Esophageal cancer is a disease that occurs in the esophagus – the long tube that runs from your throat to your stomach and carries food and liquids to the stomach for digestion. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma arises from the inside lining layer of the esophagus, often in the upper and middle portions; adenocarcinoma begins in glandular cells and occurs lower in the esophagus, near the stomach.
Statistics
- In 2024, approximately 22,370 new cases of esophageal cancer are expected to be diagnosed in the United States.
- An estimated 16,130 Americans will die from the disease in 2024.
- In Texas, an estimated 1,430 new esophageal cancer cases are anticipated in 2024, and 1,060 Texans are expected to die from the disease.
Risk Factors
- Age: Esophageal cancer risk increases with age and is most often diagnosed over age 55.
- Gender: Men are three to four times more likely to develop esophageal cancer than women.
- Race: African Americans are two times more likely to develop squamous cell esophageal cancer than white people.
- Personal History: People who have had mouth, throat, or lung cancer have a higher risk of esophageal cancer.
- Gastroesophageal Reflux Disease (GERD): People with a history of acid reflux have a slightly higher risk.
- Barrett’s Esophagus: Barrett’s esophagus results from long-term severe acid reflux. In this situation, the lining cells of the lower esophagus undergo a change to a glandular type of cell. This change may lead to a greater risk of developing adenocarcinoma.
- Tobacco and Alcohol: Tobacco and alcohol use significantly raise the risk of esophageal cancer. When both are used, the risk is much greater than with use of either alone.
- Obesity: People who are overweight or obese have a higher risk of esophageal cancer, which may be related to higher risk of gastroesophageal reflux disease.
- Diet: There are some reports that a diet high in processed meat may correlate with increased risk of esophageal cancer, and a plant-based diet correlates with a lower risk.
- Esophageal Diseases and Injury: People with achalasia, tylosis, Plummer-Vinson syndrome, and exposure to certain chemicals, such as lye, face a higher risk of esophageal cancer.
Symptoms and Signs
Esophageal cancer symptoms vary from person to person. People with any of these symptoms should consult their physician:
- Loss of Appetite
- Trouble swallowing that worsens over time
- Persistent indigestion or heartburn
- Pain, pressure, or burning in chest
- Frequent choking on food or vomiting
- Hoarseness or chronic cough
- Unintentional weight loss
- Bleeding in the esophagus
- New lumps under the skin, enlarged lymph nodes
Tips for Prevention
Risk of esophageal cancer can be reduced by maintaining a healthy and active lifestyle, including not using tobacco, minimizing or avoiding alcohol intake, eating a plant-based and balanced diet, and maintaining a healthy weight. Texas Oncology recommends people reduce risk factors for GERD and seek treatment for gastroesophageal reflux disease. People with Barrett’s esophagus should be screened regularly for signs of progression to cancer.
Treatment
There are many treatment options for people with esophageal cancer, and these are often used together or in sequence. Treatments can include endoscopic ablation with laser therapy or electrocoagulation, surgery, radiation with electron beam or proton therapy, and systemic (medication) therapy such as chemotherapy, targeted therapy, or immunotherapy. Palliation of symptoms and supportive care are also very important. Esophageal cancer is often found at a later stage and treatments may relieve symptoms and improve quality of life even when a cure is not expected. Texas Oncology encourages patients to consider participating in a clinical trial when available.