The esophagus is the tube that carries food from the mouth to the stomach. Esophageal cancer is the growth of cancer cells in this tube.
There are 2 main types of esophageal cancer:
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Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The term cancer refers to malignant growths. These growths invade nearby tissues and spread to other parts of the body. It is not clear exactly what causes these problems in the cells, but is likely a combination of genetics and environment.
Esophageal cancer is more common in men, and in people aged 50 years and older.
Other factors that may increase your chances of esophageal cancer:
Esophageal cancer may cause:
You will be asked about your symptoms and medical history. A physical exam will be done.
Your esophagus may need to be viewed. This can be done with:
Talk with your doctor about the best treatment plan for you. Options are based on the stage of your cancer and may include one or more of the following:
Endoscopy uses tubes to insert a lighted camera and surgical instruments.
In early stage cancers, the endoscope may be inserted through the mouth to remove tumors from the wall of the esophagus.
Endoscopy in late stage cancers may be done through small incisions in the chest to remove all or part of the esophagus, along with surrounding tissues and lymph nodes. Endoscopy is less invasive and allows for faster healing than open esophagectomy.
Most esophageal cancers are detected in late stages, so endoscopic resection may not be an option.
Open esophagectomy allows for removal of part or all of the esophagus through 1-2 large incisions. In some cases, the the stomach or piece of small intestine is pulled up into the chest and attached to the upper end of the esophagus, above the cancer. In others, a synthetic tube or a piece of small intestine is substituted.
This procedure is difficult. It has high rates of complications, and low rates of success. Mortality immediately following surgery is often high.
Radiation is used to kill cancer cells and shrink tumors. Radiation does not cure esophageal cancer, but it does offer temporary relief of symptoms and in some cases, shrinkage of the tumor. Radiation used in conjunction with chemotherapy, and sometimes followed by esophagectomy, may offer improved survival over any method used alone. Radiation may be:
The drugs will enter the bloodstream and travels through the body. It will kill mostly cancer cells. Some healthy cells may also be killed.
Chemotherapy alone will not cure this type of cancer. It is only used when the cancer has already spread and cannot be cured. At this point, it is used to help shrink the tumor, ease pain, or control nausea.
Chemoradiotherapy or Combined Modality Therapy
Chemotherapy and radiation therapy together are better than radiation alone. It has also been shown that these 2 treatments may be as effective as surgery alone.
This is a 3-step therapy. It includes chemotherapy, radiation therapy, and surgery. This has been shown to be a most aggressive form of therapy. It may be the best way to get a cure.
High-intensity light may be used to try to kill cancer cells.
A combination of drugs and special lights are used to try to kill cancer cells. The medication is absorbed into the cancer cells. The special lights stimulate the medication to kill the cancer cells.
This therapy is a promising treatment. It is only appropriate in a small number of people. There are limits to how far the infrared light source will travel into the cancer itself. The tumor must be small. It is also not used in cancer that has spread to any lymph nodes or other structures.
To help reduce your chances of esophageal cancer:
This type of cancer is usually detected in later stages. People who have risk factors, especially GERD or Barrett esophagus, should talk to their doctor about screening tests. Screening tests will look for cancer before symptoms appear.