Esophageal Cancer

Esophageal cancer is a serious and complex disease which happens when cancer cells form in the tissues of the esophagus. This condition may respond best to early treatment, so check with your doctor if you think you may have certain risk factors such as smoking or heavy alcohol use.

What Is Esophageal Cancer?

The esophagus is the 10-inch-long muscular tube that carries food and water from the mouth to the stomach. A small flap called the epiglottis covers the windpipe, so the food travels down the stomach and does not interfere with normal breathing. When the cells in the esophagus lining grow very quickly, they can form a tumor. The tumor can spread to other organs, such as the lymph nodes. Several types of cancer can develop in the esophagus:

• Adenocarcinoma – this type of cancer starts in the gland cells, usually in the lower third of the esophagus. Having Barrett's esophagus (which is caused by reflux of stomach acid) can increase the risk for adenocarcinoma. Most esophageal cancers fit into this category.
• Squamous cell carcinoma – the esophagus is lined with squamous cells. If the cancer starts in these cells, we call it squamous cell carcinoma. This condition starts most often in the neck and upper two thirds of the chest.

What Causes Esophageal Cancer?

There is no exact cause of esophageal cancer. However, the following may increase a person’s risk of developing this disease:

• Smoking
• Heavy alcohol use
• Aging
• Barrett’s esophagus – a gastroesophageal reflux disease (GERD) complication wherein cells like those found in the small intestine replace the esophagus' normal tissue lining

Talk to your doctor if you think you may be at risk for proper evaluation.

What Are the Early Signs of Esophageal Cancer

At the earliest stages, some patients may not experience any signs of esophageal cancer. As it develops, patients may experience any of these symptoms:

• Difficulty swallowing
• Hoarseness and cough
• Heartburn and indigestion
• Pain behind the breastbone
• Unintentional weight loss
• Unusual lump under the skin

Visit a doctor if you experience any of these esophageal cancer symptoms for proper diagnosis and evaluation.

Esophageal Cancer Treatment

At Saint Vincent Hospital and Cancer Center in Worcester, MA, a multidisciplinary team of gastroenterologists, medical oncologists, radiation oncologists and thoracic surgeons have extensive expertise in caring for patients with esophageal cancer and the precancerous Barrett's esophagus. We use high-definition endoscopy to examine the esophagus. If precancerous or cancerous tissue is found, it can often be removed using the same endoscopic procedure.

If more extensive esophageal cancer is found, Saint Vincent Hospital thoracic and general surgeons can treat it with an advanced procedure called esophagectomy. In this procedure, surgeons remove all or part of the esophagus and then rebuild it from part of the stomach or intestine.