What is Esophageal Cancer?
Esophageal cancer occurs in the esophagus, the long, hollow tube that runs from your throat to your stomach and moves food to your stomach for digestion. This cancer typically starts in the inner layer of the esophagus and can spread outward through the other layers as it grows.
The two main types of esophageal cancer are:
- Squamous cell carcinoma: This type of cancer originates in the flat, thin cells that line the surface of the esophagus. It's more common in the upper and middle part of the esophagus and is often associated with smoking and alcohol consumption.
- Adenocarcinoma: This type begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma is typically found in the lower part of the esophagus, and its incidence has been increasing in many parts of the world, particularly in those who have a history of gastroesophageal reflux disease (GERD) or Barrett's esophagus.
Symptoms of esophageal cancer may not appear until the disease is quite advanced and can include difficulty swallowing, weight loss, chest pain, worsening indigestion or heartburn, and coughing or hoarseness. Early detection is challenging because symptoms often appear once the cancer is advanced.
Risk Factors
Esophageal cancer has several known risk factors that can increase the likelihood of developing the disease. Here are some of the most significant ones:
- Smoking: Tobacco use is a major risk factor for esophageal cancer, particularly squamous cell carcinoma.
- Alcohol Consumption: Heavy alcohol use can increase the risk of esophageal cancer, especially when combined with smoking.
- Acid Reflux: Chronic gastroesophageal reflux disease (GERD) can lead to Barrett's esophagus, a condition where the tissue lining the esophagus changes. Barrett's esophagus significantly increases the risk of developing esophageal adenocarcinoma.
- Diet: A diet low in fruits and vegetables and certain vitamins and minerals can increase the risk of esophageal cancer.
- Obesity: Being overweight or obese can increase the risk of esophageal adenocarcinoma, likely due to increased rates of GERD in obese individuals.
- Achalasia: This is a rare disorder where the esophagus is unable to move food into the stomach properly, which can increase the risk of squamous cell carcinoma.
- Hot Liquids: Regularly consuming very hot liquids can damage the lining of the esophagus, potentially leading to cancer.
- Age, Gender, and Ethnicity: The risk of esophageal cancer increases with age and is more common in men than in women. Additionally, certain ethnicities, like African Americans, are at a higher risk for squamous cell carcinoma, while white Americans are more likely to develop adenocarcinoma.
- Chemical Exposures: Exposure to certain chemicals, such as lye, can increase the risk of esophageal cancer.
- Genetic Factors: Though less common, inherited genetic conditions or a family history of esophageal cancer can also increase risk.
Understanding these risk factors can help guide preventive measures and early detection efforts. By prioritizing regular check-ups and prompt medical attention, the GW Cancer Center Thoracic Oncology team can significantly improve the prognosis and survival of esophageal cancer.
