Esophageal Cancer

General and more comprehensive text about cancer diseases, their behavior, causes and treatment can be found here.


Esophageal cancer accounts for about one-fifth of digestive tract tumors. It occurs more frequently in men between 40 to 50 years of age. It is a very dangerous form of gastrointestinal cancers.


There are more risk factors including smoking, excessive alcohol consumption (chronic alcoholism), Barrett’s esophagus in esophageal reflux disease and possibly even regular intake of spicy foods and hot drinks. 


Unfortunately there are initially no symptoms, or they are very mild.  Later, as the tumor grows, it may cause difficulties when swallowing, painful swallowing and sore throat. Finally, the narrowing of the esophageal wall causes the return of food back into the mouth and weight loss due to the lack of nutrients. Very serious complication of an advanced cancer process may be rupture of the esophagus. The esophageal cancer may form metastases in local neck lymph nodes and cause their painless enlargement. Large esophageal cancers may even compress the windpipe and threaten the patient with a sudden suffocation.


The best possible diagnostic method is the upper GI endoscopy. A flexible endoscopic device is inserted through the mouth into the esophagus and the doctor can see any lesion by his own eyes. A sample of tissue may be taken by special forceps and sent for histological examination to confirm the diagnosis. The size and extent of the tumor may be evaluated by endosonography and computed tomography


It is necessary to avoid smoking and excessive intake of alcohol. Any cases of gastroesophageal reflux disease should be treated and patients with confirmed Barrett’s esophagus should be regularly monitored.


The best therapeutic method is local surgery, i.e. removal of the tumor mass with a part of the esophagus. However, the tumors are often diagnosed in later stages, when the surgical intervention is no longer possible. Radiotherapy or chemotherapy may be also used, but the results are not nearly as good as the surgical approach. When the patient can not be effectively treated, the doctors try at least to maintain the ability to swallow to improve the quality of remaining life.


If we are concerned that the tumor growth is soon going to disrupt the patient's ability to eat, we can consider introduction of a special hose into the stomach through the abdominal wall. This feeding tube is also known as PEG (percutaneous endoscopic gastrostomy) and it allows feeding the patient with nutrient-rich liquids.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources