The past 25 years have seen the rates of some cancers fall, thanks to better prevention efforts. During the same period, though, the frequency of esophageal cancers (cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach) rose dramatically. The cause of this increase remains a mystery, although important risk factors have been identified. Esophageal cancer is the sixth most common cause of cancer deaths worldwide.
Types of Esophageal Cancer
- Squamous cell cancer: This type of esophageal cancer is usually located in the middle portion of the esophagus. Common causes of squamous cell esophageal cancer include alcohol and tobacco use.
- Adenocarcinoma: This type of esophageal cancer is usually located in the lower portion of the esophagus, where the esophagus meets the stomach. While this type can be caused by smoking, it’s also most commonly caused by Barrett’s Esophagus and acid reflux (GERD).
Risk Factors
- Age: over 60
- Gender: male
- Use of substances: alcohol and tobacco
- Barrett’s esophagus
- History of: head or neck cancer
- Frequent drinking of very hot beverages
- Obesity
While it’s important to be aware of all potential risk factors, different risk factors are particularly important for each type of esophageal cancer.
For squamous cell cancers: Tobacco or alcohol use increase your risk the most. More than half of these cancers are linked to tobacco. Using both tobacco and alcohol together raises the risk far more than using either alone.
For adenocarcinomas: A condition called Barrett’s esophagus contributes to this form of esophageal cancer. Smoking doubles the risk of adenocarcinoma, but alcohol doesn’t play a role.
What is Barrett’s Esophagus?
Barrett’s Esophagus is a precancerous condition that increases your risk of esophageal cancer caused by chronic acid reflux. Acid regurgitation from the stomach into the esophagus causes heartburn and indigestion. Nearly everyone experiences this uncomfortable sensation at some time in life. Surveys suggest that tens of millions of Americans feel reflux symptoms at least once a week. Doctors call this “gastroesophageal reflux disease,” or GERD.
When acid reflux occurs frequently, though, the chronic irritation (esophagitis) can cause problems, including:
- The cells at the bottom of the esophagus can change form in response to the acid irritation.
- The new abnormal cell pattern is called Barrett’s esophagus.
- People with Barrett’s esophagus have a 1 in 200 chance of developing adenocarcinoma each year – far higher than the general population.
Barrett’s esophagus is both common and elusive. Approximately five to eight percent of people with GERD will also have Barrett’s esophagus. However, as many as 95 percent of people with Barrett’s esophagus don’t even know they have it! About one-quarter of people with Barrett’s have no reflux symptoms at all.
A physician can only diagnose Barrett’s esophagus through upper endoscopy.
Esophageal Cancer Symptoms
These esophageal cancer symptoms should trigger an immediate call to your doctor – particularly in someone with frequent reflux symptoms!
- Difficulty or pain with swallowing
- Pain behind the breastbone
- Coughing (sometimes blood is seen in sputum produced by the cough)
- Hoarseness
- Weight loss, when not trying to lose weight
- Frequent heartburn or indigestion
Treatment for Esophageal Cancer
Doctors us a variety of approaches to cure or control esophageal cancer. These approaches include:
- Surgery (esophagectomy, or removal of the esophagus)
- Chemotherapy
- Radiation therapy
- Photodynamic therapy (using a light-activated chemical to attack the cancer)
There are many things you can do to lower your risk for esophageal cancer!
For starters, quit tobacco! Stopping smoking will lower the risk for many cancers and other diseases – not just esophageal cancer. Next, limit alcohol to one or two drinks per day for men, and one drink per day for women. Last (but definitely not least), eat a diet high in green in yellow vegetables, and a variety of fruits!
The American College of Gastroenterology recommends:
- Treatment of GERD symptoms, in the hope of preventing esophageal cancer,
- Upper endoscopy in individuals with chronic GERD symptoms, and
- Periodic upper endoscopy in individuals with Barrett’s esophagus.
References: Hoffman, M. M.D., WebMD, Feb, 2017
Mayo Clinic, Esophageal Cancer. 2017
