Learn about Throat cancer and Esophageal Cancer from Florida Cancer Specialists & Research Institute

What is esophageal cancer?

Cancer occurs when cells develop changes in their DNA and form a mass, called a tumor. Esophageal cancer starts in the inner layer of the esophagus wall and grows outward.

The esophagus, commonly referred to as the food pipe, is a hollow, muscular tube about 10” – 13” long that connects the throat to the stomach. It is located in the center of the chest, behind the trachea (windpipe) and in front of the spine, and functions as part of the digestive system, carrying food and liquid from the throat to the stomach.

At its upper opening is a ring-shaped muscle known as the upper esophageal sphincter. It opens to allow food and to enter. Once inside, the food is pushed downward through a series of muscular contractions (called peristalsis) through the diaphragm, into the lower esophageal sphincter and through to the stomach.

Esophageal cancer is quite rare, making up just one percent of all cancers diagnosed in the U.S. each year. There are two main types of esophageal cancer, in addition to a few rare types. Squamous cell carcinoma, which usually develops in the upper and middle part of the organ, is the most common worldwide. Adenocarcinoma, which begins in the lower part of the esophagus where it meets the stomach, is the most common in the U.S. and primarily affects white men.
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What are the signs and symptoms of esophageal cancer?

General signs and symptoms of esophageal cancer can include:

• More than occasional heartburn symptoms
• Worsening heartburn symptoms
• Pain or difficulty swallowing
• Weight loss
• A persistent, unexplained cough or sore throat
• Coughing or choking when lying down
• Speaking with a hoarse voice over several weeks
• A family history of esophageal cancer or Barrett’s esophagus

Many of these symptoms can occur with other more common illnesses. Regardless, it is important to contact your health care provider if you experience any of these.
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How is esophageal cancer diagnosed?

Diagnosing esophageal cancer begins with a physical examination so that your doctor can evaluate the symptoms you are experiencing. Additional information to confirm a diagnosis and how advanced the disease is can be obtained through:

• Barium swallow study in which x-rays are taken of the esophagus after swallowing a liquid that includes barium
• Endoscopy using a flexible tube with a video lens to examine the esophagus
• Biopsy to collect tissue samples that are sent to a laboratory for examination

Other types of testing and scans may be necessary to make a definitive diagnosis and to help your care team begin planning for your personalized treatment.
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What causes esophageal cancer?

The exact causes of esophageal cancer are not clear. However, researchers believe that chronic acid reflux or GERD may contribute. Other risk factors include smoking, drinking alcohol, obesity, improper nutrition or undergoing radiation treatment to the chest or upper abdomen.
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Is esophageal cancer genetic?

A very small number of specific types of esophageal cancers are caused by inherited changes to genes. Most DNA mutations that lead to esophageal cancer occur during a person’s lifetime rather than having been inherited. However, if an immediate family member has had esophageal cancer, you may be at higher risk. Talk with your doctor for more information.
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Is esophageal cancer curable?

Because it is usually diagnosed at late stages when it is more difficult to treat, about 20% of patients diagnosed with the disease will survive five years or more. Treatment and survival rates have improved in recent years; however, esophageal cancer is rarely cured.
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How is esophageal cancer treated at FCS?

Each patient and each cancer is unique. At FCS, physicians develop a personalized treatment plan in partnership with patients. Treatment options depend on a number of factors, including the specific type and stage of cancer, possible side effects, and the patient’s overall health and personal preference. Esophageal cancer treatment can include surgery, chemotherapy, radiation, endoscopic therapy or a combination of these. Increasingly, immunotherapies that strengthen and use the body’s own immune system to attack cancer, are yielding positive outcomes. New types of immunotherapy drugs have been approved in recent years to treat the most common types of esophageal cancers. Through our extensive FCS clinical trials research program, we offer our patients access to the most advanced treatment options available.
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What are common risk factors for esophageal cancer?

The chance of developing esophageal cancer increases with age; the average age at diagnosis is 68. The lifetime risk in the United States is about 1 in 125 in men and about 1 in 417 in women, according to the American Cancer Society. Men are about three times more likely than women to have esophageal cancer, and white men develop the disease at higher rates than Black men.

The number of people diagnosed with the disease has been on the rise in recent years. Between 2012 and 2019, the rate of esophageal cancer among adults aged 45 to 64 nearly doubled in the U.S. Rising rates of unhealthy eating, obesity and heartburn, in addition to smoking and alcohol use, appear to be contributing factors.

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Is there a screening test for esophageal cancer?

There is no screening test for esophageal cancer. If your health care provider suspects cancer may be present, a variety of exams, tests and biopsies can help to confirm a diagnosis.
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What is the first sign of esophageal cancer?

Esophageal cancer often does not produce noticeable symptoms until later stages when the tumor has grown large enough to interfere with eating, swallowing or digesting food. Often, the first warning sign is difficulty swallowing or a sensation that food is stuck in the throat.
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How long can you have esophageal cancer and not know?

Esophageal cancer is a slow growing cancer and it may take years before noticeable symptoms appear. Once symptoms do appear, the cancer can progress rapidly.
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