Esophageal cancer: overview of symptoms, causes and treatment

Medically reviewed: 5, December 2023

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Cancer of the esophagus

The esophagus, also known as the gullet, is the long tube that carries food from the throat to the stomach.

When a person has cancer of the esophagus, a growth can be located anywhere along the tube and is usually diagnosed as being upper (behind the windpipe), middle (near the chest) or lower (near the stomach).

Cancer in the upper part of the esophagus is called squamous carcinoma, whereas a tumor lower down is usually referred to as an adenocarcinoma.

Symptoms of esophageal cancer

The most common early symptom of cancer of the esophagus is difficulty in swallowing. It often feels as if food has become stuck in the gullet. This may be accompanied by pain in between the shoulder blades that gets worse after eating.

These symptoms may become so uncomfortable that eating is drastically reduced, resulting in obvious weight loss.

Advanced cancer of the esophagus may cause heartburn, acid indigestion and coughing. This is caused by food getting into the lungs. Vomiting immediately after eating is also a possible symptom of cancer of the oesophagus, although it can also be caused by many other conditions

Causes of esophageal cancer

Cancer of the esophagus is a rare disease, particularly in the United States, and accounts for only 1 in 50 of new cancer cases. Possible causes include drinking too much alcohol and poor diet, although smoking is thought to be a main cause.

Iron deficiency used to be a common cause of cancer of the esophagus, but changes in diet and advances in healthcare mean that this is now very rare.

How to diagnose esophageal cancer?

Cancer of the esophagus is usually diagnosed by taking an x-ray of the gullet. To make the x-ray clearer, you may asked to drink a white, chalky liquid beforehand. This is known as a ‘barium meal’ or ‘barium swallow’. The liquid contains barium sulfate which is entirely harmless.

The barium sulfate does not allow x-rays to pass through it, so it shows up very clearly and can show any blockage in the gullet.

An endoscopy may then be carried out. This which involves passing a long thin tube with a tiny camera attached to the end, down the esophagus. A small sample of tissue can then be removed and tested for cancerous cells (known as a biopsy).

If cancer is detected, a computerized tomography scan (CT scan) may be performed in order to see if the cancer has spread to any other parts of the body.

Treatment of esophageal cancer

Radiotherapy and chemotherapy can be used to destroy the growth. However in most cases the best option for complete recovery to remove the growth by surgery.

Cancer of the esophagus is often quite advanced by the time it is diagnosed. This makes treatment more difficult.

When the esophagus has become narrowed by a growth, it may be possible to have surgery to make swallowing easier. A plastic tube called a stent may be put into the esophagus which will make it easier to breathe and swallow. This is usually done under a general anesthetic.

Prevention
Stopping smoking and limiting alcohol intake to recommended levels is the best way to reduce the risk of cancer of the esophagus.

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