Esophageal Cancer is a condition in which a malignant tumor occurs in the esophagus, the tube that carries food from the mouth to the stomach. There are two types: adenocarcinoma, which is associated with acid reflux and Barrett’s esophagus, and squamous cell, which is associated with smoking and alcohol consumption. Although rare in the United States, esophageal cancer usually occurs in men over the age of 50.
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A. They include difficulty swallowing, regurgitation of food, heartburn, weight loss, vomiting blood and chest pain that isn’t related to eating.
A. Diagnostic tests include a barium swallow, endoscopic ultrasound (EUS), esophagogastroduodenoscopy (EGD) and biopsy, or examining stools for blood. Chest MRIs, thoracic CTs and PET scans may be used for determining the stage of the disease once it has been diagnosed.
A. If the cancer is localized in the esophagus, surgery to remove it is the preferred treatment. If you can’t tolerate surgery or if the disease has metastasized (spread) to other parts of the body, chemotherapy or radiation therapy may be used. In some cases, surgery is performed in combination with chemotherapy and radiation. At other times local therapy is performed using an endoscope and may include dilation of the esophagus, insertion of a plastic or metal tube or stent, or photodynamic therapy. These endoscopic procedures are often done to help relieve difficulties in swallowing.
A. In cases where surgery is an option, the cure rate is approximately 25 percent. When radiation or chemotherapy is used to treat a localized cancer, the cure rate is somewhat lower. If cancer has spread beyond the esophagus, it is usually not curable and treatment is directed primarily toward palliative care (efforts to alleviate symptoms and make the patient as comfortable as possible).
A. You can’t prevent it, but there are several things you can do to reduce the risk:
- Don’t smoke
- Reduce or eliminate alcohol consumption to reduce the likelihood of squamous cell cancer
- See your physician if you have severe or chronic acid reflux
If you have been diagnosed with Barrett’s esophagus, schedule appointments with your gastroenterologist at least once a year. An esophagogastroduodenoscopy (EGD), which allows a biopsy to be taken, may be needed on a regular basis to monitor the condition and detect early signs of cancer.