Esophageal Cancer: Overview
What is esophageal cancer?
Cancer starts when cells change and grow out of control. The changed (abnormal) cells
often grow to form a lump or mass called a tumor. Cancer cells can also grow into
(invade) nearby tissues. And they can spread to other parts of the body. This is called
The esophagus is the swallowing tube. It carries food and liquid from your mouth to
your stomach. It sits behind your windpipe (trachea) and in front of your spine.
The wall of the esophagus is made of layers of tissue and muscle. Esophageal cancer
starts in cells that make up the inner lining layer of the esophagus. As it grows,
it moves deeper into the other layers of the esophageal wall.
Who is at risk for esophageal cancer?
A risk factor is anything that may increase your chance of having a disease. The exact
cause of someone’s cancer may not be known. But risk factors can make it more likely
for a person to have cancer. Some risk factors may not be in your control. But others
may be things you can change.
The risk factors for esophageal cancer include:
Being a man
Gastroesophageal reflux disease (GERD)
Barrett esophagus, a condition in which the cells in the esophagus change because
of long-term acid reflux
Certain other health conditions and syndromes
History of lung, throat, or mouth cancer
HPV (human papillomavirus) infection
Talk with your healthcare provider about your risk factors for esophageal cancer and
what you can do about them.
Can esophageal cancer be prevented?
There’s no sure way to prevent esophageal cancer. But you may be able to lower your
risk for it by:
Not using any form of tobacco
Limiting alcohol use
Getting to and staying at a healthy weight
Managing reflux, if needed
Treating Barrett esophagus, if needed
Are there screening tests for esophageal cancer?
There are no routine screening tests for esophageal cancer. Screening tests are done
to check for disease in people who don’t have symptoms.
But if you have Barrett esophagus or are at high risk for esophageal cancer, talk
with your healthcare provider about having an endoscopy. This test lets your provider
look inside your esophagus using a thin, lighted, flexible tube that’s put in through
your mouth. Patches of changed cells in the lining of the esophagus (called dysplasia)
can then be found and treated before they become cancer. The test can also help find
cancer early, when it’s small and easier to treat.
What are the symptoms of esophageal cancer?
Esophageal cancer often doesn’t cause symptoms until it's big and has spread. The
most common signs of esophageal cancer include:
Trouble swallowing, especially dry foods like meat, bread, or raw vegetables
Pressure or burning in your chest
Feeling like food is stuck in your throat
Losing weight without trying
Blood in stool or black, tar-like stool
Extreme tiredness (fatigue)
Many of these may be caused by other health problems. Still, it’s important to see
a healthcare provider if you have these symptoms. Only a healthcare provider can tell
if you have cancer.
How is esophageal cancer diagnosed?
Your healthcare provider will ask you about your health history, symptoms, risk factors,
and family history of disease. A physical exam will be done. You may also have some
tests done, such as blood tests and an X-ray, barium swallow, or other imaging tests.
A biopsy is the only sure way to tell if you have esophageal cancer. Small pieces
of the tumor are taken out and checked for cancer cells. Your results will come back
in about a week.
After a diagnosis of esophageal cancer, you’ll need more tests. These help your healthcare
providers learn more about your overall health and the cancer. They're used to find
out the stage and grade of the cancer. The stage is how much cancer there is and how
far it has spread (metastasized) in your body. It's one of the most important things
to know when deciding how to treat the cancer.
The grade is used as part of staging. It gives you an idea of how fast the cancer
will grow and spread.
Once your cancer is staged, your healthcare provider will talk with you about what
it means for your treatment. Be sure to ask your healthcare provider to explain the
details of your cancer to you in a way you can understand.
How is esophageal cancer treated?
Your treatment choices depend on the type of esophageal cancer you have, where it
is in your esophagus, test results, and the stage of the cancer. The goal of treatment
may be to cure you, control the cancer, or to help ease problems caused by cancer.
Talk with your healthcare team about your treatment choices, the goals of treatment,
and what the risks and side effects may be. Other things to think about are if the
cancer can be removed with surgery, how your body will look and work after treatment,
and your overall health.
Types of treatment for cancer are either local or systemic. Local treatments remove,
destroy, or control cancer cells in one area. Surgery and radiation are local treatments.
Systemic treatment is used to destroy or control cancer cells that may have traveled
around your body. When taken by pill or injection, chemotherapy and targeted therapy
are systemic treatments. You may have just one treatment or a combination of treatments.
Esophageal cancer may be treated with:
Talk with your healthcare providers about your treatment choices. Make a list of questions.
Think about the benefits and possible side effects of each choice. Talk about your
concerns with your healthcare provider before making a decision.
What are treatment side effects?
Cancer treatments, like chemotherapy and radiation, can damage normal cells. This
can cause side effects like hair loss, mouth sores, and vomiting.
Talk with your healthcare provider about side effects from your treatment. There are
often ways to manage them. There may be things you can do and medicines you can take
to help prevent or control many treatment side effects.
Coping with esophageal cancer
Many people feel worried, depressed, and stressed when dealing with cancer. Getting
treatment for cancer can be hard on your mind and body. Keep talking with your healthcare
team about problems and concerns you have. Work together to ease the effect of cancer
and its symptoms on your daily life.
Here are tips:
Talk with your family or friends.
Ask your healthcare team or social worker for help.
Speak with a counselor.
Talk with a spiritual advisor, such as a minister or rabbi.
Ask your healthcare team about medicines for depression or anxiety.
Keep socially active.
Join a cancer support group in person or online.
Cancer treatment is also hard on the body. To help yourself stay healthier, try to:
Eat a healthy diet, with a focus on high-protein foods.
Drink plenty of water, fruit juices, and other liquids.
Keep physically active.
Rest as much as needed.
Talk with your healthcare team about ways to manage treatment side effects.
Take your medicines as directed by your team.
When should I call my healthcare provider?
Your healthcare provider will talk with you about when to call. You may be told to
call if you have any of the below:
New symptoms or symptoms that get worse
Signs of an infection, such as a fever
Side effects of treatment that affect your daily function or don’t get better with
Ask your healthcare provider what signs to watch for and when to call. Know how to
get help after office hours and on weekends and holidays.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also
know what the side effects are and when they should be reported.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your healthcare provider if you have questions, especially
after office hours or on weekends.