The esophagus is a tube-like part of the digestive tract that connects the mouth with the stomach. Esophageal cancer is a cancerous (malignant) tumor of this tube. Most of these cancers occur in the lower part of the esophagus. More than 10,000 new cases are diagnosed in the United States every year.
The cause is unknown. Certain risk factors, such as heavy alcohol and tobacco use, increase the chances of getting this cancer. It isn’t contagious. Acid reflux from the stomach that occurs for a long time can lead to changes in the lining of the esophagus (Barrett’s esophagus), which can, in some cases, lead to esophageal cancer.
Trouble swallowing solid foods is the usual symptom. As the tumor grows, liquids become hard to swallow, and pain with swallowing can occur. Cancer usually spreads nearby, to lungs, windpipe, lymph glands, and liver. Hoarseness, coughing, coughing up or vomiting blood, and chest pain can result.
The best way for the doctor to make a diagnosis is with an endoscope and biopsy. With this lighted tube, passed through the mouth into the esophagus, the doctor can get tissue to study with a microscope (biopsy). X-ray studies, a barium swallow examination, or esophagography can also be done, but will need to be followed by endoscopy and biopsy to confirm the diagnosis.
After diagnosis, staging is needed to tell the extent of disease and whether it spread. A physical examination, blood tests, and computed tomography (CT) of the chest and abdomen are used. Spread to the voice box (larynx) is checked with laryngoscopy. Spread to the lungs may also be checked with bronchoscopy. These examinations use lighted tubes passed into the larynx or lungs.
Therapy depends on the stage of disease and its spread. It can include surgery, radiation, and chemotherapy (cancer-fighting drugs). In an operation called esophagectomy, the surgeon removes the cancerous part of the esophagus and lymph glands. Radiation is used instead of surgery when the tumor is too large to remove or the person cannot undergo an operation. Chemotherapy (use of medications to kill cancer cells) can be used with radiation and surgery.
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