Cancer of the esophagus (also called esophageal cancer) is a type of rare cancer that grows in the esophagus, the hollow tube that connects your throat to your stomach. The esophagus lies behind the trachea (windpipe) and in front of the spine. You probably don’t think much about your esophagus until something doesn’t feel right.

Esophageal cancer can start anywhere along the esophagus, but usually starts in the inner layer of the esophagus wall and grows outward. The American Cancer Society says approximately 20,000 new cases of esophageal cancer were diagnosed in 2022 and is more common in men than among women.

What are the symptoms?

Many people with esophageal cancer do not have symptoms in the beginning, but as the cancer grows, symptoms can include:

• Trouble swallowing
• Weight loss for no known reason
• Hiccups
• Throwing up blood
• Blood in mucus coughed up from the lungs
• Chest pain
• Hoarseness

Types of esophageal cancer

There are 2 main types of esophageal cancer: Squamous cell carcinoma and adenocarcinoma.

Squamous cell carcinoma - The inner layer of the esophagus (the mucosa) is normally lined with squamous cells. This type of cancer can occur anywhere along the esophagus but is most common in the neck area and the upper area of the chest. This form of esophageal cancer is often linked to smoking and excessive alcohol use.

Adenocarcinoma - Cancer that start in gland cells (cells that make mucus) are called adenocarcinomas and are often found in the lower third of the esophagus.

It’s not exactly clear what causes most esophageal cancers, but The American Cancer Society says there are certain risk factors to be aware of, including:

• Age - People between the ages of 45 and 70 have the highest risk of esophageal cancer.
• Gender - Men are three to four times more likely than women to develop esophageal cancer.
• Tobacco use - Using any form of tobacco, such as cigarettes, cigars, pipes, or chewing tobacco raises the risk of esophageal cancer, especially squamous cell carcinoma.
• Alcohol use - Heavy drinking over a long period of time increases the risk of squamous cell carcinoma of the esophagus, especially when combined with tobacco use.
• Barrett's esophagus - This condition can develop in some people who have chronic gastroesophageal reflux disease (GERD), or inflammation of the esophagus. People with Barrett's esophagus are more likely to develop adenocarcinoma of the esophagus.
• Diet/nutrition -A diet that is low in fruits and vegetables and certain vitamins and minerals can increase a person's risk of developing esophageal cancer.
• Obesity -Being overweight and having too much body fat can increase a person's risk of developing esophageal cancer. Read more about obesity and the risk for cancer.

How is esophageal cancer treated?

Treatment for each patient is unique. It’s important to discuss treatment options with your oncologist and what will work best for you. Treatment for esophageal cancer depends on the size and location of the tumor, the type of esophageal cancer, whether the cancer has spread and overall health. 

The most common forms of treatment are surgery, radiation therapy and chemotherapy. Surgery is used to remove as much of the cancer as possible. Radiation therapy uses X-rays or other types of radiation to kill the cancer cells. Chemotherapy uses anti-cancer drugs to kill the cancer cells and is used when the cancer cells have spread to other parts of the body.

Immunotherapy is also an option for patients. Immunotherapy is the use of medicine(s) that help a person’s immune system find and destroy cancer cells more effectively. 

Ochsner’s award-winning surgeons perform more esophagectomies (surgical removal of all or parts of the esophagus) than anyone else in Louisiana. Robotic minimally invasive surgical resection is available to 90% of our patients. Ochsner surgeons implement the newest approaches to esophageal preservation. We focus on maximizing long-term outcomes while optimizing your functional and digestive recovery.