Esophageal cancer is a very serious disease that usually starts in the cells that line the inside of your esophagus. If the cancer is not treated, it can grow to partially block the esophagus and make it difficult for you to swallow food. It can also spread to other parts of your body. The main types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. In very rare cases, lymphoma, melanoma, carcinoid tumors, and leiomyosarcoma can also occur in the esophagus.
In its earliest stages, esophageal cancer may not cause any symptoms. This is why most people with esophageal cancer get diagnosed late, after the cancer has already grown to the point where it causes problems. Difficulty swallowing (dysphagia) is the most common symptom of esophageal cancer. The difficulty often develops slowly and only becomes obvious when the tumor has grown large enough to narrow the opening of your esophagus to half its normal width.
Other symptoms of esophageal cancer can include painful swallowing, coughing up blood, weight loss, and trouble breathing if the cancer erodes or ulcerates the lining of your throat. You might also have a hoarse or dry throat if the cancer affects the nerve that makes your voice stronger.
If you have one of these symptoms, it is important to tell your doctor right away. A physical exam and a review of your health history can help your doctor find out what is causing the problem. Your doctor will also ask you about when the symptom started and how it has changed over time.
In some cases, the only symptom of esophageal Cancer is a burning sensation behind your chest bone (heartburn). Heartburn occurs when stomach acid backs up into your esophagus from the stomach. If you have heartburn for a long period of time, it can cause permanent changes in the cells that line your esophagus and raise your risk for esophageal cancer.
Some esophageal cancers start in the cells that line the esophagus, and some begin in other tissues, like the muscles or glands that produce mucus that helps you swallow. In most cases, esophageal cancer begins in the cells that line the lower part of your esophagus, known as the esophageal squamous cells. In rare cases, squamous cell cancer can start in the esophageal muscular layer or the thin layer of tissue that covers the esophagus wall.
The most common type of esophageal cancer in the United States is adenocarcinoma, which begins in the tissue that produces the mucus that helps you swallow. Squamous cell carcinoma is the second most common esophageal cancer.
Your doctor will do several tests to check for esophageal cancer. These tests might include a complete blood count, which checks the levels of different types of blood cells in your body. This can help your doctor figure out if you have low red blood cell counts, which sometimes happens with esophageal cancer.
Other diagnostic tests might include an X-ray of your esophagus, which is an image of the inside of your esophagus. Your doctor might also do an endoscopy to look for a tumor in the esophagus or nearby lymph nodes. An endoscopy involves inserting a thin, flexible tube with a camera into your mouth. It is a safe and painless way to do an examination of your esophagus and your stomach.
