What is esophageal cancer?
Definition:
Esophageal cancer is a malignant tumor of the esophagus (the muscular
tube that propels food from the mouth to the stomach).
Causes, incidence, and risk factors:
Esophageal cancer is relatively uncommon in the United States, and
occurs most often in men over 50 years old. It affects less than 5 in
100,000 people. There are two main types of esophageal cancer,
distinguished by the way they look under the microscope: squamous cell
carcinoma and adenocarcinoma.
Squamous cell cancer is associated with smoking and alcohol consumption.
The incidence of this disease in the United States has remained
relatively constant, while the incidence of adenocarcinoma of the
esophagus has risen dramatically.
Barrett’s esophagus, a complication of gastroesophageal reflux disease
(GERD), is a risk factor for the development of adenocarcinoma of the
esophagus.
Symptoms of esophageal cancer:
- Difficulty swallowing solids or liquids
- Regurgitation of food
- Heartburn
- Weight loss
- Vomiting blood
- Chest pain unrelated to eating
Signs and tests:
- Barium swallow
- EGD (esophagogastroduodenoscopy) and biopsy
- Chest MRI or thoracic CT (usually used for helping to determine the stage of the disease)
- PET scan (sometimes useful for determine stage of disease and whether surgery is possible)
- Evidence of occult blood in stool
Expectations (prognosis): Esophageal cancer is a very difficult
disease to treat, but it can be cured in patients whose disease is
confined to the esophagus. In circumstances in which surgery can be
performed, cure rates are in the range of 25%.
In some circumstances in which the cancer is localized to the esophagus
and radiation therapy is used instead of surgery, cure is possible but
is less likely than with surgery.
For patients whose cancer has spread outside the esophagus, cure is
generally not possible and treatment is directed toward relief of
symptoms.
The esophagus, stomach, large and small intestine, aided by the liver,
gallbladder and pancreas convert the nutritive components of food into
energy and break down the non-nutritive components into waste to be
excreted.
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