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April 24, 2014  
EDUCATION CENTER: Conditions
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  • Esophageal Cancer

    Quick Reference

    Reviewed by Dr. Richard Alweis

    According to the American Cancer Society, during 2002 an estimated 13,100 new cases of esophageal cancer were diagnosed and approximately 12,600 patients died from the disease. Significantly, a growing amount of evidence has indicated an increased risk of esophageal cancer in individuals with a history of recurring heartburn. Although a relatively rare form of cancer, esophageal cancer has a high fatality rate, and treatment should begin immediately upon diagnosis.

    Detailed Description

    As with all cancers, esophageal cancer is caused by an abnormal proliferation of cells. The two types of esophageal cancer, squamous cell carcinoma and adenocarcinoma, are named after the specific esophageal cells which grow irregularly. Squamous cell carcinoma is more common in the upper and middle parts of the esophagus, where there is a high concentration of squamous cells, while adenocarcinoma occurs in the lower section of the esophagus, in the secretory/glandular cells.

    The most common symptoms of esophageal cancer are pain or difficulty swallowing and weight loss, while pain in the upper chest, hoarseness, coughing, indigestion, and heartburn may also indicate a problem. Heartburn has been linked to esophageal cancer primarily through the intermediary condition of Barrett’s Esophagus. Prolonged exposure to acidic stomach contents (as in heartburn) can lead to the development of Barrett’s Esophagus, in which the normal squamous cells change into secretory/glandular cells. These cells are much more likely to become malignant. For these reasons, the American College of Gastroenterology recommends both stomach and esophageal endoscopies for individuals with a recurring history of heartburn.

    There are multiple methods used for diagnosing esophageal cancer. In addition to endoscopy, X-rays, Computed Tomography (CT) scans, endoscopic ultrasound, barium swallow, and biopsy may be utilized to determine the presence and/or stage of the cancer. A barium swallow coats the inside of the esophagus such that any growths or irregularities are easier to identify in an X-ray. If any irregularities are seen, endoscopy with biopsy would need to be done to make the diagnosis and guide treatment.

    Treatment

    Treatment for esophageal cancer varies depending on the stage of the growth, size of the tumor, and overall health of the patient. In early stages (0 – 1), the cancer is still confined to the esophagus, in the middle (2 – 3), it may have spread to nearby lymph nodes and tissues, while in the latter (4), it has spread to distant lymph nodes and organs. Surgery is the most common method of treatment, and is most effective in the earlier stages. Surgeons remove the section of the esophagus containing the growth and then simply reconnect the remainder to the stomach. Additionally, traditional cancer treatments such as chemotherapy, radiation therapy, laser therapy, and electrocoagulation may be utilized.

    Last updated: 01-Apr-03

       
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