Esophageal Cancer

Esophageal cancer is rare, but for several reasons, it deserves our attention.

Because it is usually diagnosed at later stages when it is more difficult to treat, about 20% of patients diagnosed with the disease will survive five years or more.

Treatment and survival rates have improved in recent years.

The chance of developing esophageal cancer increases with age; the average age at diagnosis is 68. The lifetime risk in the United States is about 1 in 125 in men and about 1 in 417 in women, according to the American Cancer Society. Men are about three times more likely than women to have esophageal cancer, and white men develop the disease at higher rates than black men.

The number of people diagnosed with the disease has been on the rise in recent years. Between 2012 and 2019, the rate of esophageal cancer among adults age 45 to 64 nearly doubled in the U.S. Soaring rates of unhealthy eating, obesity and heartburn, in addition to smoking and alcohol use, appear to be contributing factors.

Understanding the Esophagus
The esophagus, commonly referred to as the food pipe, is a hollow, muscular tube about 10″ – 13″ long that connects the throat to the stomach. It is located in the center of the chest, behind the trachea (windpipe) and in front of the spine, and it functions as part of the digestive system, carrying food and liquid from the throat to the stomach.

At its upper opening is a ring-shaped muscle known as the upper esophageal sphincter. It opens to allow food to enter. Once inside, the food is pushed downward through a series of muscular contractions (called peristalsis) through the diaphragm, into the lower esophageal sphincter and through to the stomach.

Several conditions can occur when the sphincter muscles do not work properly. The most common is acid reflux, when stomach acid and digestive juices flow back into the
esophagus and cause heartburn or inflammation.

Gastroesophageal reflux disease, or GERD, is a more severe form of acid reflux that can cause serious damage over time. Long-standing GERD can trigger a change in the cells that line the lower esophagus, causing Barrett’s esophagus, which is associated with an increased risk of developing esophageal cancer.

Warning Signs of Esophageal Cancer
Cancer occurs when cells develop changes in their DNA and form a mass, called a tumor. Esophageal cancer starts in the inner layer of the esophagus wall and grows outward.

Cancerous cells can also divide and spread to other parts of the body.

The exact causes of esophageal cancer are not clear. However, researchers believe that chronic acid reflux or GERD may be contributing factors. Other risk factors include smoking, drinking alcohol, obesity, improper nutrition, or undergoing radiation treatment to the chest or upper abdomen.

The Esophageal Cancer Action Network recommends talking with your doctor if you experience any of the following:
• More than occasional heartburn symptoms
• Worsening heartburn symptoms
• Pain or difficulty swallowing
• A persistent, unexplained cough or sore throat
• Coughing or choking when lying down
• Speaking with a hoarse voice over several weeks
• A family history of esophageal cancer or Barrett’s esophagus

These symptoms can signal other health problems. Taking proactive steps is vital to diagnosing problems early when prevention or treatment can be more effective.

There is no screening test for esophageal cancer. If your health care provider suspects cancer may be present, a variety of exams, tests and biopsies can help to confirm a diagnosis.

Treatment Options for Esophageal Cancer
There are two main types of esophageal cancer, in addition to a few very rare types. Squamous cell carcinoma, which usually develops in the upper and middle part of the organ, is the most common worldwide. Adenocarcinoma, which begins in the lower part of the esophagus where it meets the stomach, is the most common in the U.S. and primarily affects white men.

Treatment options depend on a number of factors, including the specific type and stage of cancer, possible side effects, and the patient’s overall health and personal preference. Esophageal cancer treatment can include surgery, chemotherapy, radiation, endoscopic therapy or a combination of these.

Increasingly, immunotherapies that strengthen and use the body’s own immune system to attack cancer are yielding positive outcomes. New types of immunotherapy drugs have been approved in recent years to treat the most common types of esophageal cancer.

New Options Through Clinical Trials
Advancements in the diagnosis and treatment of all forms of cancer continue at a rapid pace, thanks to ongoing clinical research. Clinical trials have played an important role in these advancements, which are now saving more lives. Patients who participate in these safe and carefully supervised groundbreaking research studies are receiving the latest treatments available, which can have positive impacts on their outcomes.

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About Florida Cancer Specialists & Research Institute, LLC (FLCancer.com)

Recognized by the American Society of Clinical Oncology (ASCO) with a national Clinical Trials Participation Award, Florida Cancer Specialists & Research Institute offers patients access to more clinical trials than any private oncology practice in Florida. In the past four years, the majority of new cancer drugs approved for use in the U.S. were studied in clinical trials with Florida Cancer Specialists participation.* Trained in prestigious medical schools and research institutes, our physicians are consistently ranked nationally as Top Doctors by U.S. News & World Report.

Founded in 1984, Florida Cancer Specialists has built a national reputation for excellence that is reflected in exceptional and compassionate patient care, driven by innovative clinical research, cutting-edge technologies, and advanced treatments, including targeted therapies, genomic-based treatment and immunotherapy. Our highest values are embodied by our outstanding team of highly trained and dedicated physicians, clinicians and staff.

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