Esophageal Cancer Awareness Month 2025
April is Esophageal Cancer Awareness Month. The esophagus is the narrow tube that carries food and liquid from the mouth to the stomach. All fluids and nutrients must pass through the cylinder to reach the stomach to start the digestive process. In adults, the esophagus is around 11-13 inches long and has an internal diameter around ¾ inch. The esophagus is a muscular tube and has multiple layers. The inner layer, also known as the mucosa, lines the esophagus and is moist, making it easy for food to pass to the stomach. The submucosa contains glands that secrete mucus that help keep the esophagus moist. The muscle layer uses muscles to push food down to the stomach. Finally, the outer layer covers the esophagus.
There are two main types of esophageal cancer. It can start anywhere along the length of the esophagus, but each main type starts in a different type of cell. The most common form of esophageal cancer is squamous cell carcinoma. It starts in the squamous cells that line the esophagus. It is usually found in the upper and middle part of the esophagus. It is usually caused by heavy alcohol consumption and smoking, but there are other documented risk factors as well. The other main type of esophageal cancer is adenocarcinoma, which is the most common type in the United States and Western Europe. It is one of the fastest increasing of all cancers in the United States. Adenocarcinoma starts in the glandular cells in the lower part of the esophagus and occurs near or at the junction of the esophagus and the stomach, known as the gastroesophageal junction. It is usually linked to acid reflux and obesity. There are other rare esophageal cancers including choriocarcinoma, lymphoma, melanoma, sarcoma, and small cell cancer. Rare types of esophageal cancer could be caused by the spreading of cancer from various other body parts like the lungs or breasts and into the esophagus by the lymph system or blood stream.
There are multiple risk factors for esophageal cancer. One risk factor is acid reflux, which is frequent exposure of the esophagus to stomach acid. Hiatal hernias are a major cause of acid reflux, which can then turn into gastric-esophageal reflux disease or GERD. GERD can then turn into Barrett’s esophagus where the cells lining the esophagus are altered by long term exposure to stomach acid. Barrett’s cells can then have abnormal changes known as dysplasia. Between two to five years after that, the dysplasia can tun into low grade, then high grade dysplasia, which then turns into cancer. This happens in only around one to five percent of patients with Barret’s esophagus.
Another risk factor is drinking hot drinks (above 140 degrees F). A study found that people who drank two to three mugs of black tea at 140 degrees F or higher were twice as likely to develop esophageal cancer during ten years in follow up compared to people who drank tea at lower temperatures. Obesity is also a risk factor for the cancer. Higher rates of esophageal cancer are strongly correlated with countries with higher rates of being overweight. Smoking is also a risk factor for esophageal cancer. Smokeless tobacco is also problematic because direct contact of the tobacco to gums exposes people to oral and esophageal cancer. Drinking alcohol is also a risk factor. Limiting intake can have a positive impact on esophageal health. Other risk factors include occupational and environmental exposures. There is an association between exposure to nitrosamines, tetrachlorethylene (can be found in dry cleaning and refrigerants), perchloroethylene (used in dry cleaning and degreasing metals), polycyclic aromatic hydrocarbons (created when coal, oil, gas, wood, garbage, and tobacco are burned), silica, and asbestos (fibrous mineral used for its heat- and fire-resistant properties).
Esophageal cancer has multiple signs and symptoms but has very few in its early stages. Most people do not have symptoms until the tumor grows in size to block the esophagus, making it difficult to swallow. As the cancer grows, symptoms can include blood in the stool, difficult or painful swallowing, feeling very tired, heartburn (GERD), hoarseness or coughing, loss of appetite, pain in the throat, pain in the back, and weight loss. If you have any of these symptoms and have the risk factors above, speak to a healthcare professional so problems can be diagnosed and treated as soon as possible.
If you are having trouble swallowing, there are multiple tests that can be done to diagnose esophageal cancer. The first is a trans nasal esophagoscopy. The procedure involves anesthetizing locally the nose and throat. An endoscope, which is essentially a flexible camera, is inserted through the nasal passages into the esophagus, which is then inspected by a doctor. An endoscopy uses a camera to view the esophagus. Another diagnosis method is an endoscopy with biopsy. An endoscope is used, and a tool is used to remove the cells or tissues for examination by a pathologist. The tissue is examined under a microscope or tested in other ways. An endoscopic ultrasound is also an option. A thin ultrasound probe is used, which emits soundwaves that bounce off surrounding structures like the stomach, small intestine, pancreas, bile ducts, and liver. The sound waves are recaptured by the probe and turned into black and white images that can be viewed by a doctor. Positron Emission Tomography (PET) scans are also available to doctors. It involves giving a dose of glucose that is radioactive and waiting an hour. This allows the tumor cells to absorb the radioactive glucose, making them easy to see in the scan. Doctors can also use CT scans, which is an x-ray machine that takes detailed pictures of the chest and abdomen. This can be done to see if esophageal cancer has spread. Contrast material is given by mouth or injection, so structures are more easily seen. Finally, there is a barium swallow. The patient being seen swallows a liquid barium mixture while at an x-ray machine. The barium is opaque to the x-rays and can show any points where there is narrowing of the esophagus.
There are multiple treatment options for esophageal cancer. One option is radiation therapy or radiotherapy. This approach uses high energy radiation beams to destroy cancer cells. Chemotherapy is also an option. Sometimes a combination of chemotherapy and radiotherapy could be warranted. Chemotherapy uses powerful drugs to kill cancer cells. It works by interfering with the ability of cancer cells to reproduce and grow. Surgery could also be added as part of a treatment regimen for esophageal cancer. There are multiple surgeries available to treat esophageal cancer. One surgery is trans hiatal surgery, where the surgeon makes incisions in the neck and abdomen to remove cancer. It cannot be used if the tumor involves a portion of the stomach or if there are lymph nodes in the chest that need to be removed. Ivor-Lewis’s surgery is also an option. Incisions are made in the abdomen and the right side of the chest and is most often used when the tumor is near the stomach or there are lymph nodes in the chest that need to be removed. Minimally invasive esophagectomy can also be done, where all or part of the esophagus is removed with small incisions for shorter recovery times. Finally, there is robotic surgery, where a doctor performs robotic esophagectomy using robotic arms to manipulate tiny surgical instruments.
If you were exposed to asbestos and now have mesothelioma, lung cancer, or esophageal cancer, you could be entitled to compensation. Contact us at 412-471-3980 or fill out our contact form and a member of our team will get back to you as soon as possible.
