Esophageal Cancer

The esophagus links the mouth to the stomach, forming an important part of the body's digestive system. Esophageal cancer includes lymphoma and tumors of the smooth muscle of the esophagus (which are usually not cancerous). The disease may show up as a narrowing of the esophagus, a lump or an abnormal flat area.

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Symptoms

This disease is fairly rare. Its symptoms are usually subtle and inconsistent, including:

  • Difficulty swallowing (solid foods first, then soft foods and eventually liquids)
  • Pressure, pain or burning in the chest
  • Having swallowed food come back up
  • Losing a lot of weight

Risk Factors

African Americans are three times more likely than Caucasians to develop this type of cancer. Other risk factors include:

  • Smoking and heavy alcohol use
  • Cancer in another part of the body
  • Swallowing lye or other chemicals
  • Irritation from acid or bile backflow
  • Conditions of the esophagus like achalasia, Barrett's esophagus or Plummer-Vinson syndrome (esophageal web)
  • Poor nutrition or a lack of trace minerals, particularly selenium
  • Infections
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Diagnosis

Cancer specialists have several techniques to help diagnose esophageal cancer:

  • Barium swallow. The patient drinks a special liquid (barium), which travels through the body and outlines the cancer when X-rayed.
  • Biopsy. A special instrument (endoscopy) is used to take a sample of tissue, which is examined under a microscope.
  • Endoscopic ultrasound, which allows the doctor to see if a mass has spread into the wall of the esophagus or nearby organs
  • Computed tomography (CT) scans to see if the tumor has spread to other organs, such as the liver or lungs
  • Positron emission tomography (PET) scan, which allows the doctor to see if the tumor has spread to the liver or lungs
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Treatments

Treatment usually involves a combination of options, specifically:

  • Removal of very early tumors with an endoscope
  • Chemotherapy
  • Radiation

When the cancer is advanced, swallowing can be made easier by:

  • Creating a passage through the tumor with expandable tubes that can be opened up to allow food to pass through to the stomach
  • Laser therapy, which uses laser light to destroy abnormal tissues
  • Thermal coagulation therapy, which uses either a laser or a heater probe to destroy part of the tumor to let the patient swallow more easily.