The esophagus is the long tube that connects your throat to your stomach and carries swallowed food and liquids to your digestive system. Cancer that starts in the esophagus can affect this tube in many different ways. If the cancer is in the earliest stages when it is found, the outlook for treatment and survival is better than for cancer that has spread to other parts of the body.
Symptoms of esophageal cancer can vary and often mimic other conditions. Because of this, it is important to talk with your doctor if you have any new or persistent symptoms. Your doctor will take a detailed history of your health and do a physical exam to check your general well-being. Your doctor may also order chest x-rays, which can help detect abnormalities in the tissues and bones of your upper chest and abdomen. Other diagnostic tests may include blood tests to check your overall health, a biopsy to remove and test a sample of the cancer, and imaging studies to find out how far the cancer has grown.
Your cancer will be staged based on the results of these tests and whether it has spread to lymph nodes or other tissues near where it began. Cancer staging systems use numbers that indicate how far the cancer has grown and spread. Stage 0 is the earliest stage and indicates that the cancer hasn’t spread beyond the cells in the lining of the esophagus. Cancer that has spread to other tissue or lymph nodes is considered in stage 2.
There are two main types of esophageal cancer: squamous cell esophageal cancer and adenocarcinoma esophageal cancer. Squamous cell cancer begins in the skin-like cells that line your esophagus. Adenocarcinoma cancer begins in the mucus-producing cells in the lining of the esophagus.
In the early stages of esophageal cancer, there are usually few or no symptoms. When symptoms do occur, they are often mild and easy to mistake for other conditions, such as heartburn or difficulty swallowing (dysphagia). If the cancer is in its earliest stages, your doctor will be able to treat it successfully.
If the tumor is very small in stage 1A, it may be able to be removed surgically with a procedure called endoscopic mucosal resection (EMR). This surgery involves removing the tumor and a section of the esophagus, usually along with a nearby lymph node. However, this is rare for stage 1 esophageal cancer.
If the tumor is larger in stage 1B, or if the cancer has spread to the muscles of the esophagus in the thoracic region, it can be difficult to treat with surgery. In this stage, you might be treated with chemotherapy and radiation instead. These treatments can kill cancer cells and relieve your symptoms. For these cases, your doctor will usually combine chemo with newer drugs that can help your immune system fight cancer cells. This combination of treatment is called immunotherapy.
