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Esophageal Cancer

Cancer of the esophagus is divided into two major types: squamous cell carcinoma and adenocarcinoma, depending on the type of cells that are malignant.

Squamous cell carcinomas arise in cells that line the upper two-thirds of the esophagus. Adenocarcinomas usually develop in the glandular tissue in the lower part of the esophagus. The treatment of these types may be similar but depends upon the details of each individual case.

Early esophageal cancer usually does not cause symptoms. However, as the cancer grows, symptoms may include:

  • Difficult or painful swallowing
  • Severe weight loss
  • Pain in the throat or back, behind the breastbone or between the shoulder blades
  • Hoarseness or chronic cough
  • Vomiting
  • Coughing up blood

To help find the cause of symptoms, your doctor will evaluate your medical history and perform a physical exam. Your doctor will likely recommend a chest X-ray and other diagnostic tests. These tests may include the following:

  • Barium swallow — Also called an esophagram, a barium swallow is a series of X-rays of the esophagus. You drink a liquid containing barium, which coats the inside of your esophagus. The barium causes changes in the shape of the esophagus to show up on the X-rays.
  • Gastroesophagoscopy — Also called endoscopy, this is an examination of the inside of the esophagus and stomach using a thin, lighted tube called an endoscope. An anesthetic, a substance that causes loss of feeling or awareness, is usually used during this procedure. If an abnormal area is found, your doctor can collect cells and tissue through the endoscope for a biopsy.
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Surgery

Surgery is the most common treatment for esophageal cancer. Usually, the surgeon removes the tumor along with all or a portion of the esophagus, nearby lymph nodes and other tissue in the area. An operation to remove the esophagus is called an esophagectomy.

The surgeon connects the remaining healthy part of the esophagus to the stomach so that the patient is still able to swallow. The surgeon may also widen the opening between the stomach and the small intestine to allow stomach contents to pass more easily into the small intestine.

Sometimes surgery is done after other treatment is finished.

Chemotherapy

Chemotherapy is the use of anticancer drugs to kill cancer cells. The anticancer drugs used to treat esophageal cancer travel throughout the body and are usually given by injection into a vein or intravenously.

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Reviewed by health care specialists at UCSF Medical Center.