What is Esophageal Cancer? Facts, Symptoms & Treatment
Esophageal cancer, though relatively rare, is a serious condition that affects the esophagus, the muscular tube that connects the throat to the stomach. It is estimated that around 18,000 new cases of esophageal cancer are diagnosed in the United States each year. While it is still considered a rare disease, diagnoses have grown by 600% over the last three decades. It is also the fastest growing cancer among men, especially those over age 50, are obese, and/or are frequent users of tobacco products.
Symptoms of esophageal cancer are often subtle and can be written off by people as a nagging but minor ailment. Since early detection is particularly critical to surviving this disease, having a clear understanding of the symptoms can significantly help individuals improve their chances of successful treatment.
Symptoms of Esophageal Cancer
“It’s just nagging cough.”
“My acid reflux is acting up again.”
“My throat is sore again. It must be my allergies acting up.”
Do any of these statements sound familiar?
These all reflect highly common ailments that many Americans deal with over the course of the year for a variety of reasons, including seasonal changes, allergies, diet, or just contracting the latest “bug” going around.
Faced with any of them on an infrequent basis, there’s most likely no cause for concern. But anyone chronically experiencing them or any of the symptoms listed below may want to consult with a gastroenterologist to be sure there isn’t a larger underlying issue.
We recommend speaking with a gastroenterologist if you have:
- More than occasional heartburn symptoms
- Pain or difficulty swallowing
- Persistent, unexplained cough
- Speaking with a hoarse voice over several weeks
- Persistent, unexplained sore throat
- Tendency to cough or choke when you lie down
- Family history of Barrett’s Esophagus or Esophageal Cancer
Esophageal cancer may not show any symptoms in its early stages, which makes it challenging to detect. However, as the cancer progresses, the following symptoms may manifest:
- Difficulty Swallowing (Dysphagia): One of the most common symptoms of esophageal cancer is difficulty swallowing solid foods, and in later stages, even liquids. This occurs when the tumor obstructs the passage of food through the esophagus.
- Unintentional Weight Loss: Esophageal cancer can cause unintended weight loss due to difficulty swallowing and reduced appetite.
- Chest Pain or Discomfort: Some individuals with esophageal cancer may experience chest pain or discomfort, which can be persistent and worsen over time.
- Regurgitation or Vomiting: Regurgitation or vomiting of blood or dark-colored material can also be a symptom of esophageal cancer, indicating bleeding from the tumor.
- Hoarseness or Chronic Cough: Esophageal cancer that has spread to nearby structures such as the vocal cords or lungs can cause hoarseness or a chronic cough.
- Fatigue and Weakness: Advanced esophageal cancer may lead to general fatigue and weakness due to the body’s increased metabolic demands in fighting the cancer.
Once again, early detection is your most important ally in treating and surviving esophageal cancer. Caught and treated in Stage 1 or 2, greater than 40% of people will survive 5 years or more post-diagnosis. Unfortunately, due to the subtlety of the symptoms, diagnoses too often come in later stages of the disease where only 1 in 5 Americans are likely to survive.
Checking for Esophageal Cancer
If esophageal cancer is suspected, a thorough medical evaluation by a gastroenterologist is necessary to confirm the diagnosis.
“Most esophageal cancers are diagnosed on the patient’s first endoscopy,” says Albert Ross, M.D., of the Digestive Health Institute. “Cancer might be prevented or caught at an earlier stage if a patient calls their physicians attention to subtle and earlier symptoms like frequent heartburn or a long history of heartburn.”
The following diagnostic tests may be performed:
- Endoscopy: A thin, flexible tube with a light and a camera on the end (endoscope) is passed through the mouth and into the esophagus to visualize the lining of the esophagus and detect any abnormal growths.
- Biopsy: During an endoscopy, a biopsy may be taken, which involves removing a small tissue sample from the abnormal area for further examination under a microscope to determine if it is cancerous.
- Imaging Tests: Imaging tests such as CT scans, PET scans, or MRI scans may be done to determine the size and extent of the tumor, as well as whether the cancer has spread to nearby lymph nodes or other organs.
- Barium Swallow: A series of X-rays taken after swallowing a liquid containing barium can help identify abnormalities in the esophagus and detect tumors.
Treatment Options for Esophageal Cancer
The treatment plan for esophageal cancer depends on the stage and location of the tumor, as well as the overall health and preferences of the patient. Treatment options may include:
- Surgery: Surgery is the primary treatment for early-stage esophageal cancer. It may involve removing a portion of the esophagus (esophagectomy) and reconnecting the remaining healthy portions, or removing the entire esophagus and re-routing the digestive tract to the stomach (esophagogastrectomy).
- Radiation Therapy: High-energy rays, such as X-rays or protons, are used to target and destroy cancer cells. Radiation therapy may be used before surgery to shrink the tumor, after surgery to kill any remaining cancer cells, or as palliative treatment to relieve symptoms in advanced cases.
- Chemotherapy: Chemotherapy uses drugs to kill cancer cells throughout the body. It may be used in combination with surgery or radiation therapy, or as the primary treatment for advanced esophageal cancer. Chemotherapy can also help relieve symptoms and improve quality of life.
- Targeted Therapy: Targeted therapy is a type of cancer treatment that specifically targets cancer cells without affecting healthy cells. It may be used in combination with chemotherapy or as a standalone treatment for esophageal cancer.
- Immunotherapy: Immunotherapy is a newer treatment option that harnesses the body’s immune system to fight cancer cells. It may be used in advanced esophageal cancer that has not responded to other treatments.
It is important to note that treatment plans for esophageal cancer are highly individualized and may vary depending on the specific circumstances of each patient. Consulting with a healthcare provider who specializes in treating esophageal cancer is crucial to determine the most appropriate treatment approach.
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