- The Esophagus
- What Causes Esophageal Cancer?
- What Are the Symptoms of Esophageal Cancer?
- How Is Esophageal Cancer Diagnosed?
- How Is Esophageal Cancer Treated?
The esophagus is a hollow, muscular tube that attaches from the neck to the abdomen and connects the mouth to the stomach. It moves food and liquid from the mouth to the stomach. The walls of the esophagus are made up of layers of tissues, including muscle, connective tissue and mucous membranes.
Esophageal cancer occurs when abnormal and uncontrolled growth of the cells occurs in the tissues of the esophagus. The lining of the esophagus is the most common site for cancer to develop. The esophagus is mostly lined with squamous cells, which can give rise to squamous cell cancer. The bottom portion of the esophagus, and the area where the esophagus connects to the stomach, are lined with columnar cells that can give rise to malignant tumors called adenocarcinomas. Sarcoma and small cell cancer are other rare forms of esophageal cancer include sarcoma and small cell cancer.
Risk factors that increase the chance of a person developing esophageal cancer include:
- Heavy alcohol use
- Barrett esophagus (an abnormal lining on the base of the esophagus that increases acid reflux problems)
- History of human papilloma virus
- Older age
The most common signs and symptoms of esophageal cancer are pain or difficulty swallowing, and weight loss. Other symptoms include:
- Pain behind the breast bone
- Cough and hoarseness
- Indigestion and heartburn
**These signs and symptoms should immediately be reported to your physician.**
Several tests and procedures are used to diagnose esophageal cancer, including:
- Chest x-ray
- Barium swallow (also referred to as an upper GI series)
- Biopsy (done during an esophagoscopy)
- CT or CAT scan (imaging procedure used to take pictures of the lungs, liver and other organs surrounding the esophagus)
After esophageal cancer is diagnosed, the cancer is staged (a process to determine the extent of disease) by the physician. Additional tests are ordered to complete the staging process. These tests may include:
- Endoscopic ultrasonography (EUS) (used to evaluate the tumor and lymph nodes)
- Bone scan (used to determine if the cancer has spread to the bone)
Three types of treatment for esophageal cancer include surgery, radiation therapy and chemotherapy. Surgery is the most common.
The most common surgical treatment for esophageal cancer is a procedure called an esophagectomy. In this procedure, the surgeon removes a part of (or the entire) esophagus, depending on the stage of the cancer. The remaining healthy tissue is then reconnected to the stomach (a process known as anastomosis) so the patient can continue to swallow. Lymph nodes may be removed and viewed under a microscope to determine if the cancer has spread.
Radiation therapy is administered according to the type and stage of the cancer. An "intraluminal intubation and dilation" is a standard procedure during radiation therapy where a plastic tube is inserted to keep the esophagus open.
Chemotherapy may be recommended as a single agent or in combination with other drugs. The way chemotherapy is administered depends on the type and stage of cancer.
Chemoradiation is recommended according to the type and stage of cancer.