Esophageal cancer starts in your esophagus, the long muscular tube that moves food from your throat to your stomach. Most people don’t notice symptoms until after the cancer has spread. If detected early, healthcare providers may be able to eliminate the cancer with surgery and other treatments. When they can’t cure the cancer, they focus on extending lifespan, easing symptoms and maintaining quality of life.
Esophageal cancer is the 10th most common cancer in the world. It starts in the tissues in your esophagus, the long muscular tube that moves food from your throat to your stomach. Tumors caused by esophageal cancer may not cause noticeable symptoms until the cancer has spread.
Healthcare providers treat early-stage esophageal cancer with surgery to remove the tumors or ease symptoms. They may use treatments such as chemotherapy, radiation therapy and immunotherapy to treat more advanced or later-stage esophageal cancer. When they can’t cure the cancer, they focus on helping people live longer, easing symptoms and maintaining quality of life. Medical researchers are working on treatments that will help people with esophageal cancer live longer.
Esophageal cancer happens when cancerous cells in your esophageal tissue begin to multiply, eventually creating a tumor. Esophageal cancer is aggressive, but many people don’t notice symptoms until after the cancer has spread. That’s because your esophagus stretches to make room for big things, like large bites of food. As the tumor grows, it starts to block your esophagus’ opening. You may have trouble swallowing or notice that it hurts to swallow.
There are two types of esophageal cancer:
Sometimes, healthcare providers can do surgery to remove small tumors. Unfortunately, only 25% of people with this cancer receive a diagnosis before the cancer spreads.
Esophageal cancer affects about 4 in 100,000 people in the U.S. It typically affects men and people designated male at birth (DMAB) who are age 60 or older. It’s more common in men and people DMAB than in women and people designated female at birth (DFAB). People who are Black and people who are Asian with this condition usually have squamous cell esophageal cancer. People who are white are more likely to have adenocarcinoma esophageal cancer.
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Difficulty swallowing is the first symptom people may notice. Other symptoms include:
Esophageal cancer typically grows very rapidly. Your esophagus is very flexible and expands around the tumor as it grows. This is why people often don’t have symptoms until the cancer has spread.
Healthcare providers don’t know the exact cause, but they’ve identified risk factors that increase the chance of developing esophageal cancer, including:
A healthcare provider will ask questions about your symptoms and medical history. They may do the following tests to diagnose the condition:
Healthcare providers use what they learn in diagnosis to classify or stage esophageal cancer. Cancer staging systems lay the foundation for cancer treatment.
When healthcare providers stage esophageal cancer, they look at factors such as cancer tumor location and depth, if it has spread to nearby lymph nodes and if the cancer has spread to other distant tissues or organs.
They also establish tumor grades. Tumor grades tell your provider whether tumor cells look and act like healthy cells. Low-grade tumors are slow-growing tumors and may be less aggressive. High-grade tumors have cells that divide very quickly and can be more aggressive.
Esophageal cancer treatment depends on the cancer stage and grade. Treatment options include:
You may be able to reduce your risk by eating well so you’re at a weight that’s right for you and that you can maintain. You may also reduce your risk by avoiding activities such as using tobacco, frequently drinking lots of alcohol or working around certain solvents. Having an HPV infection is a risk factor for esophageal cancer. Ask your healthcare provider if you should receive the HPV vaccine.
There isn’t a recommended way to screen for esophageal cancer. But if you have Barrett’s esophagus or certain other conditions, your healthcare provider may recommend screening. Your healthcare provider may do an EGD to do this screening. If your healthcare provider recommends screening, they’ll let you know how often you should have screening.
That depends on factors like your overall health and if you received a diagnosis before the tumor spread. Healthcare providers often successfully treat early-stage esophageal cancer. About 46% of people treated for early-stage esophageal cancer are alive five years after diagnosis.
Healthcare providers may not be able to destroy the cancer, especially if it’s already spread. They can provide treatment to help you live well as long as you’re able, maintain quality of life and ease symptoms. They may recommend palliative care that can help you live comfortably and without pain.
Esophageal cancer surgery may have significant side effects like nausea and vomiting or heartburn. You may need help to manage these side effects. Many people treated for esophageal cancer have the following issues:
That depends on your situation. People who had early-stage cancer removed with surgery will have a different follow-up schedule from people who’ve advanced cancer that’s spread.
If your treatment was successful, your healthcare provider may recommend checkups every three to six months for the first two years after treatment and then checkups every six to 12 months for the next three years. Your healthcare provider may do a physical examination, blood tests, imaging tests and endoscopy.
Esophageal cancer is a life-threatening illness. If you have this condition, you may want to ask a healthcare provider the following questions:
A note from Cleveland Clinic
Esophageal cancer is the 10th most common cancer in the world. It’s also one of the most challenging cancers to treat. That’s because it causes symptoms that people may not notice until after the cancer has spread. Often, there’s no cure for esophageal cancer. In that situation, healthcare providers concentrate on treatments that will help people live as long as possible and have the best quality of life for as long as possible. Few things in life are more difficult than hearing you’re sick and there’s no cure. You may need time and help to come to terms with your situation. Healthcare providers understand that and will do everything they can to help you, such as recommending speaking with a mental health specialist.
Last reviewed by a Cleveland Clinic medical professional on 09/06/2022.
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