Overview

Esophageal cancer is cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.

Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.

Esophageal cancer care at Mayo Clinic

Symptoms

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.

Causes

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.

Risk factors

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

Complications

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.

Prevention

You can take steps to reduce your risk of esophageal cancer. For instance:

  • Quit smoking. If you smoke, talk to your doctor about strategies for quitting. Medications and counseling are available to help you quit. If you don't use tobacco, don't start.
  • Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
  • Eat more fruits and vegetables. Add a variety of colorful fruits and vegetables to your diet.
  • Maintain a healthy weight. If you are overweight or obese, talk to your doctor about strategies to help you lose weight. Aim for a slow and steady weight loss of 1 or 2 pounds a week.

Esophageal cancer care at Mayo Clinic

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.

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