Facts on esophageal cancer

Even though esophageal cancer is an uncommon cancer, any signs or symptoms of it should not be ignored as only about 20 percent of patients survive at least 5 years after diagnosis.  Knowing what to look for and possible ways to prevent this cancer is a first step in avoiding it to begin with. 

Cancer of the esophagus

The esophagus is a hollow, muscular tube about 10 to 13 inches in length connecting the throat to the stomach.  It lies behind the trachea (windpipe) and in front of the spine.

It allows the passage of food and liquids from the throat to the stomach.

When cells within the esophagus begin to grow out of control is when it is diagnosed as esophageal cancer.  The walls of the esophagus have several layers – the mucosa, the submucosa, the muscularis propria, and the adventitia. 

Cancer of the esophagus starts in the inner layer (mucosa) and grows outward through the submucosa.  There are two main types of esophageal cancer – squamous cell carcinoma and adenocarcinoma.  Squamous cell carcinoma occurs anywhere along the esophagus and adenocarcinoma starts in gland cells.

At this time, screening the general public regularly for esophageal cancer is not recommended as no screening test has been shown to lower the risk of dying from this disease.  However, people with Barrett’s esophagus should be followed more closely as they have a higher risk of developing esophageal cancer. 

Key statistics about esophageal cancer

The American Cancer Society has estimated the following statistics for esophageal cancer in the United States for 2016:

·         About 16,910 new cases will be diagnosed (13,460 in men and 3,450 in women).

·         About 15,690 deaths will occur (12,720 in men and 2,970 in women).

·         It is 3 to 4 times more common in men than women.

·         The lifetime risk of esophageal cancer in the U.S. is about 1 in 125 men and 1 in 435 women.

·         Esophageal cancer represents about 1% of all cancer diagnoses in the U.S.

·         It is much more common in Iran, northern China, India, and southern Africa.

·         Survival rates have improved over the years – during the 1960’s and 1970’s only about 5% survived at least 5 years.

·         Today, 20% of patients survive at least 5 years.

·         The earlier esophageal cancer is diagnosed, the greater the survival rate.

Risk Factors

Anything that can affect or change your chance of getting a disease is a risk factor.  Having a risk factor does not mean you will get the disease but it can increase the possibility.  Esophageal cancer has several risk factors of which fortunately many can be altered through lifestyle changes:

·         Age – Chances increase with age – less than 15% of cases are found in people younger than age 55.

·         Gender – Men are 3 times more likely to develop it than women.

·         Gastroesophageal reflux disease (GERD) – people with GERD have a slightly higher risk.

·         Barrett’s esophagus – This is where damage has occurred to the inner lining of the esophagus.  The squamous cells get replaced with gland cells which over time may become more abnormal.  Most people with Barrett’s esophagus do not go on to develop esophageal cancer.

·         Tobacco and alcohol use – Any tobacco products such as cigarettes, cigars, pipes, and chewing tobacco are major risk factors.  The more they are used, the greater the chance of getting it.  With alcohol, the more you drink, the higher the risk of developing esophageal cancer.  Smoking and drinking account for about 90% of esophageal squamous cell carcinomas in the United States.

·         Obesity – Increases the risk of adenocarcinoma of the esophagus. 

·         Diet – A diet high in processed meat and low in fruits and vegetables appears to increase risk.  Drinking very hot liquids frequently may increase risk for squamous cell esophageal cancer due to damage to the cells lining the esophagus. 

Symptoms

Esophageal cancer is usually found because of symptoms the person is having which include:

·         Trouble swallowing

·         Chest pain

·         Weight loss

·         Hoarseness

·         Chronic cough

·         Vomiting

·         Hiccups

·         Pneumonia

·         Bleeding into the esophagus

Having one or more of the above symptoms does not automatically mean you have esophageal cancer as they can be due to other conditions.  But the sooner you have them checked out by a doctor the sooner the cause can be found and treated.

Prevention

Prevention of esophageal cancer may not always be possible but the more you can do to reduce your risk, the greater the chance you will avoid it.

·         Avoid tobacco and alcohol.

·         Eat a healthy diet and maintain a healthy body weight.

·         If you have GERD or Barrett’s esophagus, get them treated as soon as possible.