What Is Cancer of the Esophagus?
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body.
To understand esophagus cancer, it helps to know about the normal structure and function of the esophagus.
- The esophagus is a hollow, muscular tube that connects the throat to the stomach. It lies behind the trachea (windpipe) and in front of the spine.
- Food and liquids that are swallowed travel through the inside of the esophagus (called the lumen) to reach the stomach. In adults, the esophagus is usually between 10 and 13 inches (25 to 33 centimeters [cm]) long and is about ¾ of an inch (2cm) across at its smallest point.
The wall of the esophagus has several layers. These layers are important for understanding where cancers in the esophagus usually start and how they can grow.
- Mucosa: This layer lines the inside of the esophagus.
- Submucosa: This is a layer of connective tissue just below the mucosa that contains blood vessels and nerves.
- Muscularis propria: This is a thick layer of muscle under the submucosa. It contracts in a coordinated way to push food down the esophagus from the throat to the stomach.
- Adventitia: This is the outermost layer of the esophagus, and is formed by connective tissue.
Cancer of the esophagus (also called esophageal cancer) starts in the inner layer (the mucosa) and grows outward (through the submucosa and the muscle layer).
There are 2 main types of esophageal cancer:
- Squamous cell carcinoma
This type of cancer can occur anywhere along the esophagus, but is most common in the portion of the esophagus located in the neck region and in the upper two-thirds of the chest cavity. It makes up less than half of esophageal cancers in this country.
- Adenocarcinoma
Cancers that start in gland cells (cells that make mucus) are called adenocarcinomas. This type of cancer usually occurs in the distal (lower third) part of the esophagus.
Facts about Esophageal Cancer
Cancers that start in the esophagus are much more common in men than in women. Many of these cancers are linked to tobacco or alcohol use, or to excess body weight.
The American Cancer Society’s estimates for esophageal cancer in the United States for 2019 are:
- About 17,650 new esophageal cancer cases diagnosed (13,750 in men and 3,900 in women)
- About 16,080 deaths from esophageal cancer (13,020 in men and 3,060 in women)
Although many people with esophageal cancer will go on to die from this disease, treatment has improved and survival rates are getting better. During the 1960s and 1970s, only about 5% of patients survived at least 5 years after being diagnosed. Now, about 20% of patients survive at least 5 years after diagnosis.
Risk Factors:
- AGE
The chance of getting esophageal cancer increases with age. Less than 15% of cases are found in people younger than age 55.
- GENDER
Men are more likely than women to get esophageal cancer.
- GASTROESOPHAGEAL REFLUX DISEASE(GERD)
In many people, reflux causes symptoms such as heartburn or pain that seem to come from the middle of the chest. In some, though, reflux doesn’t cause any symptoms at all. People with GERD have a slightly higher risk of getting adenocarcinoma of the esophagus.
- TOBACCO AND ALCOHOL
- The use of tobacco products, including cigarettes, cigars, pipes, and chewing tobacco, is a major risk factor for esophageal cancer.
- Drinking alcohol also increases the risk of esophageal cancer. The more alcohol someone drinks, the higher their chance of getting esophageal cancer.
- OBESITY
People who are overweight or obese (very overweight) have a higher chance of getting adenocarcinoma of the esophagus.
- DIET
Certain substances in the diet may increase esophageal cancer risk. For example, there have been suggestions, as yet not well proven, that a diet high in processed meat may increase the chance of developing esophageal cancer. On the other hand, a diet high in fruits and vegetables is linked to a lower risk of esophageal cancer.
Signs and Symptoms of Esophageal Cancer
Trouble swallowing
Feeling like the food is stuck in the throat or chest, or even choking on food. The medical term for trouble swallowing is dysphagia.
Chest pain
Sometimes, people have pain or discomfort in the middle part of their chest. Some people get a feeling of pressure or burning in the chest.
Weight loss
About half of people with esophageal cancer lose weight (without trying to).
Other symptoms
Other possible symptoms of cancer of the esophagus can include:
- Hoarseness
- Chronic cough
- Vomiting
- Hiccups
- Bone pain
- Bleeding into the esophagus. This blood then passes through the digestive tract, which may turn the stool black. Over time, this blood loss can lead to anemia (low red blood cell levels), which can make a person feel tired.
Having one or more of the symptoms above does not mean you have esophageal cancer. In fact, many of these symptoms are more likely to be caused by other conditions. Still, if you have any of these symptoms, especially trouble swallowing, it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.
