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Esophageal Cancer


Disease: Esophageal Cancer Esophageal Cancer
Category: Tumors

Disease Definition:

The esophagus is a long hollow tube that runs from the throat to the stomach, carrying the swallowed food to the stomach to be digested. Esophageal cancer is cancer that occurs in the esophagus, and it usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. Esophageal cancer is quite common in Asia and parts of Africa.

Work Group:

Symptoms, Causes


Some of the signs and symptoms of esophageal cancer may include:


  • Fatigue
  • Chest pain
  • Difficulty swallowing
  • Losing weight without trying


Esophageal cancer doesn’t cause any signs or symptoms in its early stages. In case someone notices any persistent signs and symptoms that are worrisome, they should see a doctor.


The risk of esophageal cancer increases if someone has been diagnosed with Barrett’s esophagus, which is a precancerous condition. A person should ask a doctor what screening tests to consider and what symptoms to watch for that could signal that their condition is worsening.


When the cells in the esophagus develop errors or mutations in their DNA, esophageal cancer occurs. The causes of these mutations are not clear. They make cells grow and divide out of control and the accumulating abnormal cells form a tumor in the esophagus, which could grow and invade nearby structures and spread to other parts of the body.


The type of esophageal cancer someone has helps determine their treatment options. This cancer is classified according to the type of cells that are involved. Esophageal cancer could be classified in these types:


Squamous cell carcinoma:

This type usually occurs in the middle of the esophagus and it is the most prevalent esophageal cancer worldwide. The squamous cells are flat, thin cells that line the surface of the esophagus.



This type usually occurs in the lower portion of the esophagus. It begins in the cells of mucus-secreting glands in the esophagus.


Other types:

Lymphoma, sarcoma, melanoma, choriocarcinoma and small cell cancer are some of the rare forms of esophageal cancer.



Some of the complications that esophageal cancer could cause include:


Obstruction of the esophagus:

Because of cancer, it may be difficult or even impossible for food and liquid to pass through the esophagus. In order to relieve esophageal obstruction, a number of treatments are available, such as using an endoscope and special tools in order to widen the esophagus and place a metal tube called a stent to hold the esophagus open. Surgery, laser therapy, chemotherapy, radiation therapy and photodynamic therapy are some of the other available treatment options.


Bleeding in the esophagus:

Bleeding can be caused by esophageal cancer, requiring endoscopic procedures or surgery. Usually, bleeding is gradual; however, at times it could be sudden and severe.


Cancer pain:

A person may experience pain due to advanced esophageal cancer. In order to make the patient more comfortable, the doctor will try to determine the causes of the pain and appropriate treatments.



A tracheoesophageal fistula, which could causes severe and sudden couging when swallowing, occurs when esophageal cancer erodes the esophagus and creates a hole into the trachea or wind pipe.


Severe weight loss:

Swallowing food and drinks may be quite difficult due to esophageal cancer, which will make maintaining weight difficult. The patient may either be recommended the placement of a feeding tube to provide nutrition, or they may be referred to a nutritionist who can discuss strategies for finding easier-to-eat foods that are high in calories.


Treatment for esophageal cancer will be based on:


  • The type of cells involved in the cancer
  • The cancer’s stage
  • The patient's overall health
  • The patient's own preferences for treatment



Surgery to remove cancer could be either performed alone or in combination with other treatments. Some of the operations that are done to treat esophageal cancer are:


Surgery to remove very small tumors:

Someone may be recommended removing the cancer and a margin of healthy tissue that surrounds it in case their cancer is very small, confined to the superficial layers of the esophagus and hasn’t spread. Surgery could be done using an endoscope passed down the throat and into the esophagus to access the cancer in its very early stages.



During this surgery, the portion of the esophagus containing the tumor is removed, along with nearby lymph nodes. The remaining esophagus is reconnected to the stomach, usually by pulling the stomach up to meet the remaining esophagus. In some cases, in order to replace the missing section of the esophagus, a portion of the colon is used.



During this surgery, a part of the esophagus is removed, along with nearby lymph nodes and the upper part of the stomach and the remaining esophagus is reconnected to the stomach, usually by pulling the stomach up to meet the remaining esophagus. In some cases, in order to replace the missing section of the esophagus, a portion of the colon is used.


Infection, bleeding and leakage from the area where the remaining esophagus is reattached are some of the serious complications of esophageal cancer surgery. Surgery to remove the esophagus will be performed as an open procedure using large incisions or with special surgical tools that are inserted through several small incisions in the skin (laparoscopically). The patient's situation and the surgeon’s experience and preferences are some of the things that will determine how the surgery turns out.



The drug treatment that uses chemicals to kill cancer cells is called chemotherapy. The drugs used in chemotherapy are usually used either before or after surgery in people with esophageal cancer. Radiation therapy could be combined with chemotherapy. In order to help relieve signs and symptoms caused by the cancer, people with advanced cancer can use chemotherapy alone.
Depending on the chemotherapy drugs someone receives, the side effects could vary.



In this type of therapy, high-powered energy beams are used in order to kill cancer cells. Radiations could either be placed inside the body near the cancer, a method called brachytherapy, or it could come from a machine outside the body that aims the beams at the cancer, a method called external beam radiation. In people with esophageal cancer, radiation therapy is usually combined with chemotherapy. This therapy is also used in relieving the complications of advanced esophageal cancer, such as when a tumor grows large enough to stop food from passing to the stomach.
Sunburn-like skin reactions, accidental damage to nearby organs including the heart and the lungs, and painful or difficulty swallowing are some of the side effects of radiation to the esophagus.



The effectiveness of each treatment could be enhanced when chemotherapy is combined with radiation therapy. Combined treatment could be used before surgery, or it could be the only treatment that the patient receives. However, the likelihood and the severity of the side effects are increased when chemotherapy and radiation treatments are combined.


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