The esophagus is the hollow tube that serves as the passageway for food and liquid from the mouth to the stomach. Esophageal cancer is when cells in the esophagus start to grow uncontrollably.
When esophageal cancer starts to spread, it goes beyond the lining of the esophagus and spreads into the nearby lymph nodes. When the cancer cells enter the lymphatic system, they can potentially travel throughout the body.
Esophageal cancer may show limited symptoms or may be asymptomatic during its early stages. This makes it difficult to diagnose and treat in a timely manner.
Kinds of esophageal cancer
Adenocarcinoma
This occurs in the lining of the lower part of the esophagus near the stomach where mucus is produced. This mucus helps food pass through.
Squamous cell carcinoma
Cancer cells start to grow in the flat cells that line the inner layer of the esophagus.
Risk Factors
Esophageal cancer often occurs in men who are 50 years old and above. People who smoke and drink too much alcohol may also be at higher risk of getting esophageal cancer. People who are obese or have nutritional deficiencies are also at risk.
Conditions that increase the risk of esophageal cancer include:
- Gastroesophageal reflux disease (GERD) – This occurs when fluid from the stomach regurgitates causing a burning sensation in the chest (heartburn)
- Barrett’s esophagus – Barrett’s esophagus is a complication of GERD. The cells in the esophagus change to look like cells that make up the intestine due to prolonged exposure to acid from the stomach.
- Achalasia – Achalasia is a condition wherein the nerves of the esophagus are damaged and paralyzed, making it difficult to push down food into the stomach.
Genetic diseases such as Bloom syndrome, Fanconi anemia, and Howel-Evans syndrome are also associated with esophageal cancer.
Symptoms
During the early stages, symptoms of esophageal cancer can be mistaken for other conditions such as GERD. Symptoms often worsen as the cancer progresses.
Symptoms include:
- Difficulty swallowing
- Chest pain
- Heartburn
- Unexplained weight loss
- Persistent coughing
- Blood in the stool
- Vomiting blood
- Decreased appetite
- Indigestion
- Lump under the skin in the chest
Esophageal cancer can spread to other parts of the body which can also produce different symptoms depending on the affected organ. Symptoms may include:
- Hypercalcemia – Abnormal levels of calcium are present in the body.
- Respiratory Fistulas – Abnormal connections between blood vessels causes blood to pass through the lungs, without the lungs receiving sufficient oxygen.
Diagnosis
The doctor will conduct a physical exam to check for any lumps especially in the upper gastrointestinal tract. Lifestyle factors and medical history will also be taken into account. Tests used to help in diagnosing esophageal cancer include:
- Barium Swallow – The patient drinks barium so that the esophagus’ contours are more visible in an x-ray. The esophagus is usually smooth but if the x-ray shows any abnormalities, it can be a sign of cancer.
- Esophagoscopy – A tube with a camera passes through the patient’s esophagus and high-resolution images are displayed so that the physician can have a closer look at the inner layer of the esophagus.
- Biopsy – During the esophagoscopy, the doctor will collect a sample of the esophageal tissue. The tissue is examined under a microscope for signs of cancer.
Aside from an X-ray, other imaging tests such as CAT, MRI, and PET scans will also be conducted especially if there is a suspicion that the esophageal cancer has already spread to other parts of the body.
Treatment
Esophageal cancer progresses and causes death especially if it is diagnosed in its late stages. The earlier the diagnosis and treatment, the higher the chances of recovery. Treatment depends on the stage the cancer is in and the type of esophageal cancer.
Treatment may include:
- Surgery – This may include an esophagectomy, the procedure of removing all or part of the esophagus. Lymph nodes that might be infected and a part of the stomach may also be removed to stop the cancer from spreading.
- Radiation therapy – A beam of radiation is aimed at the tumor to interfere with the division and growth of the cancer cells.
- Chemotherapy – Drugs are administered orally or intravenously to kill or stop the growth of the cancer cells. In some instances, chemotherapy is used to reduce the size of the tumor before surgery.
- Supportive Care – People who are affected with terminal esophageal cancer can opt for palliative care. They can receive treatments that can alleviate pain and lessen the severity of symptoms.
People affected with esophageal cancer may also choose to partake in clinical trials that will help in cancer research.
Key takeaway
Esophageal cancer is a disease wherein cancer cells start growing in some parts of the esophagus and can spread to the lymph nodes and other parts of the body. Esophageal cancer presents mild to no symptoms during its early stages, and is usually diagnosed in its late stages. Treatment such as chemotherapy, radiation therapy, and surgery are options for managing this form of cancer.
Learn about Other Cancers here.
