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Esophageal Cancer

Esophageal cancer is a disease that occurs in the esophagus – a long tube that runs from your throat to your stomach which carries food and liquids to the stomach for digestion. The esophagus wall has several layers. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinomas occur in the inside layer of the esophagus whereas adenocarcinomas begin in the glandular cells and occur in the lower esophagus, near the stomach.

Statistics

  • In 2016, 16,910 new cases of esophageal cancer are expected to be diagnosed in the United States.
  • An estimated 15,690 Americans will die from the disease in 2016.
  • In Texas, an estimated 1,045 new esophageal cancer cases were anticipated, and 913 Texans were expected to die from the disease in 2015.

Risk Factors

  • Age: The risk of esophageal cancer increases with age with the majority of people diagnosed being over the age of 55.
  • Gender: Men are three times more likely to develop esophageal cancer than women. 
  • Personal History: People who have had lung, mouth, or throat cancer have a higher risk of esophageal cancer.
  • Acid Reflux: People with a history of acid reflux have a slightly higher risk.
  • Barrett’s esophagus: Barrett’s esophagus results from long-term acid reflux. In this situation, the lining cells of the esophagus undergo a change to a glandular type of cell, and this change may result in a greater risk of developing adenocarcinoma.
  • Tobacco and alcohol: Both tobacco and alcohol significantly raise the risk of esophageal cancer. Together, the risk is much greater than either alone.
  • Obesity: People who are overweight or obese have a higher risk of esophageal cancer, as this population is more likely to have reflux.
  • Diet: A diet high in processed meat may increase risk of esophageal cancer, but a diet high in fruits and vegetables lowers the risk.
  • Esophageal diseases and injury: People with achalasia, tylosis, Plummer-Vinson syndrome, and exposure to or injury from certain chemicals face a higher risk of esophageal cancer.

Symptoms and Signs

Esophageal cancer varies with each patient. People with these symptoms should consult their physician:

  • Trouble swallowing which gets worse over time
  • Chest pain
  • Weight loss with no known cause
  • Indigestion and heartburn
  • Persistent hoarseness, cough, or hiccups
  • Blood in stool or vomiting of blood
  • Loss of appetite
  • Pneumonia
  • Pain in the bones
  • Pain located behind the breastbone

Tips for Prevention

Some cases of esophageal cancer are preventable by maintaining a healthy lifestyle, including not using tobacco, limiting alcohol intake, eating a healthy diet, and maintaining an ideal weight. Texas Oncology recommends people with Barrett’s esophagus get tested to look for signs of cancer. Preventing Barrett’s esophagus and esophageal cancer may be possible by treating reflux. If you have chronic heartburn or reflux, you should contact your physician as treatment may lower your risk of Barrett’s esophagus and esophageal cancer.

Treatment

Treatment options for people with esophageal cancer include surgery, radiation therapy, proton therapy, chemotherapy, targeted therapy, or a combination of these treatments. Esophageal cancer is often found at later stages and many treatments are aimed at symptoms, but the cancer is difficult to control with current treatments; therefore, many doctors encourage patients to consider participating in a clinical trial.

Source: American Cancer Society, National Cancer Institute, National Library of Medicine, and Texas Cancer Registry