus is a long tube that runs from the back of the throat to the stomach. It is an important organ in the digestive process, as it helps facilitate the movement of food and liquid from the mouth and throat to the stomach. When cancer begins in the esophagus, it is referred to as esophageal cancer. There are two types of esophageal cancer:
- Adenocarcinoma: Adenocarcinoma is the most commonly diagnosed type of esophageal cancer in the US and develops in the cells that secrete mucus.
- Squamous cell carcinoma: Squamous cell carcinoma develops in the cells that line the inside of the esophagus.
Symptoms of Esophageal Cancer
Early stages of esophageal cancer may not cause any symptoms. Individuals who do show signs of esophageal cancer may experience:
- Dysphagia (difficulty swallowing)
- Unexplained weight loss
- Pressure, pain, or a burning sensation in the chest
- Frequent indigestion or heartburn
- Hoarseness of the voice
- A cough that won’t go away
Causes of Esophageal Cancer
The exact cause of esophageal cancer is unknown. However, smoking and heavy consumption of alcohol have been linked to an increased risk of developing esophageal cancer. Additional risk factors may include:
- Age (risk of developing esophageal cancer significantly increases after the age of 55)
- Gender (men are more likely to develop esophageal cancer than women)
- Gastroesophageal reflux disease (GERD)
- Barrett’s esophagus (a condition that damages the lower portion of the esophagus as a result of GERD)
- Being overweight or obese
What to Expect at Your Appointment
During your appointment, your doctor will ask you to describe your symptoms in addition to the severity and length of time you have noticed your symptoms. In order to make a diagnosis, your doctor may prescribe a battery of tests. Some of these tests may include:
- Esophagram: Also called a barium swallow test, this test requires the patient to drink a liquid solution containing barium before x-ray images are taken. This liquid coats the esophagus, accentuating abnormalities.
- Upper endoscopy: An upper endoscopy allows doctors to see if there is an abnormality in the tissue of the esophagus. The doctor will use an instrument called an endoscope, a thin flexible tube with a camera and a light on the end, to project an image onto a nearby screen. The endoscope is passed through the mouth and into the esophagus, and is then used to look around and observe any abnormal growths in the esophagus.
- Endoscopic ultrasound: An endoscopic ultrasound is used to analyze the depth to which a tumor has grown as well as if it has spread to the lymph nodes. During this procedure, a thin, flexible tube with ultrasound attached to the end is passed through the mouth, into the esophagus. Ultrasound waves produce a picture that physicians use for analysis.
- Imaging studies: Imaging studies, such as a CT scan, an MRI scan, or a PET scan, produce detailed images of the region around the esophagus. These images are used to determine if there is an abnormal growth, the size of a tumor, or if cancer has spread.
- Bronchoscopy: A bronchoscopy is performed to determine whether a tumor is growing in the patient’s airway, such as the trachea or windpipe. During this procedure, an endoscope is passed through the nose or the mouth, into the windpipe, and into the lungs.
- Biopsy: A biopsy is used to make a definitive diagnosis of either malignant or benign tissue of the tumor. During a biopsy, a small amount of tissue from the growth is collected and analyzed in a laboratory.
Non-Surgical Treatments for Esophageal Cancer
Treatments recommended for esophageal cancer depends on the stage of cancer as well as the patient’s overall health and treatment preferences. If surgery is required, chemotherapy and/or radiation therapy may be used either before or after surgery to kill cancer cells, eliminate symptoms of cancer, and decrease the risk of cancer recurrence.
Surgical Treatment for Esophageal Cancer and Post-Treatment
Procedures used to treat esophageal cancer include:
- Minimally invasive thoracic surgery: Minimally invasive surgery includes a variety of surgeries that use multiple, tiny incisions, instead of the one long incision used for open surgery. This type of surgery will be recommended to patients who are in good health and have a diagnosis that has not metastasized (spread) or penetrated deeper layers of the esophagus.
- Esophagectomy: If cancer has spread to the lymph nodes, it may be necessary to remove a portion of the esophagus and the surrounding lymph nodes. Esophagectomy is the name given to this procedure. Once the portion of the esophagus is removed, what remains is reattached to the stomach. This procedure can be performed using minimally invasive or open techniques.
- Esophagogastrectomy: If cancer has spread to the lymph nodes and to the stomach, it may be necessary to remove part of the esophagus, the lymph nodes, and a portion of the stomach. This procedure is called an esophagogastrectomy. This procedure can be performed using minimally invasive or open techniques.
Immediately following surgery, patients will be moved to the recovery unit, where they will be monitored over the course of a few days for any complications.
It may be necessary to follow a specific diet, such as a liquid diet, for the first few weeks following surgery. Recovery time and specific post-treatment instructions will vary depending on the type of surgery that was performed as well as the complexity of the surgery. In order to ensure a safe recovery and decrease the risk of complications, it’s important to follow all instructions given to you by the surgeon as well as attend all follow-up appointments.
Make an Appointment
For an appointment with a specialist, call 202-877-3627.