Diseases & Conditions

Esophageal Cancer: Causes, Symptoms, Diagnosis & Treatment

What is Esophageal Cancer?

Esophageal cancer begins in the esophagus. The esophagus is the tube between your throat and stomach that food passes along. Esophageal cancer develops when cancerous cells in the tissue of the esophagus begin to grow in an uncontrolled way and form a tumor. Cancer of the esophagus often has no symptoms until it has spread to other parts of the body. If it is caught early, doctors can offer treatments and surgery to manage the condition.

The two types of esophageal cancer are:

Adenocarcinoma: The most common type, this form of esophageal cancer develops in the mucus-making tissue which helps us to swallow. It usually develops in the lower part of the esophagus.
Squamous cell carcinoma: This type of esophageal cancer begins in squamous cells lining the esophagus. It usually affects the middle and upper parts of the esophagus.

What are the Symptoms of Esophageal Cancer?

Esophageal cancer is an aggressive form of the disease, but the symptoms are often not noticeable until it has spread. This is because the esophagus naturally stretches as we swallow food, so tumors may not be felt. Once the tumor grows, it can block the opening and swallowing may hurt or become hard. Other symptoms can include:

Unexplained weight loss
Chronic cough
Hoarseness
Coughing up blood
Vomiting
Heartburn
Pain in the throat, back, between the shoulder blades or behind the breastbone.

What Causes Esophageal Cancer?

The exact cause of esophageal cancer isn’t known, but there are risk factors that are known to increase the risk of it developing. These include:

Smoking or using tobacco products
Drinking too much alcohol
Obesity
A history of head or neck cancer
Barrett’s esophagus/chronic acid reflux: Untreated acid reflux can cause a change in cells in the esophagus.
Human papillomavirus (HPV): This is a common virus that can cause changes in the tissue of the mouth, vocal cord, genitals, hands and feet.
Other disorders: Some rare diseases, such as achalasia and tylosis can increase risk.
Exposure to certain chemicals: Long-term exposure to cleaning solvents can increase the risk of developing esophageal cancer.
Regular exposure to certain substances: Such as coal, metal and rubber.

How Can I Prevent Esophageal Cancer?

Esophageal cancer can’t be prevented, but there are certain things you can do to reduce the risk:

Maintain a healthy diet: Focus on a balanced diet and maintain a healthy weight.
Avoid tobacco and limit alcohol consumption: Quit smoking and limit alcohol to moderate levels.
Avoid HPV infection: Ask your doctor about the HPV vaccine.
Let your doctor know about Barrett’s esophagus diagnosis: Your doctor may provide screening if you are at an increased risk.

How is Esophageal Cancer Diagnosed?

Your doctor will perform a thorough physical examination, discuss your symptoms, and take your medical history. Advances in technology have improved the accuracy and efficiency of many gastrointestinal cancer diagnostic tests, including the tests for esophageal cancer. Diagnostic tests may include:

Barium swallow: This can identify tumors and cancer-related abnormalities and involves drinking a substance which makes the esophagus visible on X-ray.
PET/CT scan: Can be used to show if cancer has spread.
Esophagogastroduodenoscopy: An advanced endoscopic technique, using high-definition imaging. The procedure involves inserting a thin tube with a very small camera into the mouth to look at the esophagus and into the stomach. The doctor can pass very small surgical instruments through the endoscope to allow the removal of a tissue sample (biopsy) for testing.
Esophageal endoscopic ultrasound: Part or the Esophagogastroduodenoscopy procedure, an ultrasound probe can take images of the esophagus and show whether the cancer has spread.

What are the Treatment Options for Esophageal Cancer?

Treatment for esophageal cancer will depend on several factors, including the stage of the cancer and your overall health. A multidisciplinary team of experts will work with patients to discuss treatment options and preferences.

Thanks to advances in technology, doctors can now provide personalized treatment plans for patients diagnosed with esophageal cancer.

At Cleveland Clinic Abu Dhabi, experts create a personalized treatment plan tailored to each patient. Treatment options include:

Surgery: Removal of some or most of the esophagus is the most common treatment. This is called an esophagectomy. A new esophagus can be created by pulling some of the stomach up into the chest.
Photodynamic therapy: Drugs called photosensitizers are used to destroys tumors. The medication is activated by light, causing a chemical reaction which kills cancer cells.
Endoscopic submucosal dissection: Removal of part of the esophagus in early-stage cancers.
Endoscopic mucosal resection: This procedure removes tumors within the esophagus’s mucosal lining.
Endoscopic laser therapy: To ease the symptoms of esophageal cancer that is blocking the tube and making swallowing hard.
Chemotherapy: Medications are used to destroy cancer cells or prevent their growth.
Radiation therapy: High-energy X-rays or other types of radiation are used to target and destroy cancer cells. It can be used before surgery to shrink tumors or after surgery to kill any remaining cancer cells.
Targeted therapy: This treatment option uses drugs that specifically target cancer cells, sparing healthy cells. Targeted therapies can be used in combination with chemotherapy.
Immunotherapy: The patient’s own immune system is used to help fight cancer cells.

Esophageal cancer can be an aggressive type of cancer. Talk to your doctor if you are experiencing any of the symptoms of cancer of the esophagus.

This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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