Cancer of the Esophagus
(Esophageal Cancer · Oesophageal Cancer)
In this condition factsheet:
The Facts on Cancer of the Esophagus
The esophagus is a muscular tube between the mouth and stomach. It's about 25 cm to 35 cm (10 to 14 inches) long in an average adult and about 2 cm (¾ inch) wide. The esophagus is made up of several layers. The cancer usually begins in the innermost layer and works its way outwards. Cancer can occur anywhere along the length of the esophagus. However, most esophageal cancers occur in the lower-third region of the esophagus.
Esophageal cancer is three times more common among men than women and is found more often in people of African descent than in Caucasians. Although it accounts for approximately 1% of all cancers in the North American population, esophageal cancer is the second most common cancer in parts of Asia.
Causes of Cancer of the Esophagus
As with most cancers, the actual causes of esophageal cancer are unknown. There are, however, some known risk factors in its development. Some of these include:
- age – this type of cancer is usually found in people over the age of 55
- alcohol abuse
- chewing tobacco
- poor nutritional status (i.e., not eating sufficient fruits and vegetables)
- consuming highly irritating foods or drinking very hot liquids – this likely causes injury to the mucosal tissue in the esophagus
- exposure to toxins such as solvents
- human papillomavirus (HPV) – this virus causes genital warts and has also been linked to esophageal cancer, although this link has not yet been proven
- obesity
- smoking
- ingestion of lye, which is a corrosive chemical substance (e.g., accidentally swallowing lye as a child)
Some cancerous tumours in the esophagus have spread there from elsewhere in the body. Cancers of the larynx, pharynx, tonsils, lungs, breast, liver, kidney, prostate, testicles, bone, and skin can all spread to the esophagus.
People with certain medical conditions can have an increased risk of developing esophageal cancer. These conditions include:
- achalasia: People with achalasia have difficulty emptying the esophagus because the muscles are unable to push the food effectively from the mouth to the stomach.
- gastroesophageal reflux disease (GERD): People who have had GERD (a condition where stomach acid splashes up into the esophagus) for a long time are at a higher risk of esophageal cancer.
- Plummer-Vinson syndrome and Barrett's esophagus: People with these disorders have abnormal cells in the esophagus that can become cancerous.
- tylosis: People with this skin disorder tend to have a higher incidence of esophageal cancer.
Symptoms and Complications of Cancer of the Esophagus
The symptoms of esophageal cancer generally don't begin to show until the tumour has progressed. They include:
- chest pain (radiating towards the back)
- fatigue
- hoarseness or coughing (when not explained by other causes such as a cold) – a rare initial symptom
- pain when swallowing
- persistent heartburn
- progressive difficulty in swallowing, starting with solids
- weight loss
While these symptoms can be signs of other difficulties, it's important to get them checked if they persist.
One of the most obvious problems associated with this type of cancer is difficulty swallowing. As the tumour gets larger, swallowing firm food becomes impossible and eventually only fluids can get by. After surgery where part of the esophagus is removed, swallowing may be hard for a time but should improve as healing progresses.
A second problem that arises is weight loss due to the problems associated with swallowing. Consulting a dietitian in order to maintain a good nutritional status is an important step in treating esophageal cancer. Poor nutrition can slow the healing process.
Finally, the cancer can spread to the rest of the body, most commonly the lungs and liver.
Complications can arise from the treatment as well as from the cancer, especially if the cancer has spread.
