The esophagus is the tube that transports food from the throat to the stomach. Esophageal cancer is the growth of cancer cells the esophagus.
There are two main types of esophageal cancer:
- Squamous cell cancer—arises from the cells that line the upper part of the esophagus
- Adenocarcinoma—arises from glandular cells that are present at the junction of the esophagus and stomach
Cancer occurs when cells in the body divide out of control. If cells keep dividing, a mass of tissue forms. These are called growths or tumors. If the tumor is malignant, it is cancer. They can invade nearby tissue and spread to other parts of the body.
Factors that may increase your chance of esophageal cancer include:
- Age: 60 or older
- Sex: male
- Smoking or smokeless tobacco use (such as chewing tobacco or snuff)
- Alcohol use
- History of gastroesophageal reflux]]> , especially if this has caused ]]>Barrett's esophagus]]>
- Achalasia (chronic dilation of the esophagus)
- Infection with Helicobacter pylori (causes stomach ]]>ulcers]]> )
- Certain rare genetic conditions such as Plummer Vinson syndrome and tylosis
- Damaged esophagus from toxic substances, such as lye
- History of cancer of the head and/or neck
- ]]>Human papilloma virus (HPV) infection]]>
- ]]>Alendronate (Fosamax)]]> (rare) ]]>*¹]]>
- Trouble swallowing
- Painful swallowing
- Hoarse voice
- Pain in the throat, back, chest
- Nausea, vomiting
- Coughing up blood
- Weight loss
The structure and location of the esophagus makes it easy for cancer to spread very early. This can make a cure more difficult. People who have related conditions, especially reflux, should discuss regular screening tests with their doctor. This may include endoscopy.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
- Chest x-ray]]> —an x-ray of the chest area
- ]]>Upper GI series]]> —a series of x-rays of the esophagus and stomach taken after drinking a barium solution (also called barium swallow)
- Esophagoscopy—examination of the esophagus using a lighted scope
- ]]>Biopsy]]> —removal of a small sample of esophageal tissue to test for cancer cells
- CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
- ]]>Bone scan]]> —to see if the cancer has spread to the bones
Treatment may include:
A surgery may be done to remove the tumor. The doctor might remove all or part of your esophagus, as well. A plastic tube might be used to replace the missing portion of esophagus.
The use of radiation to kill cancer cells and shrink tumors. Radiation may be:
- External radiation therapy—radiation directed at the esophagus from a source outside the body
- Internal radiation therapy – radioactive materials placed into the esophagus in or near the cancer cells
The use of drugs to kill cancer cells. Chemotherapy may be given in many forms. This can include by pill, injection, and via a catheter. The drugs enter the bloodstream. It travels through the body. It will kill mostly cancer cells. Some healthy cells may also be killed.
Chemotherapy alone will not cure this type of cancer. It is only used when the cancer has already spread and cannot be cured. At this point it is used to help shrink the tumor and help ease pain or control nausea.
Chemoradiotherapy or Combined Modality Therapy
Chemotherapy and radiation therapy together are better than radiotherapy alone. It has also been shown that these two treatments may be as effective as surgery alone.
Chemotherapy and radiation therapy are followed by a surgery. This has been shown to be a most aggressive form of therapy. It may be the best way to cure a patient of their disease.
High-intensity light used to try to kill cancer cells.
A combination of drugs and special lights used to try to kill cancer cells.
This therapy is a promising treatment approach but is only appropriate in a very small number of patients. There are limits of how far the infrared light source will travel into the cancer itself. The tumor must be very small (smaller than ¼ inch thick). It must not involve any lymph nodes or other structures.
American Association of Otolaryngology–Head and Neck Surgery
American Cancer Society
Canadian Cancer Society
Canadian Society of Otolaryngology
Clinical Oncology . 2nd ed. Churchill Livingstone, Inc.; 2000.
Far AE, Aghakhani A, Hamkar R, et al. Frequency of human papillomavirus infection in oesophageal squamous cell carcinoma in Iranian patients. Scand. J Infect. Dis . 2007;39(1):58-62.
National Cancer Institute website. Available at: http://www.cancer.gov/ .
Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 6th ed. W.B. Saunders Company; 1998.
*¹1/13/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Wysowski DK. Reports of esophageal cancer with oral bisphosphonate use. N Engl J Med. 2009;360:89-90.
Last reviewed February 2009 by ]]>Igor Puzanov, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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