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Esophageal Cancer

Esophageal cancer is a disease that occurs in the esophagus – a long tube that runs from your throat to your stomach which carries food and liquids to the stomach for digestion. The esophagus wall has several layers. The two most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinomas occur in the inside lining layer of the esophagus, whereas adenocarcinomas begin in the glandular cells and occur in the lower esophagus near the stomach.

Esophageal Cancer Statistics

  • In 2018, approximately 17,290 new cases of esophageal cancer are expected to be diagnosed in the United States.
  • An estimated 15,850 Americans will die from the disease in 2018.
  • In Texas, an estimated 1,172 new esophageal cancer cases are anticipated, and 964 Texans are expected to die from the disease in 2018.

Esophageal Cancer Risk Factors

  • Age: The risk of esophageal cancer increases with age, with the majority of people diagnosed over the age of 55.
  • Gender: Men are three to four times more likely to develop esophageal cancer than women.
  • Race: African Americans are two times more likely to develop squamous cell esophageal cancer. 
  • Personal History: People who have had lung, mouth, or throat cancer have a higher risk of esophageal cancer. 
  • Gastroesophageal Reflux Disease (GERD): People with a history of acid reflux have a slightly higher risk. 
  • Barrett’s Esophagus: Barrett’s esophagus results from long-term acid reflux. In this situation, the lining cells of the lower esophagus undergo a change to a glandular type of cell, and this change may result in a greater risk of developing adenocarcinoma.
  • Tobacco and Alcohol: Both tobacco and alcohol significantly raise the risk of esophageal cancer. Together, the risk is much greater than either alone.
  • Obesity: People who are overweight or obese have a higher risk of esophageal cancer, as this population is more likely to have gastroesophageal reflux.
  • Diet: A diet high in processed meat may increase risk of esophageal cancer, but a diet high in fruits and vegetables lowers the risk. Frequently consuming very hot liquids may increase risk as well.
  • Esophageal Diseases and Injury: People with achalasia, tylosis, Plummer-Vinson syndrome, and exposure to or injury from certain chemicals face a higher risk of esophageal cancer.

Esophageal Cancer Symptoms

Esophageal cancer varies with each patient. People with these symptoms should consult their physician:

  • Trouble swallowing that gets worse over time
  • Pain, pressure, or burning in chest
  • Weight loss
  • Indigestion and heartburn
  • Persistent hoarseness, cough, or hiccups 
  • Blood in stool or vomitus 
  • Loss of appetite 
  • Pain in the bones
  • Pain located behind the breastbone or throat
  • Choking on food

Esophageal Cancer Prevention

For many, esophageal cancer can be prevented by maintaining a healthy lifestyle, including not using tobacco, limiting alcohol intake, eating a healthy diet, and maintaining an ideal weight. Texas Oncology recommends people with Barrett’s esophagus get tested for signs of cancer. Preventing Barrett’s esophagus and esophageal cancer may be possible by treating reflux. If you have chronic heartburn or reflux, you should contact your physician as treatment may lower your risk of Barrett’s esophagus and esophageal cancer.

Esophageal Cancer Treatment Options

Treatment options for people with esophageal cancer include surgery, radiation therapy, proton therapy, chemotherapy, targeted therapy, immunotherapy, endoscopic treatments, or a combination of these treatments. Esophageal cancer is often found at later stages and many treatments are aimed at relieving symptoms, but cannot cure the cancer. Many doctors encourage patients to consider participating in a clinical trial.

Benefits of Proton Therapy for Esophageal Cancer

  • High-energy, precisely-targeted proton beams can deliver high doses of radiation to destroy cancerous cells, reducing recurrence rates for many cancer cases.
  • Proton therapy is non-invasive and may reduce side effects.
  • Patients treated with proton therapy may have increased tolerance for chemotherapy.
  • Patients can maintain their current quality of life during and after treatment.
  • It is sometimes used effectively to treat areas that have already been treated with radiation.

Source: American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, and Texas Cancer Registry


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