What is Cancer of the Esophagus (Esophageal Cancer)?

Esophageal cancer, also called cancer of the esophagus, happens when the cells that line the esophagus become abnormal and grow at a rate beyond control. The esophagus is a fancy word for your food pipe. Your food pipe is made up several layers. The innermost layer is a called the mucosa, which contains three distinct layers itself. The mucosa’s innermost layer is called the epithelium and happens to be where most esophageal cancers start. 

What are signs and symptoms of esophageal cancer?

A lot of cancers share signs and symptoms with each other, and with other conditions that are totally benign. If you notice any of the following issues, please consult your doctor before assuming the worst:

  • Trouble swallowing. You may notice you find it more difficult to swallow as your tumor grows
  • Weight loss and lack of appetite, which could be caused by difficulty swallowing
  • Feeling a burning sensation or pressure in chest pain and discomfort
  • Hoarseness
  • A cough that doesn’t go away
  • Hiccups
  • Bleeding in the esophagus
  • Bone pain
  • Pneumonia

How is Esophageal Cancer Diagnosed and Treated?

It can be helpful to think of esophageal cancer as existing on a continuum, with heartburn on one end, gastroesophageal reflux disease (GERD in the middle), and esophageal cancer at the other end.

Now, most of us will get heartburn or acid reflux at some point in our lives. However, when it doesn’t go away and lasts for months or even years is when things can get a little dangerous. Having chronic symptoms may mean you have gastroesophageal reflux disease (GERD).

Some GERD can be treated with over-the-counter or prescription drugs along with some tweaks to your diet and sleeping habits. But untreated GERD that lasts for years can cause permanent damage to the inner lining of your esophagus. In fact, the cells that line your esophagus change in response to years of irritation from stomach acid—and that’s where trouble can arise. The new cells that begin replacing the lining of the esophagus lead to Barrett’s esophagus, a pre-cancerous condition that is estimated to affect more than 12 million adults in the United States.

In a more severe form of Barrett’s, the lining of the esophagus also contains dysplasia (cells that are turning into cancer). But the good news is that even if you do have Barrett’s esophagus, the odds that you’d get cancer from it are still pretty slim (less than 1% each year), according to the University of Maryland Medical Center. That risk rises to 5% over the course of your lifetime. Regardless, whether you have chronic GERD or Barrett’s esophagus, it’s still a good idea to touch base with your doctor just to make sure everything is okay.

Also, it’s important to know the risk factors for esophageal cancer. If you have any of the signs and symptoms of esophageal cancer mentioned above, have had chronic GERD, or have Barrett’s esophagus, please know that any of the following can increase your chances of developing esophageal cancer:

  • Smoking
  • Weighing 20% more than your ideal weight (medically defined as “obese”)
  • Drinking alcohol
  • Drinking very hot liquids on a regular basis
  • Not eating very many fruits or vegetables
  • Having trouble swallowing
  • Having bile reflux
  • Having gastroesophageal reflux disease (GERD)

The good news is doctors have several ways they can diagnose and treat esophageal cancer using:

  • Devices that take very detailed pictures of your esophagus and gather more information about your condition;
    • High-definition endoscopy with narrow band imaging
    • Video Laser Endomicroscopy (VLE)
    • Endoscopic ultrasound (EUS)
  • Procedures that allow them to examine, monitor, and/or treat cells and tissue for abnormalities:
  • WATS3D (wide-area transepithelial sampling with 3D computer analysis)
  • Molecular/DNA analysis of Barrett’s esophagus
  • Bravo™ pH probe
  • 24-hour pH testing with impedance and esophageal manometry
  • Stretta anti-reflux endoscopic therapy