27 Sep 2024

Esophageal cancer occurs in the hollow muscular tube that is responsible for aiding in the process of digestion and moving food and liquids from the mouth to the stomach. This type of cancer can develop after the formation of a tumor, or uncontrolled group of cells, turns malignant.

The cause of the development of esophageal cancer is not known, although it is believed to be related to abnormalities and mutations in the DNA of the cells related to or involved with the esophagus. These types of mutations can cause the cells to divide and multiply more rapidly than normal cells. These mutations can also disrupt cell function, and not die off when they should.

There are two main types of esophageal cancer. They are:

  • Squamous cell carcinoma occurs when cancer starts in the flat, thin cells that make up the lining of the esophagus. This form most often appears in the top or middle of the esophagus, but it can appear anywhere.
  • Adenocarcinoma occurs when cancer starts in the glandular cells of the esophagus that are responsible for the production of fluids such as mucus. Adenocarcinomas are most common in the lower portion of the esophagus.

There are certain risk factors you should be aware of that do increase your risk for developing this cancer. By avoiding or decreasing these risk factors, you may lessen your overall risk for this type of cancer. Many of these risk factors involve anything that irritates or inflames the cells within the esophagus. These risk factors are:

  • consuming alcohol
  • smoking
  • having a reflux disorder, such as gastroesophageal reflux disease
  • having Barrett’s esophagus, which is a condition characterized by damaged esophageal lining due to gastroesophageal reflux disease
  • being overweight
  • not eating enough fruits and vegetables
  • having achalasia, a condition where the muscle at the bottom of the esophagus does not relax properly

There are also certain groups of people that have a higher risk factor due to other medical illnesses and issues. They are:

  • Men are three times more likely than women to develop esophageal cancer.
  • Esophageal cancer is more common in African Americans than in other ethnicities.
  • Your chances of developing esophageal cancer increase with age. If you are over the age of forty-five, your risk may be higher.

The early symptoms of esophageal cancer you may not experience any signs that give you much thought. Heartburn and chest discomfort can be two of the earliest signs, although many do not present as esophageal cancer until the cancer has progressed. The symptoms you may experience are:

  • unintentional weight loss
  • indigestion
  • heartburn
  • pain or difficulty when swallowing
  • frequent choking while eating
  • vomiting
  • food coming back up the esophagus
  • chest pain
  • fatigue
  • chronic cough
  • hiccups

Diagnosing esophageal cancer can include any of the tests, or a combination of, below.

  • An endoscopy involves the use of an instrument that is a narrow tube with a camera attached, that goes down your throat and allows your doctor to view the lining of your esophagus to check for abnormalities and irritation.
  • A barium swallow is an X-ray imaging test that allows your doctor to see the lining of your esophagus. To do this, you swallow a chemical called barium while the images are being obtained.
  • A biopsy is a process in which your doctor removes a sample of suspicious tissue with the help of an endoscope and sends it to a lab for testing.
  • A CT scan, PET scan, or MRI may be used to see if cancer has spread to other parts of the body.

Treatment for your esophageal cancer will depend on the stage and severity of your condition and overall health. The most common methods of treatment are surgery, chemotherapy and radiation, or a combination of the lot.

Surgery may be the answer if your cancer is small and has not spread further into the body, it may be more easily removable. Using an endoscope or by making several small incisions, your doctor can remove the cancer. In a standard esophageal cancer case, the surgeon will operate through a larger incision to remove a portion of the esophagus and lymph nodes surrounding, if need be. The esophagus is then reconstructed with tissues from the stomach or large intestine. In severe cases, a portion of the stomach may also be removed. There are many other risks and complications with any surgical intervention, including pain, bleeding, leaking around the area of the esophagus rebuild, or issues with where the esophagus attaches to the other organs. This can also result in lung and stomach complications, problems with swallowing, nausea, heartburn and infections.

Chemotherapy is used to treat esophageal cancer by using very strong medications to attack the cancer cells. Doctors use this treatment before or after surgery, or on their own. This treatment can also accompany radiation therapy. There are several side effects with chemotherapy, and most arise because these drugs kill not only your damaged cells, but healthy cells, too. The side effects that you experience will depend on the type of chemotherapy you are having. These side effects could be any or all these things:

  • hair loss
  • nausea
  • vomiting
  • fatigue
  • pain
  • mental fog
  • exhaustion
  • skin issues
  • neuropathy & more

Radiation therapy is a form of cancer treatment that uses beams of radiation to kill cancer cells. The radiation is administered externally, or on the outside of the body, using a machine. Internally, radiation can be administered using brachytherapy. Radiation is commonly used together with chemotherapy as a treatment. The side effects tend to be more magnified of each treatment type when multiple treatments are combined. The side effects from radiation treatment could include:

  • skin that looks sunburned
  • pain or difficulty when swallowing
  • fatigue
  • painful ulcers in the lining of the esophagus

Radiation therapy side effects can, unfortunately, last months or years after treatment has ended. This includes esophageal stricture and difficulty swallowing.

While there is no sure way to prevent esophageal cancer, there are steps you can take to immediately lower your risk. Those are:

  • Avoiding cigarettes and chewing tobacco is key.
  • Limiting your consumption of alcohol is also thought to lower your risk.
  • Eating a diet with lots of fruits and vegetables and maintaining a healthy weight may also be effective ways to avoid esophageal cancer.

If you suspect you have esophageal problems or cancer, do not hesitate to contact your doctor to set up your appointments to help get you back on the right path to health once again.

Citations:

Mayo

ACS

NIH