Esophageal cancer occurs when cancer cells develop in the esophagus, a tube-like structure that runs from your throat to your stomach. Food goes from the mouth to the stomach through the esophagus. The cancer starts at the inner layer of the esophagus and can spread throughout the other layers of the esophagus and to other parts of the body (metastasis).
What Are the Symptoms of Esophageal Cancer?
Symptoms of esophageal cancer include:
Difficulty and pain when swallowing
Weight loss
Pain in throat, in mid chest or between shoulder blades.
Coughing
Hoarseness
Indigestion and heartburn
What Causes Esophageal Cancer?
There are a number of factors which increase a person's risk of developing esophageal cancer. They include:
Smoking or other use of tobacco.
Heavy alcohol use.
Consumption of smoked meat, fish and use of pickled and high salted foods.
In addition, certain groups -- men, the elderly, and African-Americans -- are at greater risk for esophageal cancer.
How Is Esophageal Cancer Diagnosed?
To diagnose esophageal cancer, your doctor will review your symptoms, medical history, and examine you. In addition, he or she may order certain blood tests and X-ray exams.
Tests for esophageal cancer may include:
Chest X-ray.
Barium X-ray where you drink a liquid which coats your esophagus. This makes the esophagus stand out on the X-ray so that your doctor can identify certain problems.
Endoscopy: the doctor passes an endoscope, a thin, lighted tube, down your throat into your esophagus in order to examine it.
Biopsy: during an endoscopy, the doctor can take cells or tissue from your esophagus. The cells are examined under a microscope for signs of cancer.
Other tests, including computed tomography (CT) scans, may be performed to determine if the cancer has spread, or metastasized, outside of the esophagus. This process is called "staging." The doctor needs this information in order to plan your treatment.
What Are the Stages of Esophageal Cancer?
The stages of esophageal cancer are given a number (I through IV); the higher the number, the more advanced the cancer. The stages are:
Stage 0. The cancer is in the cells that line the esophagus.
Stage I. The cancer has moved to the next layer of cells in the esophagus.
Stage II. The cancer is in the outer wall of the esophagus. In addition, the cancer may have spread to the lymph nodes (small glands that are part of the immune system).
Stage III. The cancer has spread beyond the esophagus.
Stage IV. This is the most advanced stage. The cancer has spread to other organs in the body as well as to lymph nodes far from the esophagus.
There are several tests to determine the stage of esophageal cancer, including:
Chest X-ray.
Bronchoscopy . The trachea (windpipe) and lungs are examined with a bronchoscope, a thin, lighted tube that is inserted through the nose or mouth.
Laryngoscopy . The doctor uses the lighted tube to examine the larynx (voice box).
CT scan. A procedure that creates sharp pictures of the inside of the body.
Endoscopic ultrasound, or endosonography. A lighted tube bounces sound waves off organs in the body to create pictures called sonograms.
Thoracoscopy. An endoscope is placed into the chest through an incision to examine the inside of the body for cancer.
Laporoscopy. The lighted tube is inserted through an incision in the abdomen to examine the organs and take tissue samples.
How Is Esophageal Cancer Treated?
As with many cancers, esophageal cancer treatment has a greater chance of success if the cancer is caught early. Unfortunately, by the time esophageal cancer is usually diagnosed, it is often already in an advanced state (has spread throughout the esophagus and beyond).
Treatment of esophageal cancer depends on many factors, including the stage of the cancer and the overall health of the patient.
There are five standard methods for treating esophageal cancer:
Radiation therapy. Kills cancer cells with X-rays or other radiation.
Chemotherapy. Powerful drugs that kill cancer cells.
Laser surgery. The cancer cells are killed with a beam of light.
Electrocoagulation. The cancer cells are killed with an electric current.
How Are the Stages of Esophageal Cancer Treated?
Treatment options for esophageal cancer by stage involve the following:
Stage 0. Surgery
Stage I, II, and III. Surgery, chemotherapy and radiation.
Stage IV. Chemotherapy, radiation, laser, Treatment for this stage focuses on "palliative" therapy. Palliative therapy is meant to relieve the pain and difficulty swallowing caused by cancer, and is often given to patients who are in an advanced stage of cancer, or who are near the end of their lives.