Esophageal Cancer

As one of the top ten deadliest cancers in the US, esophageal cancer is certainly a very serious disease.  This cancer originates in the esophagus which is the tube which carries food from the throat to the stomach.  The disease affects more men than women and has resulted in the death of 66,659 Americans between 2003 and 2007.

The incidence of esophageal cancer has risen in recent decades; currently over 14,000 people die from this disease every year. New cases and deaths from esophageal cancer in the United States in 2012 have been estimated at 17,460 and 15,070 successively.

Although esophageal cancer is certainly of great concern and increasing in rate, it is not as widespread or common as other forms of cancer in the US.  It tends to affect men more than women and those who are over 50.

There are two main types of this disease.  They are called squamous cell carcinoma and adenocarcinoma.  Squamous cell esophageal cancer is linked closely to smoking and alcohol abuse.

Gastroesophateal reflux disease tends to increase the risk for adenocarcinoma of the esophagus which is the more common type of esophageal cancer.  Those men who are overweight and who smoke regularly are at greater risk for developing the disease.

It is important to watch for typical symptoms which can include the following:

  • Regurgitation of food through the mouth and esophagus
  • Chest pain (not related to eating)
  • Problems or difficulty swallowing solid food or liquids
  • Heartburn
  • Vomiting of blood
  • Unexpected weight loss

There are a number of tests which are used to detect the presence of esophageal cancer.    One test is called the barium swallow.  In this test the patient drinks a milky substance which contains barium which is a radioactive isotope.  This compound can be tracked through x-rays as it moves through the esophagus to the stomach.

A chest MRI or thoracic CT scan can be performed to determine how extensive the disease is. Endoscopic ultrasound is used for the same purpose.  And an esophagogastroduodenoscopy is done to take biopsy samples of the affected areas.

If the cancer is localized and remains in the esophagus, surgery in the most commonly used type of therapy.  The surgery is designed to remove as much of the cancer as possible.  In some cases chemotherapy, radiation therapy or a combination of the two is performed instead of surgery or it may be used in addition to surgery.

If the patient is deemed too ill to stand the rigors of the surgery or if the disease has spread to other organs, chemotherapy or radiation therapy may be used to help to reduce the symptoms. It is not intended to cure the disease however.  Early detection is very important to improve the chances for long term survival of this disease.  If it is caught in the early stages where the tumor is localized in the esophagus and has not spread beyond this organ, then surgery along with chemotherapy or radiation therapy can be very effective at removing all traces of the cancer.

If the tumor is large enough to affect the ability of the patient to swallow, then an endoscopic dilation of the esophagus may be necessary.  In some cases photodynamic therapy is used to inject a special drug into the tumor which is then exposed to light.  The light activates the medicine which then attacks and hopefully eradicates the tumor.

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