Cancer of the Esophagus

What is cancer of the esophagus?

Cancer of the esophagus, also called esophageal cancer, is a tumor or abnormal growth of cells in the tube that connects your throat to your stomach. This tube is called the esophagus.

Cancer of the esophagus is uncommon. Most often people who get it are middle-aged or older. It is more common in men than in women. African-Americans are also more likely to get this kind of cancer. The chance of long-term recovery from cancer of the esophagus is usually poor but is better if the cancer is found early.

How does it occur?

The cause of cancer of the esophagus is not known.

You are more at risk for esophageal cancer if you use any tobacco product or drink a lot of alcohol. You are also more at risk if you:

have had long-term reflux of fluid from the stomach into the lower esophagus (hiatal hernia)
have long-standing heartburn
eat a diet short on fruits, vegetables, and certain minerals
drink a lot of very hot liquids

What are the symptoms?

Symptoms include:

Trouble swallowing (food may feel as though it is stuck in your throat or behind your breastbone). First, you may have trouble swallowing solid foods. Later, soft foods may be hard to swallow. Eventually you may have trouble swallowing even liquids.
A burning feeling when food is swallowed.
Heartburn when you drink hot liquids.
Pain behind the breastbone that does not go away.
Weight loss.

As the tumor grows, your esophagus gets narrower. Symptoms in later stages of the cancer may include drooling, spitting up pieces of undigested food, and weight loss. Lung infections caused by liquids spilling over into your windpipe (trachea) are common. You may also have hoarseness and coughing if other tissues near the esophagus are affected by the cancer.

How is it diagnosed?

Your health care provider may use the following tests:

A barium swallow x-ray allows your health care provider to watch liquids move from your esophagus to your stomach. It can help show the size, shape, and location of the cancer.
A procedure called an endoscopy may be done. After you are given a drug to make you sleepy, a slim flexible tube with a tiny camera is inserted through your mouth so your provider can look at your esophagus.
A sample of tissue may be removed from an area of the esophagus that appears abnormal. The tissue is examined for the presence of cancer. This test is called a biopsy and is usually done during an endoscopy.
Blood tests and other x-rays and scans may be done to see if the disease has spread beyond the esophagus.

How is it treated?

Treatment depends on the size and location of the cancer, whether and how much it has spread, your age, and your general health. You may be treated with surgery, radiation therapy, chemotherapy, or a combination of these treatments.

Surgery may remove part of the esophagus and nearby lymph nodes. It can cure some people whose cancer has not spread beyond the esophagus. For others, it simply relieves some symptoms.
Radiation therapy uses high-energy radiation to kill cancer cells. It is often used to relieve pain and shrink the tumor to make swallowing easier.
Chemotherapy uses special anticancer drugs given by mouth or an injection through the skin or into a vein.

Combining surgery with other treatments such as chemotherapy or radiation therapy may help some people live longer and with fewer symptoms.

How long will the effects last?

Early diagnosis is key to survival. If you have any of the symptoms and are at a high risk for this disease, see your health care provider. Unfortunately, the cancer is often not diagnosed until symptoms appear during the later stages of the disease, and the cancer can spread easily. However, improved treatments have helped increase the life span and comfort of people with this disease.

How can I avoid getting esophageal cancer?

There is no sure way to prevent this kind of cancer. You can reduce your risk of getting it if you don't smoke and if you drink only a moderate amount of alcohol. To catch any problems early, have regular checkups and be aware of any change in your bodily functions.

How can I take care of myself?

Talk to your health care provider if you have concerns about the course of your illness and treatments. Ask about side effects you may have from treatments. You may want to make a list of questions at home and take it with you when you visit your provider. Ask a friend to go with you who can listen, too. If you don't understand something, ask your provider to explain it. Take notes if you need to.

The following guidelines may help control your symptoms:

Eat small, frequent meals.
Follow your health care provider's advice about foods you should eat to maintain your strength and to provide nutrients that will heal tissues after treatment.
If you are a heavy drinker or smoker, talk to your provider about quitting.
Get plenty of rest and sleep.
Take pain medicine as prescribed.
If possible, join a cancer support group.

For more information, contact your local chapter of the American Cancer Society or call 800-ACS-2345. The National Cancer Institute (800-4-CANCER) is another resource. You may also visit their Web sites at http://www.cancer.org or http://www.cancer.gov.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File CNC3523F.HTM Release 9.0/2006