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Esophageal Cancer

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 carcinomas occur in the inside lining layer of the esophagus, often in the upper and middle portions; whereas, adenocarcinomas begin in glandular cells and occur lower in the esophagus near the stomach.

Statistics

  • In 2022, approximately 20,640 new cases of esophageal cancer are expected to be diagnosed in the United States.
  • An estimated 16,410 Americans will die from the disease in 2022.
  • In Texas, an estimated 1,289 new esophageal cancer cases were anticipated in 2021, and 1,012 Texans were 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.
  • 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, and this change may lead to a greater risk of developing adenocarcinoma.
  • Tobacco and Alcohol: Both tobacco and alcohol use significantly raise the risk of esophageal cancer. When both are used, the risk is much greater than with 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 or injury from 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, which gets worse over time
  • Persistent indigestion or heartburn
  • Pain, pressure, or burning in chest
  • Frequent choking on food or vomiting after eating
  • Hoarsenessor chronic cough
  • Unintentional weight loss
  • Bleeding in the esophagus: coughing or vomiting up blood
  • New lumps under the skin, enlarged lymph nodes
  • Persistent abdominal pain
  • Bone pain

Tips for Prevention

Risk of esophageal cancer can be reduced by maintaining a healthy and active lifestyle, including not using tobacco, limiting or avoiding alcohol intake, eating a plant-based and balanced diet, and maintaining an healthy weight. Texas Oncology recommends people reduce risk factors for GERD and get 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 cure is not expected. Texas Oncology encourages patients to consider participating in a clinical trial when available.

Sources: American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, and Texas Cancer Registry


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