Esophageal cancer is cancer of the esophagus. The esophagus is a hollow tube that carries food and liquids from the throat to the stomach. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and makes swallowing easier. The esophagus is located just behind the trachea (windpipe). In an adult, the esophagus is about 10 inches (25 cm) long.
Cancer is a disease that affects cells, the body’s basic unit of life. To understand any type of cancer, it is helpful to know about normal cells and what happens when they become cancerous.
The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells when they are needed. This process keeps the body healthy and functioning properly. Sometimes, however, cells keep dividing when new cells are not needed. The mass of extra cells forms a growth or tumor. Tumors can be benign or malignant.
- Benign tumors are not cancer. They usually can be removed and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely a threat to life.
- Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. These cancer cells can invade and destroy the tissue around them. Cancer cells can also break away from a malignant tumor and enter the bloodstream or lymphatic system (the tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases). This process, called metastasis, is how cancer spreads from the original (primary) tumor to form new (secondary) tumors in other parts of the body.
Cancer that begins in the esophagus (also called esophageal cancer) is divided into two major types, squamous cell carcinoma and adenocarcinoma, depending on the type of cells that are malignant. Squamous cell carcinomas arise in squamous cells that line the esophagus. These cancers usually occur in the upper and middle part of the esophagus. Adenocarcinomas usually develop in the glandular tissue in the lower part of the esophagus. The treatment is similar for both types of esophageal cancer.
If the cancer spreads outside the esophagus, it often goes to the lymph nodes first. (Lymph nodes are small, bean-shaped structures that are part of the body’s immune system.) Esophageal cancer can also spread to almost any other part of the body, including the liver, lungs, brain, and bones.
Esophageal Cancer Symptoms
Early esophageal cancer symptoms usually are not apparent. However, as the cancer grows, symptoms of esophageal cancer may include:
- difficulty in swallowing often including pain.
- rapid and severe weight loss
- pain in the throat or back, behind the breastbone or between the shoulder blades
- hoarseness and/or chronic cough
- bouts of vomiting
- coughing up blood
- aspiration Pneumonia
- chest pain
These symptoms are not exclusive to esophageal cancer or any other condition. However, when they are apparent, it is important to contact your primary care physician.
Diagnosing Esophageal Cancer
To help find the cause of esophageal cancer symptoms, the doctor evaluates a person’s medical history and performs a physical exam. The doctor usually orders a chest x-ray and other diagnostic tests. These tests may include the following:
- An esophagram: A series of x-rays of the esophagus. The patient drinks a liquid containing barium, which coats the inside of the esophagus. The barium makes any changes in the shape of the esophagus show up on the x-rays.
- An endoscopy: An examination of the inside of the esophagus using a thin lighted tube called an endoscope. An anesthetic (substance that causes loss of feeling or awareness) is usually used during this procedure. If an abnormal area is found, the doctor can collect cells and tissue through the endoscope for examination under a microscope. This is called a biopsy. A biopsy can show cancer, tissue changes that may lead to cancer, or other conditions.
Esophageal Cancer Staging
If the diagnosis is esophageal cancer, the doctor needs to learn the stage of disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, to what parts of the body. Knowing the stage of the disease helps the doctor plan treatment. Listed below are descriptions of the four stages of esophageal cancer.
- Stage I – The cancer is found only in the top layers of cells lining the esophagus.
- Stage II – The cancer involves deeper layers of the lining of the esophagus, or it has spread to nearby lymph nodes. The cancer has not spread to other parts of the body.
- Stage III – The cancer has invaded more deeply into the wall of the esophagus or has spread to tissues or lymph nodes near the esophagus. It has not spread to other parts of the body.
- Stage IV – The cancer has spread to other parts of the body. Esophageal cancer can spread almost anywhere in the body, including the liver, lungs, brain, and bones.