There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma.
Squamous cell esophageal cancer is linked to smoking and alcohol abuse.
Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Other risk factors include smoking, being male, or being obese.
Esophageal Cancer Symptoms
Symptoms may include any of the following:
- Backward movement of food through the esophagus and possibly mouth (regurgitation)
- Chest pain not related to eating
- Difficulty swallowing solids or liquids
- Heartburn
- Vomiting blood
- Weight loss
Esophageal Cancer Diagnosis
Tests used to help diagnose esophageal cancer may include:
- Barium swallow
- Chest MRI or thoracic CT (usually used to help determine the stage of the disease)
- Endoscopic ultrasound (also sometimes used to determine the stage of disease)
- Esophagogastroduodenoscopy (EGD) and biopsy
- PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible)
Multidisciplinary Approach to Esophageal Cancer Treatment
When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using:
- Open surgery, during which one or two larger incisions are made.
- Minimally invasive surgery, during which a 2 to 4 small incisions are made in the belly. A laparoscope with a tiny camera is inserted into the belly through one of the incisions.
Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus.
Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform.
If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms.
Beside a change in diet, other treatments that may be used to help the patient swallow include:
- Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open.
- A feeding tube into the stomach.
- Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor.
At the Wake Forest Baptist Comprehensive Cancer Center, management of gastrointestinal cancers focuses on preventive measures, early detection and the most advanced forms of treatment.
Some of these cancers are among the most complex and difficult to treat, and patients can take comfort in knowing they are being treated by a team of specialists that is among the most experienced in the country.
It is because of our multidisciplinary approach to cancer treatment, that we have been designated by the National Cancer Institute as a Comprehensive Cancer Center, one of only 51 in the country.