Esophageal cancer

Esophageal cancer is the formation of cancer cells in the esophagus (the tube that connects mouth to the stomach). It starts within the cells in any part of the esophageal wall and later can spread to the other parts. Esophageal cancer is the sixth most common cancer of the world; in India it is second and fifth most common cancer in men and women respectively.


In the early stages of cancer, the symptoms are not evident. The esophageal cancer symptoms appear only in the later stages and include:

  • Difficulty and pain during swallowing
  • Weight loss
  • Hoarse voice
  • Pain in the chest behind the breastbone
  • Cough that doesn’t go away
  • Indigestion
  • Heartburn

Coping and support

It is a very sad thing for the patient to know that he/she has cancer. This can also lead to depression and loss of self-esteem. Therefore, coping is of high importance for such people. Keep trying ways to make yourself feel comfortable. The below mentioned are some helpful tips:

  • Understand clearly and deeply about esophageal cancer and make decisions for your better care. You may learn this from your doctor, or online sources, etc.
  • Keep in regular touch with your friends and family members. They can be of a great emotional support and strength for you during your treatment. Talk to good listener friends and share your feelings with them.

TNM staging system

The doctors use this system to describe the esophageal cancer stages. The diagnostic test reports are used to answer the questions like:

  • Tumor (T)-how deep is the tumor growth, into the esophageal wall and surrounding tissues?
  • Node (N)-has the tumor spread to the lymph nodes?
  • Metastasis (M)-has the cancer metastasized or spread to other body parts?

Risk factors

Some types of esophageal cancers are due to alcohol and tobacco consumption. The risk is much higher in people who use both of them.

Some other types of esophageal cancers are related to the condition called gastro-esophageal reflux disease (GERD).

Due to the acidic rush from the stomach to the esophagus, the cells of the walls get damaged and over time it can lead to the formation of malignant cells. Medical conditions such as Achalasia (a motility disease of the esophagus) can increase the risk for esophageal cancer.

Your risk for esophageal cancer also goes up as you age. Also, males are at higher risk for esophageal cancer over females.


As the esophageal cancer advances, it can lead to certain complications as mentioned below:

  • Pain: Initially, pain may not be present but is felt in the advanced stages of esophageal cancer.
  • Esophageal bleeding: Bleeding with esophageal cancer can be either gradual or sudden and can become severe at times.
  • Esophageal obstruction: This can lead to a difficulty in passing food and drinks through your esophagus.


As you have understood the risk factors for esophageal cancer, you can take steps to prevent this cancer.

  • Quit smoking and drinking, or at least drink in moderation.
  • Eat more of healthy and colorful fruits and vegetables.

Maintain a healthy weight by aiming at loosing 1 or 2 pounds each week.


Due to mutations in the DNA of the cells lining the esophagus, they become malignant. These cells repeatedly divide in an uncontrolled manner producing abnormal cells and thus the tumor. The exact cause for these mutations to occur is not known.

The other causes include unusual infections with fungi, yeast, and human papillomavirus (HPV).

Certain foods such as beetle nuts can also increase the risk of esophageal cancers.

Because of no early symptoms, esophageal cancer is usually diagnosed in the advanced stages.

If you present the signs and symptoms of esophageal cancer, your doctor will take your medical history and family history. Following this, certain tests are performed to confirm the diagnosis. If cancer is detected, further tests are performed to understand the stage of esophageal cancer.

Test type Purpose of the test
Imaging tests (CT, MRI, PET) Creates clear cross-sectional images of the esophageal tube using sound or radio waves, etc. To detect the exact location of the cancer To know how far the cancer has spread
Barium swallow test Barium coated esophagus is examined using X-rays The first test performed if swallowing difficulty is reported To detect abnormalities in the surface of the esophageal lining
Endoscopy To look the inside of the esophageal tube with a camera fixed to the endoscope To diagnose cancer and to determine the extent of spread of esophageal cancer
Thoracoscopy and laparoscopy Cutting open the chest wall or abdomen under anesthesia and observing the inside with a small camera To check if cancer has spread and decide the benefits of surgery for that patient
Biopsy Examines small tissues from the esophagus under microscope To ensure that esophageal cancer is present

The esophageal cancer treatment is based on cells involved in producing cancer, the stage of cancer, and your overall health. It helps to relieve symptoms and prevents the advancing of cancer. The treatment options for esophageal cancer are:


Surgery is done to remove cancer and can be used either alone or may be combined with other treatments. Surgery may be performed either to remove very small tumors or to remove a portion of the esophagus or to remove part of the esophagus and part of the stomach.


Chemotherapy involves the use of drugs to kill the cancer cells. These drugs may be prescribed before or after surgery. In advanced stages, this therapy can help to relieve the signs and symptoms.

Radiation therapy

This therapy employs high-energy radio waves to destroy cancer cells. Radiation therapy is generally combined with chemotherapy and can be given before or after the surgery.