What is Esophageal Cancer?

The esophagus is a hollow muscular tube that’s responsible for moving food from the throat to the stomach. Esophageal cancer can occur when a malignant tumor forms in the lining of the esophagus. As the tumor grows, it can affect the deep tissues and muscle of the esophagus. A tumor can appear anywhere along the length of the esophagus, including where the esophagus and the stomach meet.

What Are The Common Types Of Esophageal Cancer?

There are two common types of esophageal cancer:

Squamous cell carcinoma occurs when cancer starts in the flat, thin cells that make up the lining of the esophagus. This form most often appears in the top or middle of the esophagus, but it can appear anywhere.

Adenocarcinoma occurs when cancer starts in the glandular cells of the esophagus that are responsible for the production of fluids such as mucus. Adenocarcinomas are most common in the lower portion of the esophagus.

Symptoms:

During the early stages of esophageal cancer, you probably won’t experience any symptoms. As your cancer progresses, you may experience:

• Unintentional weight loss
• Indigestion
• Heartburn
• Pain or difficulty when swallowing
• Frequent choking while eating
• Vomiting
• Food coming back up the esophagus
• Chest pain
• Fatigue
• Chronic cough
• Hiccups

Treatment of Esophageal Cancer

Surgery

If the cancer is small and hasn’t spread, your doctor can remove the tumor using a minimally invasive approach, using an endoscope and several small incisions. In the standard approach, the surgeon operates through a larger incision to remove a portion of the esophagus and sometimes the lymph nodes around it. The tube is reconstructed with tissue from the stomach or large intestine. In severe cases, a portion of the top of the stomach may be removed as well. The risks of surgery can include pain, bleeding, leaking in the area where the rebuilt esophagus is attached to the stomach, lung complications, problems swallowing, nausea, heartburn, and infection.

Chemotherapy

Chemotherapy involves the use of drugs to attack cancer cells. Chemotherapy may be used before or after surgery. It sometimes accompanies the use of radiation therapy. Chemotherapy has a number of possible side effects. Most arise because chemotherapy drugs also kill healthy cells. Your side effects will depend on the drugs your doctor uses. These side effects can include:

• Hair loss
• Nausea
• Vomiting
• Fatigue
• Pain
• Neuropathy

Radiation Therapy

Radiation therapy uses beams of radiation to kill cancer cells. Radiation may be administered externally (with the use of a machine) or internally (with a device placed near the tumor, which is called brachytherapy). Radiation is commonly used along with chemotherapy, and side effects are usually more severe when a combined treatment is used. The side effects of radiation can include:

• Skin that looks sunburned
• Pain or difficulty when swallowing
• Fatigue
• Painful ulcers in the lining of the esophagus

It’s possible to experience some side effects of treatment long after treatment finishes. These can include esophageal stricture, where the tissue becomes less flexible and can cause the esophagus to narrow, making it painful or difficult to swallow.

Targeted Therapy

Targeted therapies can target specific proteins on cancer cells as a way to treat the cancer. A small portion of esophageal cancers can be treated with Trastuzumab. It targets the HER2 protein on the surface of the cancer cell where the protein has been helping the cancer cells to grow. Also, cancers can grow and spread by creating new blood vessels. Ramucirumab is a type of targeted therapy called “monoclonal antibody,” and this bonds to a protein called VGEF, which helps make new blood vessels.

Other Treatments

If your esophagus is obstructed as a result of cancer, your doctor may be able to implant a stent (a tube made of metal) into your esophagus to keep it open. They may also be able to use photodynamic therapy, which involves injecting the tumor with a photosensitive drug that attacks the tumor when exposed to light. Long-term outlook Your chances for recovery improve the earlier the cancer is found. Esophageal cancer is usually found in the later stages when it can only be treated but not cured. Your chances of survival may improve with surgery if the cancer hasn’t spread outside of your esophagus.