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Dignity Health offers a team approach to the care and treatment of esophageal cancer, offering the latest in diagnosis and treatment options.
Types of Esophageal Cancer
Esophageal cancer results from the uncontrolled growth of cells in the esophagus. This type of cancer begins in the layer of tissue that lines the inside of the esophagus. As cancer progresses, it grows into deeper layers of the esophagus and sometimes spreads to other areas of the body. There are two main types of esophageal cancer:
- Squamous cell carcinoma starts in the flat cells that line the esophagus. This type of cancer used to be the more common type of esophageal cancer, but now fewer than half of esophageal cancers in the U.S. are squamous cell carcinoma.
- Adenocarcinoma starts in the cells that produce and release mucus or other fluids in the esophagus. Now the most common type of esophageal cancer in the U.S., adenocarcinoma is associated with Barrett’s esophagus.
Esophageal cancer occurs most often in men and people 55 and older. Other risk factors include:
- Having Barrett's esophagus
- Smoking cigarettes, cigars, or pipes; chewing tobacco; or drinking alcohol
- Being overweight
- Eating a diet high in certain foods, such as processed meat
- Having achalasia, tylosis, Plummer-Vinson syndrome, or human papillomavirus (HPV).
Most cases of esophageal cancer do not cause symptoms in the early stages. By the time symptoms appear, the disease may already be fairly advanced. Symptoms may include:
- Trouble swallowing
- Feeling like food is stuck in the throat or chest, or choking on food
- Pain, discomfort, or a burning sensation in the middle of the chest
- Unexplained weight loss
- Hoarseness or chronic cough
- Bone pain
- Bleeding into the esophagus, which can cause stools to turn black.
If you experience these symptoms, see your doctor as soon as possible.
At Dignity Health, you will receive a thorough evaluation from our team of esophageal experts. A medical history and physical exam will help us understand your risk factors, symptoms, and physical signs of disease. You may also undergo one or more tests:
- Imaging tests, including x-rays, MRI, barium swallow, CT scan, PET scan, or ultrasound to look for signs of cancer and find out whether it has spread. Norton Thoracic Institute has the Valley’s only confocal endomicroscopy, a powerful microscope used to diagnose esophageal cancer.
- Endoscopy so that your doctor can examine any abnormal areas of the esophagus and obtain samples of tissue (biopsies). Endoscopic ultrasound may also be performed.
- Bronchoscopy to see if cancer has spread to the windpipe or lungs.
- Thoracoscopy and laparoscopy to obtain lymph node and other tissue samples to see if cancer has spread.
Your doctor will use your test results to determine the stage of cancer and to develop a treatment plan.
Your personalized treatment plan will depend on the type and stage of the esophageal cancer—how deeply it has grown into the walls of the esophagus and whether it has spread to the lymph nodes or other organs. The stages of esophageal cancer range from Stage 0 (only in the first layer of the esophagus) to Stage 4 (cancer in the esophagus, lymph nodes and other organs). Surgery alone can sometimes be used to cure esophageal cancer in its early stages; however, more advanced cases usually require a combination of treatments:
- Surgery to remove cancerous or precancerous tissue.
- Chemotherapy, the use of oral or IV drugs to kill cancer.
- Radiation therapy, the use of high-energy rays to destroy cancer cells.
- Endoscopic treatments to destroy precancerous and cancerous cells, to relieve symptoms, or both. This treatment may include radio frequency ablation, laser ablation, endoscopic mucosal resection, argon plasma coagulation, electrocoagulation, or esophageal stenting.
You can reduce your risk of developing cancer of the esophagus by following these guidelines:
- Avoid tobacco and alcohol.
- Maintain a healthy weight and eat a balanced diet.
- Get regular care for gastroesophageal reflux disease or Barrett’s esophagus.