In the early stages of esophageal cancer, you might not experience any symptoms. However, as the cancer progresses, you may experience symptoms like vomiting, frequent choking while eating, or chronic cough.

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.

During the early stages of esophageal cancer, there may be no symptoms.

As cancer progresses, a person may notice:

  • difficulty or pain when swallowing
  • chest pain
  • unexpected weight loss
  • persistent cough
  • a hoarse voice
  • vomiting
  • bleeding in the esophagus, which may lead to black stools
  • fatigue due to anemia, which can result from bleeding
  • bone pain and other symptoms, if cancer spreads to other parts of the body
  • indigestion and heartburn
  • a lump under the skin

The cause of esophageal cancer isn’t yet known, but it involves changes in the DNA of cells related to the esophagus.

These changes signal the cells to multiply more rapidly than normal cells and disrupt the signal for these cells to die when they should.

This causes cells to accumulate and become tumors.

Are there different types of esophageal cancer?

Some factors that may increase the risk of esophageal cancer include:

  • alcohol consumption
  • smoking
  • having a reflux disorder, such as gastroesophageal reflux disease (GERD)
  • having Barrett’s esophagus, which features a damaged esophageal lining due to GERD
  • obesity combined with GERD
  • being male, as males are three times more likely than females to develop esophageal cancer

What’s the link between esophageal cancer and acid reflux?

Testing methods for diagnosing esophageal cancer include the following:

  • An endoscopy involves the use of an instrument with a camera attached to a tube that goes down your throat and allows your doctor to view the lining of your esophagus to check for abnormalities and irritation.
  • A barium swallow is an X-ray imaging test that allows your doctor to see the lining of your esophagus. To do this, you swallow a chemical called barium while the images are being obtained.
  • A biopsy is a process in which your doctor removes a sample of the suspicious tissue with the help of an endoscope and sends it to a lab for testing.
  • A CT scan, PET scan, or MRI may be used to see if cancer has spread to other parts of the body.

Around half of all people who receive a diagnosis of esophageal cancer will do so when cancer has already spread beyond the esophagus.

How do doctors diagnose esophageal cancer?

Treatments for esophageal cancer will depend on the stage and other factors. Options include surgery, chemotherapy, and radiation therapy.

Surgery

If the cancer is small and hasn’t spread, a surgeon can remove the tumor using a minimally invasive approach. This will involve an endoscope and several small incisions.

They may also operate through a larger incision to remove a portion of the esophagus and sometimes the lymph nodes around it. They will reconstruct the tube with tissue from the stomach or large intestine.

In severe cases, a surgeon may also need to remove a portion of the top of the stomach.

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.

Radiation therapy

Radiation therapy uses beams of radiation to kill cancer cells. Doctors may combine it with other treatments.

There are two ways to deliver radiation.

External delivery is by using a machine. Otherwise, a health professional can place a device near the tumor in a procedure known as brachytherapy.

Other treatments

If a tumor obstructs the esophagus, a doctor may implant a small tube called a stent into the esophagus to keep it open.

Another option is laser therapy, which involves injecting the tumor with a photosensitive drug that attacks the tumor when exposed to light.

The staging of esophageal cancer can be quite complex. It will depend on the type of esophageal cancer, where it spreads to, and the grade, or how fast-growing the tumor is.

The basic stages are as follows, but you can learn more in our dedicated article on how doctors stage esophageal cancer.

Stage numberDescription
0 High-grade dysplasia, where cancer only affects the top layer of cells in the esophagus
1Cancer is growing in the esophagus but has not spread to lymph nodes
2Cancer affects deeper layers around the esophagus and may affect lymph nodes
3Cancer affects lymph nodes and tissues near the esophagus but has not reached distant organs
4Cancer affects organs further from the esophagus and may be present throughout the body, such as the liver or lungs.

How do doctors stage esophageal cancer, and what do the stages mean?

According to the American Cancer Society, the 5-year relative survival rates for esophageal cancer are as follows:

Stage of cancer5-year relative survival rate
Localized, or still in the esophagus47%
Regional, has spread to nearby lymph nodes33%
Distant, throughout the body 6%
Overall21%

These figures are based on past statistics and do not refer to any individual. A person’s age, overall health, and other factors also play a role.

How can you recognize end-stage esophageal cancer?

Although there’s no sure way to prevent esophageal cancer, some steps can help lower the risk.

For instance:

  • Avoid smoking and tobacco use.
  • Limit alcohol consumption.
  • Seek treatment for GERD.
  • If a doctor recommends it, taking medications that may help lower the risk, such as nonsteroidal anti-inflammatory drugs.
  • Following a healthy lifestyle with a varied diet and regular exercise.

What is the life expectancy for esophageal cancer?

This will depend on the stage at diagnosis and various individual factors, such as a person’s age and how their body responds to treatment. Overall, a person with a diagnosis of esophageal cancer has a 21% chance of living at least another 5 years compared with someone who does not have this disease.

What are the signs of esophageal cancer?

Often, there are no signs in the early stages, but a person may begin to notice they have difficulty swallowing, a persistent cough, and a hoarse voice. They may also have indigestion and heartburn and a lump under the skin.

Is esophageal cancer curable?

Esophageal cancer is not usually curable, but treatment can enable a person to live longer and improve their quality of life. People who receive a diagnosis in the early stage, before cancer spreads, have a 47% chance of living another 5 years or more after their diagnosis, compared with someone who does not have esophageal cancer.

Esophageal cancer affects the tube that carries the food from the throat to the stomach. There may be no symptoms at first, but in time a person may develop a cough, a hoarse voice, heartburn, and other symptoms.

Treatment is available to manage esophageal cancer. The options will depend on the stage of cancer and other factors. They include surgery, radiation therapy, and chemotherapy.