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About esophageal cancer

The esophagus is the hollow tube that connects the throat to the stomach, allowing food to pass. It sits behind the trachea, or windpipe, and in front of the spine. Esophageal cancer develops when the tissue that lines the esophagus becomes malignant.

What causes esophageal cancer?

Researchers believe esophageal cancer may develop from damaged DNA in the cells that line the esophagus. The DNA damage is frequently caused by long-term irritants, such as chronic tobacco or alcohol use. 

Other factors that may lead to esophageal cancer include:

  • Obesity
  • Conditions like gastroesophageal reflux disease (GERD), Barrett"s esophagus and achalasia
  • A diet low in fruits, vegetables and certain vitamins and minerals

Learn more about risk factors for esophageal cancer

Who gets esophageal cancer?

The risk for developing esophageal cancer increases with age, and men are three to four times more likely than women to be diagnosed with the disease. People who are obese or who drink or smoke excessively, especially in combination, are also more likely to develop esophageal cancer.

People with certain conditions are also at higher risk. These conditions include:

  • GERD
  • Barrett"s esophagus
  • Achalasia
  • Tylosis
  • Esophageal webs

Esophageal cancer is rare, accounting for 1 percent of all cancers diagnosed in the United States. According to the American Society of Clinical Oncology, an estimated 18,440 Americans will be diagnosed with esophageal cancer in 2020. The disease accounts for more than 2 percent (more than 16,000) of cancer deaths each year in the United States.

Esophageal cancer types

Esophageal cancers are classified depending on the type of cell in which they form. The two primary types of esophageal cancer are:

Adenocarcinomas of the esophagus: This is the most common type of esophageal cancer in the United States. Esophageal adenocarcinomas form in the mucus-forming gland cells of the esophageal lining, often in the lower part of the esophagus. Obesity and persistent acid reflux, which may or may not develop into Barrett"s esophagus, are associated with a higher risk for adenocarcinomas of the esophagus.

Squamous cell carcinoma: This type of esophageal cancer forms in squamous cells most often found in the upper part of the esophagus, in the upper chest and the neck. According to the American Cancer Society, squamous cell carcinoma once was the most common type of esophageal cancer, but now accounts for less than half of all new cases.

Learn more about esophageal cancer types

Esophageal cancer symptoms

In its early stages, esophageal cancer typically doesn"t cause signs or symptoms. Once the disease has advanced, the most common symptom is often trouble swallowing, or dysphagia, caused when the opening to the esophagus contracts and becomes smaller. This symptom generally worsens over time.

Other symptoms of esophageal cancer include:

  • Unintentional weight loss
  • Chest pain or discomfort
  • Hoarseness
  • Chronic cough
  • Indigestion and heartburn

Learn more about esophageal cancer symptoms

Diagnosing esophageal cancer

A diagnosis of esophageal cancer is usually determined after several tests have been performed. People with conditions that increase their risk of developing esophageal cancer, such as Barrett"s esophagus, may be advised to have regular endoscopic exams to look for changes in tissue.

Diagnostic tests may include:

  • Advanced genomic testing
  • Nutrition panel
  • Upper endoscopy
  • Biopsy
  • Endoscopic ultrasound (EUS)
  • Imaging scans
  • Lab tests

Learn more about diagnosing esophageal cancer

Treating esophageal cancer

Depending on the type and stage of the disease, treatment for esophageal cancer may include therapies delivered either alone or in combination. These treatments may include:

  • Immunotherapy
  • Targeted therapy
  • Gastrointestinal procedures
  • Radiation therapy
  • Surgery
  • Interventional radiology

Learn more about treatments for esophageal cancer

Next topic: What are the risk factors for esophageal cancer?

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