Esophageal Cancer

The esophagus is a tube that leads from the mouth into the stomach. Esophageal cancer occurs when cells in the esophagus begin to mutate and grow rapidly. According to the National Cancer Institute, about 15,000 new cases are diagnosed in the United States every year.

Risk Factors

People are at a higher risk for developing esophageal cancer because of certain factors. These may include:

• gender; men are at higher risk for developing esophageal cancer than women
• smoking
• age; patients are generally older than 60
• history of gastroesophageal reflux (GERD)

Symptoms

As the cancer begins, there may be no noticeable symptoms. However, as it grows, symptoms of esophageal cancer may include:

• difficulty or pain while swallowing
• chest pain, or pain between the shoulder blades
• persistent, hacking cough
• coughing up blood
• unexplained weight loss

Diagnosis

When a patient presents with symptoms that might suggest esophageal cancer, your doctor will use several diagnostic methods to make an accurate diagnosis.

1. Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:
   • Chest X-ray
   • CT scan
2. Your doctor may want to do further tests. These tests may include:
   • Esophagoscopy. In this test, your doctor wants to examine the esophagus. Usually using mild anesthesiology, called a twilight sleep, your doctor will insert an endoscope, a thin, lighted tube into your esophagus. If any abnormalities are seen under the scope, your doctor can remove a section to be examined later in the lab. This biopsy will show signs of cancer or other abnormalities .
   • Esophagram. In this test, your doctor wants to watch the patterns of movement in the esophagus. You will be asked to drink a barium mixture, which is why this test is sometimes called a barium swallow. This barium coats the esophagus, and a series of X-rays is taken. In this way, your doctor can visualize the esophagus.

A Diagnosis of Esophageal Cancer

After you have undergone any of these tests, your doctor may inform you that you have esophageal cancer. There are two main types of esophageal cancer:

• squamous cell carcinoma
• adenocarcinoma

Treatment
There are three primary types of treatment for esophageal cancer:

• surgery
• chemotherapy
• radiation therapy
• laser or ablative therapy

Some of the diagnostic procedures described above are also used as surgical treatments to remove the cancer. Depending on the staging (how far the cancer is spread), your thoracic team will create an appropriate treatment regimen personalized for you. This treatment regimen is based on currently available scientific evidence and research designed for optimal results in cancer treatment.