written by – Sherry Mistro-Henn
medically reviewed by – Dr. Brian Hemphill
April is Esophageal Cancer Month
In 2016, approximately 17,000 adults in the US will be diagnosed with esophageal cancer. Prevalence is more common in men who are about 4 times more likely to develop esophageal cancer than women. People between the ages of 45 and 70 are at the highest risk of developing esophageal cancer.
The esophagus is the muscular tube that connects the throat to the stomach. As a result of its squeezing and pushing, food moves down through the esophagus into the stomach. The lining of the esophagus is where cancer can start. Cancer cells begin growing and then invade the esophageal wall and spread to other organs in the body. There are two types of esophageal cancer – squamous cell and adenocarcinoma.  Squamous cell cancer usually forms in the upper and middle sections of the esophagus. Adenocarcinoma usually forms in the lower, glandular tissue near the stomach.
A diet low in fruits and vegetables or obesity can increases the risk of esophageal cancer. The use of tobacco may damage the lining of the esophagus and create a risk of both squamous cell and adenocarcinoma cancer. Prolonged and/or heavy alcohol consumption also increases the risk of developing esophageal cancer. Adenocarcinoma of the esophagus can be caused by inflammatory conditions such as chronic reflux disease. The inflammation causes damage to the cells lining the esophageal tissue.
Signs or symptoms of esophageal cancer include pain or difficulty swallowing. Pressure and burning in the chest, indigestion or heartburn are common also. Frequent choking on food, unexplained weight loss, vomiting, pain in breastbone or throat should also be investigated to rule out cancer and investigate other digestive problems.
Esophageal cancer can be detected by tests like a barium swallow or x-ray that is taken after swallowing a liquid that coats the esophagus and highlights any unusual changes or tumors. EGD, or upper endoscopy, involves a long tube with a camera being inserted down the esophagus to see any abnormal areas and obtain tissue for biopsy of any suspicious areas. The esophagus can be stretched during this procedure to allow ease of eating if difficulty in swallowing exists. An ultrasound can find out if a tumor has grown into the wall of the esophagus and if it has spread beyond the esophageal wall. A biopsy of the suspicious tissue can be taken, examined, and tested for molecular factors. CT scans, MRI imaging and PET scans can detect esophageal tumors as well.
Current research for esophageal cancer is investigating a variety of single agents as well as a combination of treatments. Drugs that target the growth of the cancer cells and those that boost the body’s own immune system and its ability to fight cancer are being studied.  In addition to treatment of the disease, palliative care or easing the symptoms and side effects, is also a very important area of research to ensure that quality of life can be maintained  throughout treatment.
Special thanks to Dr. Brian Hemphill
Sources:
Cancer.net
Cancer.org
