Esophageal Cancer

Esophageal cancer arises when cells that make up the tissue lining the esophagus grow out of control.

The two most common forms of esophageal cancer are named for the type of cell that becomes cancerous:

• Squamous cell carcinoma (also called epidermoid carcinoma) arises from squamous (skin) cells, the thin, flat cells lining the esophagus. This particular type of cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus.
• Adenocarcinoma begins in cells that make and release mucus and other fluids and usually form in the lower part of the esophagus, near the stomach.

The risk factors for esophageal cancer include:

• Smoking
• Heavy alcohol consumption
• Having Barrett’s esophagus, a condition that may be caused by gastric reflux (heartburn), which irritates the esophagus
• Race – African-American men are more likely to develop esophageal cancer

If you have a higher risk, it does not mean you will get esophageal cancer. However, you may be followed closely to look for early cancers and pre-cancers.

Experts at Houston Methodist recommend people with a high risk of esophageal cancer be screened regularly via upper endoscopy. During this test, the doctor looks at the inside of the esophagus through a flexible, lighted tube (an endoscope or esophagoscope) inserted through the mouth. A biopsy may or may not be taken at this time.

Esophageal cancer symptoms include:

• Problems swallowing food or even liquids
• Feeling like food is stuck in the throat or chest
• Choking on food
• Involuntary weight loss due to problems swallowing
• Dark/black stool
• Fatigue
• Chest pain
• Hoarseness
• Chronic cough
• Hiccups and vomiting

Some of these symptoms are common in other disorders of the esophagus that are not cancerous, including gastroesophageal reflux disease (GERD) and esophageal motility disorders. Esophageal cancer is rarely diagnosed in people without symptoms and is usually discovered because of tests done for other medical problems or due to screening.

It's important to consult with your doctor if you notice one or more symptoms of esophageal cancer. When detected early, there is a better chance of recovery. 

If your doctor suspects esophageal cancer, a variety of tests and procedures may be used to further examine the esophagus, including:

• Physical exam and medical history
• Chest X-ray
• Barium swallow test – after drinking a white, chalky fluid (barium) that coats the walls of your esophagus, X-rays are taken to visualize whether there are abnormal areas of the esophagus
• Esophagoscopy (or upper endoscopy) – a  thin, flexible, lighted tube is inserted into your mouth and guided gently down your throat, enabling your doctor to look for abnormal areas in your esophagus, as well as remove a tissue sample for biopsy, if needed
• Biopsy – the only definitive way to diagnose esophageal cancer, esophageal tissue is removed and examined under a microscope by a pathologist

If esophageal cancer is diagnosed, follow-up tests are used to determine if the cancer has spread within the esophagus or to other parts of the body. This is called staging and is vital in guiding treatment choices. Various imaging tests, including bronchoscopy and endoscopic ultrasound, may be used during this process.

The highly skilled medical oncologists and thoracic surgeons at Houston Methodist offer the most advanced esophageal cancer treatments available.

Learn more about how our experts treat esophageal cancer >