UofL Physicians - Surgery
401 E. Chestnut St., Suite 710
Louisville, KY 40202
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Tel: 502-562-4673
RCGMartinMd.com
Learn More About
Esophagus Cancer
Anatomy of the Esophagus
The esophagus is a muscular tube that connects the throat (pharynx) to the stomach, playing a critical role in moving food and liquids to the digestive system. The esophagus is lined with tissue that can be affected by various conditions, including inflammation, Barrett’s esophagus, and cancer.
What is Esophageal Cancer?
Cancer develops when abnormal cells grow uncontrollably and form a mass, known as a tumor. Tumors can be benign (non-cancerous) or malignant (cancerous). Esophageal cancer is a disease in which malignant cells form in the tissues of the esophagus, often impacting its ability to carry food and liquids to the stomach.
Types of Esophagus Cancer
There are two main types of esophageal cancer:
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Adenocarcinoma – More common in the lower esophagus and associated with chronic acid reflux and Barrett’s esophagus.
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Squamous Cell Carcinoma – Typically forms in the upper and middle sections of the esophagus and is often linked to smoking and alcohol use.
Symptoms
Common symptoms of esophageal cancer include:
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Difficulty swallowing (dysphagia)
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Unexplained weight loss
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Chest pain or discomfort
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Chronic cough or hoarseness
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Acid reflux or persistent heartburn
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Feeling like food is stuck in the throat
Risk Factors
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Smoking and heavy alcohol consumption
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Chronic acid reflux (GERD)
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Barrett’s esophagus (a precancerous condition)
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Obesity
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Diet low in fruits and vegetables
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Human papillomavirus (HPV) infection
Barrett's esophagus occurs when the normal cells that line the lower part of the esophagus (called squamous cells) are replaced by a different cell type (called intestinal cells). This process usually occurs as a result of repetitive damage to the inside of the esophagus caused by long standing gastroesophageal reflux disease (GERD). In people with GERD, the esophagus is repeatedly exposed to excessive amounts of stomach acid and bile. Interestingly, the intestinal cells of Barrett's esophagus are more resistant to acid and bile than squamous cells, suggesting that these cells may develop to protect the esophagus from acid exposure. The problem is that the intestinal cells have a risk of transforming into cancer cells.**
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Barrett's Esophagus Management and Monitoring:​
Patients with Barrett's esophagus often undergo regular surveillance endoscopies to monitor for precancerous changes. Lifestyle modifications and medications to control acid reflux are essential to managing the condition.
Barrett's Esophagus
How Many Americans Are Diagnosed with Esophagus Cancer?
Each year, approximately 20,000 new cases of esophageal cancer are diagnosed in the United States, with men being more commonly affected than women.
Diagnosis and Tests
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Endoscopy (EGD) – A thin, flexible tube with a camera is used to examine the esophagus.​​​​​​​​​
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Biopsy – Tissue samples are taken to check for cancerous cells.
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Imaging Tests – CT scans, PET scans, and barium swallow X-rays can help detect abnormalities.
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Esophageal Manometry – Measures esophageal muscle contractions and function.
What Are Esophagus Cancer Stages?
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Stage 0 – Abnormal cells found in the inner lining (precancerous).
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Stage I – Cancer is confined to the top layer of esophageal tissue.
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Stage II – Cancer has grown deeper into the esophageal wall.
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Stage III – Cancer has spread to nearby lymph nodes or tissues.
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Stage IV – Cancer has metastasized to distant organs.
Deep Dive into Staging
Esophageal cancer staging helps determine treatment options. Doctors use the TNM system:
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T (Tumor) – How deeply the tumor has grown into the esophagus.
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N (Nodes) – Whether cancer has spread to nearby lymph nodes.
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M (Metastasis) – Whether cancer has spread to other organs.
Emotional and Social Support
A diagnosis of esophageal cancer can be overwhelming. Support resources include:
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Counseling and therapy for emotional health.
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Support groups for patients and caregivers.
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Nutrition counseling to help with dietary needs.
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Palliative care for symptom management.
What Treatments Exist for Esophagus Cancer?
Esophageal cancer treatment depends on the stage and overall health of the patient. Treatment options include:
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Surgery – To remove cancerous tissue.
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Endoscopic Treatments
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Endoscopic Mucosal Resection (EMR) to treat early stage (<=T1b and Barretts Esophagus)
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Endoscopic Stenting for relieving the obstruction of the cancer
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Radiation therapy – Uses high-energy beams to kill cancer cells.
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Chemotherapy – Uses drugs to target cancer cells.
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Targeted therapy & Immunotherapy – Helps the body’s immune system fight cancer.