Esophageal cancer is a malignant (cancerous) tumor of the esophagus, the muscular tube that moves food from the mouth to the stomach. Its symptoms can include trouble swallowing (dysphagia), chest pain, bleeding, weight loss, and heartburn. Obviously these symptoms can overlap with many benign, non-cancerous diseases. The most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma, which develop in the cells that line the wall of the esophagus. Squamous cell esophageal cancer is associated with smoking and alcohol consumption. Barrett’s esophagus, a complication of acid reflux (see GERD, BARRETT’S ESOPHAGUS) is a risk factor for the development of adenocarcinoma of the esophagus.
Tests used to help diagnose esophageal cancer may include X-rays (barium swallow), endoscopy (EGD) and biopsy (tissue sampling), the ”gold standard” of diagnosis, and more sophisticated radiological studies such as chest CT, MRI, or PET scans. When esophageal cancer is only in the esophagus and has not spread elsewhere, surgery is the treatment of choice, with the goal of removing the cancer. Sometimes chemotherapy, radiation therapy, or a combination of the two may be used instead of ,or in addition to,surgery. Esophageal cancer is a very difficult disease to treat, and unless it is detected early, chances of survival are not good.
In terms of prevention, avoiding smoking and limiting alcoholic consumption can be helpful. People with symptoms of severe reflux should undergo upper endosopy to screen for a particular type of abnormal lining called Barrett’s esophagus (see BARRETT’S ESOPHAGUS). If present, the cells in this lining have the potential to turn into esophageal cancer, and they should be endoscopically biopsied and assessed every few years (a process called endoscopic surveillance).