Medically reviewed by Peter C. Enzinger, MD
Although it is not a common disease, esophageal cancer affects about 18,000 new patients each year in the United States. Typically, the disease is found more often in men than in women, with men having about a ten-fold higher risk of developing esophageal cancer.
“Esophageal and gastric cancers are some of the most stubborn and aggressive cancers that we treat in the United States today,” explains Peter Enzinger, MD, director of the Center for Esophageal and Gastric Cancer at Dana-Farber. “Therapies must be quite aggressive to treat these cancers, but we must know how to effectively treat any side effects as well.”
Here are five key facts you should know about esophageal cancer:
1. What are the risk factors associated with esophageal cancer?
While smoking and drinking can increase the likelihood of developing esophageal cancer, the disease can affect anyone.
Some common risk factors are:
- Males
- People with Barrett’s esophagus
- People with Gastroesophageal reflux disease (GERD)
- Obesity
- Smoking (including pipes and cigars)
2. What is Barrett’s esophagus and how does it relate to esophageal cancer?
Barrett’s esophagus is a pre-cancerous or, in some cases, early form of esophageal cancer. It is often due to chronic inflammation from acid reflux and appears as abnormal cells lining the esophagus. When detected early, there is a better chance of preventing the further development of cancer.
If diagnosed, it is important to treat Barrett’s esophagus to prevent the development of esophageal cancer. People diagnosed with an early form of Barrett’s esophagus will take medication and make lifestyle changes to reverse symptoms. If it is a high-grade form of Barrett’s esophagus, doctors may use a procedure called radiofrequency ablation, which removes abnormal tissue and allows normal tissue to grow back.
3. What are the signs and symptoms of esophageal cancer?
The early stages of esophageal cancer typically have no symptoms. As the disease advances, symptoms start to become more noticeable. The most common symptoms include painful/difficult swallowing, weight loss, and regurgitation of food.
4. How is esophageal cancer diagnosed?
A physician will conduct several tests to determine whether someone has esophageal cancer. The tests typically include a combination of chest X-rays, barium swallow, esophagoscopy, endoscopy, blood chemistry studies, complete blood count (CBC), or endoscopic ultrasound (EUS).
5. What are the treatment options for esophageal cancer?
Esophageal cancer is difficult to treat because it is usually diagnosed in later stages of the disease. For many patients, doctors will perform surgery to remove the cancer. If the disease is diagnosed in a later stage, doctors may also recommend chemotherapy and/or radiation therapy prior to surgery.
Patients may also consider clinical trials for treatment. Dana-Farber currently offers several clinical trials for esophageal cancer and a national list is maintained at clinicaltrials.gov.
For more information on esophageal cancer, visit the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center.
for patients with gerd how often should you have a endoscopy to look for cancer?
This says “no symptoms.” I’m no doctor, but I think severe heartburn is a big symptom of damage to the esophagus. If you are popping tums everyday you may have a bigger problem then you think. Get checked. My father-in-law was gone in 6 months after diagnosis, but had heart burn for 20 years. A beautiful fish tank in his memory is at Dana-Faber. 🙂
Dear Kara:
Thank you for commenting and I’m so sorry about your father-in-law. Typically, there are no symptoms at early stages but thank you for reminding people about the importance of getting things checked out. And I’m sure many patients, family and staff enjoy the fish tank every day.
–Michael
Kara, you are spot on with this. We have been trained to believe that heartburn is normal. Just take a Tums or Rolaids and you’re all set. As a matter of fact, this is going to mask the symptoms that would get you the attention you need for early diagnosis. When my wife first complained of difficulty in swallowing, she was given omeprazole. When it stopped helping, they increased the dose. When she finally choked and needed emergency intervention, they ordered the first significant test (I think they went in this order: Upper GI, X-Ray, CT Scan. It was probably 2 months between her first visit and the first major test. The good news? She has been 7 years since she was treated with no evidence of disease. And the doctor’s office that she visits is much more careful with these cases now.
My dad was also gone within 6 mos. after diagnosis. Not only did he have reflux, but for TWO YEARS prior he went to doctors complaining of a sore throat (thinking he had a persistent cold) but by the time they thought to look into ANYthing it was too late.
Dear Sharon —
We are so sorry to hear about the loss of your father. Thank you for connecting with us and sharing your story.
Lost my 46 year old husband to esophageal cancer 5 years ago. No symptoms until he was already in advanced stage 4. Chemo, Radiation and and Esophagectomy all for nothing. Sucks.
I hear ya’.!!! ~ loud & clear.!!! Absolutey devastating ‘way-too-go’ .. Seen it, been there., & it sux!!
Dear Colleen:
We’re so sorry about your husband. Thank you for taking the time to read and comment.
–Michael
Diagnosed at 46 as well. Radiation, Chemo, esophajectomy, and more Chemo, I just received results of 24 month scan with no evidence of recurring disease. I am back to work full time as a firefighter in Everett Ma. Forever grateful to my DFCI/BWH team.
Dear Joe–
Wonderful to hear you are doing well. Thank you for sharing and connecting with us. All the best to you and your family!
My father was diagnosed 6/13 at Stage IV. He started having pain when swallowing and had lost weight. He died 8 months later after giving it a good fight. No one should have to go through what he endured. No dr. had ever suggested endoscopy. My thought is why not have the endoscopy while having a colonoscopy? To those of you who are winning the fight – best of luck!!! To those of you who have lost a loved one from this dreaded disease – it sucks big time!!!
Dear Julie —
We are so sorry to hear about your father. Thank you for taking the time to read and connect with us. Wishing you and your family all the best.
Though treated at UMass Worcester and not Dana Farber, I am a miracle patient who survived all of this and am currently cancer free and living a normal life. With the exception of some digestive issues related to the stomach and esophageal resection surgery I underwent, I have no ongoing problems. I had a stage 4 tumor, 3 inches in length growing from my lower esophagus into my stomach, and went through a huge battery of radiation, chemo, and surgery… all very intense but if you have a strong constitution and will to live, along with this care you can get through it. I am going on four years distance from my diagnosis and amaze my doctors whenever I see them. The medical community, technology, precision radiation techniques, pharmaceuticals, hospitals, etc., are as good here in Massachusetts as anywhere in the world! Phil Coleman
Dear Phil —
It is so great to hear how well you are doing — thank you so much for sharing and connecting with us. Wishing you all the best!
My Dad was one of the lucky ones. In 1992 he had some new some pretty radical (at the time) surgery by Dr. Sugerbaker at Dana Farber where they removed part of his esophagus and pulled his stomach up and attached them. He was one of 1,000 that lived more than a few years and one of 10,000 that lived more than 10 years. The radiation damaged his heart and that caused lots of medical problems in the years that followed, but we all felt lucky to have him in our lives for another 18 years and he we was thrilled to see several of this children get married and enjoy time with many grandchildren.No doubt at all that the Dana Farber saved his life.I understand that the same doctor traveled far and wide showing others this technique in the following years.
Dear Stephen —
It’s wonderful to hear that you had a chance to spend many years with your father. Thank you so much for connecting with us and sharing your story. All the best!
My father-in-law had this about 6 years ago. He had radiation then the surgery and is cancer free now. I beleive his surgery was at Beth Isreal Deaconess. The worst part for us was the recovery and modifying of his diet. Luckily my wife (his daughter) is was an oncology nurse at the time so she helped out alot during the recovery. He still has stomach issues and can’t eat a lot of what he used too and still gets sick alot. But I think he still considers him self lucky to have had the great care he received!
I Had been diagnosed with Barrets when my gastro md did an endoscopy. I saw on Dr Oz that people using himalayan salt no longer had Barrets. I started using himalayan salt because of all the other good benefits. Two yeara ago at my last endoscopy my Dr. told me I had no sign of Barrets. I go back in March 2015 for another endoscopy.
I have Barrett’s, and I am curious about your experience with himalayan salt. Did you just use it in place of iodized salt or did you have to take it in larger quantities? What did the doctor feel was the medicinal properties of it? I am obese and have edema issues, so I don’t use salt much, but I am interested in this as I would love to find something to help this condition. I hate living with the fear of having a pre-cancerous condition and wondering if I have to have endoscopies every couple years forever. Thanks!
Dear Ginger —
There is not much evidence out there that shows the benefits of Himalayan salt vs. regular salt. However, a less-processed option like sea salt or Himalayan salt may be a personal preference. Overall, it’s important to watch the amount of sodium in your diet, especially in packaged baked foods as well as crackers, sauces, broth and soup. Most adults should consume no more than 2300 mg of sodium each day and for some the recommended level is even lower. For more information on how to flavor your food without using lots of salt, check out this webpage: http://www.dana-farber.org/Health-Library/Flavorful-meals-without-the-salt.aspx
I hope this is helpful and wish you all the best!