Esophageal Cancer 101: April Awareness

We all know the old saying, “April showers bring esophageal cancer awareness,” right? Maybe not, but anyone impacted by this disease would like that to be the case. April is recognized as Esophageal Cancer Awareness Month, an effort to make more people aware of the disease.

The American Cancer Society projects that about 21,500 new cases of esophageal cancer will be diagnosed within the United States in 2023 and just over 17,000 of those newly diagnosed will be men. Esophageal cancer makes up about 1% of all cancers in the United States, but it is the seventh deadliest cancer for men. There are currently no screenings recommended to evaluate or identify this disease.

The esophagus is the long, hollow, muscular tube that runs between the throat and the stomach. Food and liquids travel through it to be digested. It extends roughly 10-13 inches and has a diameter of about three-quarters of an inch. There are two separate sphincters in the esophagus, one at the top, near the throat, and another at the bottom, leading to the stomach. The function of these sphincters is to limit stomach acids and digestive juices from exiting the stomach or esophagus.

There are two main types of esophageal cancer. One is squamous cell carcinoma found near the neck or the upper two-thirds of the esophagus and the other is adenocarcinoma, found in the lower third of the esophagus. Adenocarcinoma is more commonly diagnosed.

The causes of esophageal cancer are unknown, though several risk factors have been identified. Those include:

·      Having a history of GERD (gastroesophageal reflux disease)

·      Using tobacco in any form (cigarettes, pipes, cigars, chewing tobacco)

·      Alcohol use

·      Gender (men more impacted than women) and age (over age 55)

·      Obesity

·      Living a sedentary lifestyle

·      Drinking extremely hot liquids regularly

·      Being diagnosed with Barrett’s esophagus

·      Previous treatment with radiation in the chest, neck, or abdomen

·      History of cancer in the lungs, mouth, or throat

Esophageal cancer is typically diagnosed in later stages, making treatment and prognosis more complicated. By the time symptoms are apparent, the cancer has often had an opportunity to grow or metastasize. Symptoms that most commonly precede an esophageal cancer diagnosis include:

·      Difficulty swallowing

·      Unintended weight loss

·      Chest pain or pressure

·      Indigestion that is difficult to treat

·      Coughing

·      Hoarseness

If you experience any of these symptoms in more than a temporary way, consult with a doctor to assess for diagnosis or treatment.

Esophageal cancer typically originates in the cells that line the esophagus. When those cells become irritated in a long-term manner, like from ongoing or untreated reflux or long-term tobacco use, the DNA in the cells in the esophageal lining may become damaged or altered, leading to cancer.

Physicians who may treat a patient diagnosed with esophageal cancer come from different specialties. Depending on required treatment, they may include thoracic surgeons, surgical oncologists, gastroenterologists, radiation oncologists, and medical oncologists. Treatment itself depends on the stage and severity of the esophageal cancer, but could involve surgery, radiation, chemotherapies, and/or immunotherapies.

Dr. Srilata Gundala is the owner and founder of Hope & Healing Cancer Services in Hinsdale, Illinois and has seen reason to be hopeful about esophageal cancer treatment, “More and more immunotherapies are being used and having some measure of success in the treatment of esophageal cancer. This is a good thing for those diagnosed. Aside from treatment, though, diminishing the risk factors under your control is the most effective way of preventing an esophageal cancer diagnosis.”

If you are interested in working to prevent an esophageal cancer diagnosis, the best and most effective means of prevention include these lifestyle changes:

·      Quit smoking and any tobacco use

·      Moderate alcohol consumption

·      Maintain a healthy weight

·      If living with reflux, get treatment for GERD

·      Increase consumption of fruits and vegetables

·      Increase daily physical activity

·      If there is a history of esophageal cancer in your family, get evaluated for any inherited gene mutations.

Written By: Sheila Quirke, MSW

Reviewed By: Srilata Gundala, MD