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Esophageal Cancer (Cancer of the Esophagus)

Esophageal Cancer Facts

The esophagus is a muscular tube measuring 20-25 cm (8-10 in) long and 2-3 cm (0.75-1.25 in) wide that serves as a conduit for moving food and drink from the mouth to the stomach. Two major types of esophageal cancers exist, as follows:

  • Squamous cell carcinoma arises from the surface (epithelial) cells that line the esophagus.
  • Adenocarcinoma arises from the esophageal glands or within a segment of Barrett's esophagus (see below).
  • Most tumors occur in the lower esophagus.

What are the risk factors for esophageal cancer?

Both types of esophageal cancer more commonly affect men older than 60 years, but risk factors for adenocarcinoma are different from those of squamous cell carcinoma.

  • Adenocarcinoma of the esophagus is most commonly seen within a segment of Barrett's esophagus, where they arise from chronic peptic sores in the lower esophagus. This is an acquired condition characterized by precancerous cells that replace the normal cellular lining of the lowest portion of the esophagus. The condition occurs as a complication of chronic reflux of gastric contents (GERD) into the lower esophagus.
  • Squamous cell carcinoma occurs more commonly in people who heavily use tobacco and alcohol or who have previously swallowed some caustic substance, for example lye. The disease is also more common in people who have been diagnosed with squamous cell cancer of the head and neck.
  • Men are up to 5 times more likely than women to be diagnosed with esophageal cancer.
    • Among men, African Americans have the highest rate, more than 2.7 times greater than the rate for non-Hispanic white men.
    • Incidence rates generally increase with age in all racial and ethnic groups.
  • Cancer of the esophagus is a common cancer in developing countries of the world, where most tumors are squamous cell cancers.
  • Important risk factors in developing countries include the following:
    • Nutritional deficiencies related to lack of fresh fruit and vegetables
    • Drinking hot beverages
    • A range of chewing and smoking habits
    • HPV infection (squamous cell cancer of the esophagus)
  • In the developed world, adenocarcinoma is becoming more common than squamous cell cancer.
Medically Reviewed by a Doctor on 6/3/2016
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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 diagnosed for many people, 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.

  • Surgery. Part or all of the esophagus may be removed.
  • Radiation therapy. Kills cancer cells with radiation.
  • Chemotherapy. Powerful drugs that target cancer cells throughout the body. Typically used in combination with radiation therapy and/or surgery.

Endoscopic treatments that may be done to treat precancers or very small, early cancers include endoscopic mucosal resection to remove the inner lining of the esophagus, laser ablation to kill cancer cells directly, photodynamic therapy that can target cancer cells with a special laser light, and electrocoagulation, which uses electric current to destroy cancer cells.

In addition, your doctor may recommend that you take part in a clinical trial, in which new drugs or treatments are tested in patients. The success of these tests helps determine if the drugs or treatments will be approved by the Food and Drug Administration.


WebMD Medical Reference

Read What Your Physician is Reading on Medscape

Esophageal Cancer »

Esophageal carcinoma was well described at the beginning of the 19th century, and the first successful resection was performed in 1913 by Frank Torek.

Read More on Medscape Reference »

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