Esophageal Cancer

ExitCare ImageEsophageal cancer occurs when abnormal cells within the esophagus begin to divide rapidly and uncontrollably. The esophagus is the tube that carries food and drink from the throat into the stomach.

CAUSES

The exact cause of esophageal cancer is not known. It is believed that esophageal cancer occurs due to many factors. People are at a higher risk of developing esophageal cancer if they:

  • Are older than 65 years of age.

  • Are male.

  • Smoke or use tobacco.

  • Drink heavily.

  • Eat a poor diet (low in fruits and vegetables).

  • Are overweight (obese).

  • Have conditions which result in long-standing damage or irritation to the esophagus. These conditions include:

  • Acid reflux (the stomach acid leaks back up the esophagus, damaging it).

  • Barrett Esophagus (abnormal cells are found in the lower part of the esophagus, usually due to acid reflux occurring over a long period of time).

  • Achalasia (the muscles and nerves of the esophagus do not work properly. Food and drink do not move in a normal way down the esophagus and into the stomach).

  • Esophageal webs (thin strings of tissues grow within the esophagus).

  • Damage due to toxic exposures (an example would be swallowing a caustic poison such as lye).

SYMPTOMS

Symptoms can include:

  • Trouble swallowing.

  • Chest or back pain.

  • Unintentional weight loss.

  • Severe tiredness (fatigue).

  • Hoarse voice.

  • Cough.

DIAGNOSIS

Esophageal cancer is usually diagnosed by performing:

  • Barium swallow. After drinking barium (a liquid that coats the esophagus), a series of X-rays are taken which can reveal abnormalities.

  • Endoscopic exam. A lighted scope is used to view the inside of the esophagus.

  • Biopsy. Small pieces of the esophagus are removed for exam in a lab. This can be done through the scope used for an endoscopic exam.

TREATMENT

Treatment of esophageal cancer depends on a number of factors, including:

  • Characteristics of the cancer cells present.

  • Tumor size.

  • Whether the cancer has spread to lymph nodes or to other more distant locations (such as other organs or bone).

The types of treatments used for esophageal cancer include:

  • Surgery to remove as much of the cancer as possible.

  • Chemotherapy (medicines that kill cancer cells).

  • Radiation therapy to kill cancer cells.

  • Combinations of chemotherapy and radiation therapy.

  • Biological therapy that uses antibodies in ways that can take advantage of the weaknesses of the tumor cells.

Your caregivers will also address your needs for pain relief, nutrition, and help with swallowing problems if these develop.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Maintain a healthy diet. Advice from a nutritionist can be helpful when addressing your specific needs.

  • Consider joining a support group. This may help you learn to cope with the stress of having esophageal cancer.

  • Seek advice to help you manage treatment side effects.

SEEK MEDICAL CARE IF:

  • You develop problems with swallowing that are getting worse.

  • You notice new fatigue or weakness.

  • You experience unintentional weight loss.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a sudden increase in pain.

  • You have trouble breathing.

  • You have a fever.

  • You vomit blood or black material that looks like coffee grounds.

  • You faint.