Symptoms and causes

Signs and symptoms of esophageal cancer include:

  • Difficulty swallowing (dysphagia)
  • Weight loss without trying
  • Chest pain, pressure or burning
  • Worsening indigestion or heartburn
  • Coughing or hoarseness

Early esophageal cancer typically causes no signs or symptoms.

When to see a doctor

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

If you've been diagnosed with Barrett's esophagus, a precancerous condition that increases your risk of esophageal cancer caused by chronic acid reflux, ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening.

Screening for esophageal cancer isn't done routinely except for patients with Barrett's esophagus because of a lack of other easily identifiable high-risk groups. If you have Barrett's esophagus, discuss the pros and cons of screening with your doctor.

It's not exactly clear what causes esophageal cancer.

Esophageal cancer occurs when cells in your esophagus develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor in the esophagus that can grow to invade nearby structures and spread to other parts of the body.

Types of esophageal cancer

Esophageal cancer is classified according to the type of cells that are involved. The type of esophageal cancer you have helps determine your treatment options. Types of esophageal cancer include:

  • Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.
  • Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.
  • Other rare types. Some rare forms of esophageal cancer include small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.

It's thought that chronic irritation of your esophagus may contribute to the changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

  • Having gastroesophageal reflux disease (GERD)
  • Smoking
  • Having precancerous changes in the cells of the esophagus (Barrett's esophagus)
  • Being obese
  • Drinking alcohol
  • Having bile reflux
  • Having difficulty swallowing because of an esophageal sphincter that won't relax (achalasia)
  • Having a steady habit of drinking very hot liquids
  • Not eating enough fruits and vegetables
  • Undergoing radiation treatment to the chest or upper abdomen

As esophageal cancer advances, it can cause complications, such as:

  • Obstruction of the esophagus. Cancer may make it difficult or impossible for food and liquid to pass through your esophagus.
  • Pain. Advanced esophageal cancer can cause pain.
  • Bleeding in the esophagus. Esophageal cancer can cause bleeding. Though bleeding is usually gradual, it can be sudden and severe at times.
April 04, 2017
References
  1. Esophageal and esophagogastric junction cancers. Fort Washington, Pa.: National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Nov. 22, 2016.
  2. Niederhuber JE, et al., eds. Cancer of the esophagus. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 22, 2016.
  3. Cameron JL, et al., eds. Neoadjuvant and adjuvant therapy of esophageal cancer. Current Surgical Therapy. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 22, 2016.
  4. What you need to know about cancer of the esophagus. National Cancer Institute. https://www.cancer.gov/publications/patient-education/wyntk-esophagus-cancer. Accessed Nov. 22, 2016.
  5. Saltzman JR, et al. Diagnosis and staging of esophageal cancer. http://www.uptodate.com/home. Accessed Nov. 22, 2016.
  6. Gibson MK, et al. Epidemiology, pathobiology, and clinical manifestations of esophageal cancer. http://www.uptodate.com/home. Accessed Nov. 22, 2016.