Esophageal Cancer — Early Detection and First Steps

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Understanding Esophageal Cancer

Esophageal cancer is a disease that causes cancer cells to form in the tissues of the esophagus, a hollow, muscular tube that food and liquid move through.
Several lifestyle factors, like smoking or heavy alcohol use, can increase a person’s risk of developing esophageal cancer.
The disease can be tough to treat because it is often diagnosed late.
It’s important to be aware of symptoms that may indicate esophageal cancer, such as pain/difficulty swallowing, weight loss, and pain behind the breastbone.

Esophageal cancer is a disease that causes cancer cells to form in the tissues of the esophagus, a hollow, muscular tube that food and liquid move through when traveling from the throat to the stomach. The wall of the esophagus is made of up several layers of tissue; cancer begins on the inside lining and spreads to the outer layers of the esophagus as it grows.

Several lifestyle factors, like smoking or heavy alcohol use, can increase a person’s risk of developing esophageal cancer. About 20,640 new cases of esophageal cancer are diagnosed in the U.S. every year, according to American Cancer Society estimates, and it is more common among men. About 16,510 new cases will be diagnosed in men, while 4,130 will be diagnosed in women. More than 16,000 people on average pass away from the disease every year.

“Esophageal cancer, we know is a tough one,” Dr. Brendon Stiles, a thoracic surgeon at Montefiore Medical Center, told SurvivorNet. “It’s one of the cancers with some of the lowest cure rates out there, but like many cancers, if we find it early, we can often treat it effectively—either with surgery, with surgery and chemotherapy, with chemotherapy and radiation.”

Dr. Stiles recommends that patients report any symptoms that may indicate esophageal cancer to their doctors right away, since there are more treatment options when the cancer is caught early.

Esophageal cancer symptoms

Unfortunately, symptoms can be a bit vague, so those experiencing them may not think cancer right away. Still, it’s important to be aware of signs of this disease, which include:

Pain/difficulty swallowing
Weight loss
Pain behind the breastbone
Hoarseness/cough
Indigestion/heartburn
A lump under the skin

“Try to get diagnosed early,” Dr. Stiles said. “For esophageal cancer, that means getting screened, getting endoscopies if you have any symptoms. The problem with esophageal cancer is it can mimic a lot of other things. You lose a little weight, have a little trouble swallowing, have a little heartburn—those are tough symptoms to pin down sometimes and often leads to patients with esophageal cancer presenting with later disease.”

Staging esophageal cancer

The two most common types of esophageal cancer are:

Squamous cell carcinoma (which forms in the thin, flat cells lining the inside of the esophagus)
Adenocarcinoma (cancer begins in the glandular cells, or the cells in the lining of the esophagus that produce and release fluids like mucus)

After you receive an esophageal cancer diagnosis, your doctor will need to determine the type, as well as the stage. Both types of esophageal cancer are broken up into five stages (0, 1, 2, 3, and 4).

“Once you do get diagnosed, ask what’s the stage,” Dr. Stiles said. “Patients should never be afraid to push doctors and say, ‘What is my stage? What are the treatment options at my stage? Do I have less invasive treatment options? Do I need multi-modality therapy?’ That means therapy with more than just surgery or more than just radiation with chemotherapy.”

Dr. Stiles stressed that patients with esophageal cancer must be advocates for their own disease and speak up about treatment concerns, and what other treatment options or routes may be available in their situation.

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