Esophageal cancer starts when cells mutate and grow rapidly inside the lining of the esophagus.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e45a0e4a-c0a4-4bb8-ac8f-c6909bab7494 The cancer typically begins in the inner layer of the esophagus wall and grows outward, but it can start anywhere. Esophageal cancer is a rare cancer, accounting for just 1 percent of cancer cases in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291f4af0ad-7636-4697-85d9-65c47d9b6455 The five-year relative survival rate, or the percentage of people with esophageal cancer who live for at least five years after being diagnosed compared with people who don’t have the disease, is 22 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e59762913aaf00f-1467-4735-8bd9-ec27d1bd19ce However, individual survival rates vary greatly and depend on many factors, including the size and extent of the cancer and your overall health.
Types of Esophageal Cancers Types There are two main types of esophageal cancer. What type you have depends on what kind of cell the cancer starts in: Esophageal adenocarcinoma is the most common type of esophagus cancer in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e59762980bbf1ba-3c6b-475d-858d-835ed69642ee It begins in the mucus-producing glandular cells of the esophagus. This type of cancer is usually found in the lower third of the organ. Squamous cell carcinoma begins in squamous cells, or the thin, flat cells lining the inside of the esophagus.e60dc2a1-f33c-4a05-9b50-8e3e8e59762986dc6cd7-11cc-4170-873a-0b07f2194488 While this type of cancer can occur anywhere along the esophagus, it is usually found in the neck region and upper two-thirds of the chest cavity.
Signs and Symptoms of Esophageal Cancer Symptoms You may not notice early symptoms from esophageal cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ab7b1b1-de3d-461f-9567-9638b9e21e7e But, as the tumor grows, however, it can cause:e60dc2a1-f33c-4a05-9b50-8e3e8e597629896e9eb6-a172-4ad8-88dc-3661381b8708 Difficulty swallowing Chest pain when swallowinge60dc2a1-f33c-4a05-9b50-8e3e8e59762909a3482b-b9bf-413e-9ce4-41cd56100eb9 Unexplained weight loss Hiccupse60dc2a1-f33c-4a05-9b50-8e3e8e59762909a3482b-b9bf-413e-9ce4-41cd56100eb9 Vomitinge60dc2a1-f33c-4a05-9b50-8e3e8e597629962717f3-1f91-41ac-86f8-9b6f7b93ca90 Chronic cough Hoarseness Black stool (caused by bleeding in the esophagus)e60dc2a1-f33c-4a05-9b50-8e3e8e59762900841d18-17d6-4a4d-9296-d6e68773ec31 Indigestion and heartburn Pneumonia Anemia, or low levels of red blood cells, causing fatigue and weaknesse60dc2a1-f33c-4a05-9b50-8e3e8e5976295c0972e7-8417-4c33-b3cf-42a3a8b00b47
Causes and Risk Factors of Esophageal Cancer Causes While it isn’t clear what exactly causes esophageal cancer, there are various risk factors that increase your chances of developing it. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cd9c45a7-1329-4d02-9635-ec7d5a2200df Male sex Older age Tobacco use (in any form) Alcohol use Frequently drinking very hot beverages Barrett’s esophagus, which develops when acid reflux or heartburn damages the inner lining of the esophaguse60dc2a1-f33c-4a05-9b50-8e3e8e59762953f713ec-b467-4295-8597-9d86365e6274 Gastroesophageal reflux disease, or GERD, which increases your risk for Barrett’s esophaguse60dc2a1-f33c-4a05-9b50-8e3e8e5976291095a24c-cae0-493a-bd65-7637a02981b4 Having obesity Physical inactivity Poor nutrition or a diet high in processed meatse60dc2a1-f33c-4a05-9b50-8e3e8e597629aabbcc4c-591e-488a-9bbe-1c31abf9be4c Exposure to or ingestion of certain chemicals, including lye Human papillomavirus (HPV) infectione60dc2a1-f33c-4a05-9b50-8e3e8e597629be632df3-e6ad-453c-9777-8da7da62cffd Achalasia, a disease that causes food and secretions to collect at the bottom of the esophagus Plummer-Vinson syndrome, a disease that obstructs the upper esophagus, trapping food and causing irritation History of lung, mouth, or throat cancers Certain genetic conditions, including tylosis (Howel-Evans syndrome), Bloom syndrome, Fanconi anemia, and familial Barrett’s esophaguse60dc2a1-f33c-4a05-9b50-8e3e8e597629cd9c45a7-1329-4d02-9635-ec7d5a2200df
How Is Esophageal Cancer Diagnosed? Diagnosis If your provider suspects you may have esophageal cancer because you are showing signs or symptoms of the disease, they will begin diagnosis by first inquiring about your symptoms and risk factors, including your family history of cancer and other conditions.e60dc2a1-f33c-4a05-9b50-8e3e8e597629217b77e9-2302-48af-b484-4c87b6e6fd08 They will then conduct imaging tests for esophageal cancer. This may include an endoscopy, where they view the inside of your esophagus using a long, thin tube with a light and camera at the end.e60dc2a1-f33c-4a05-9b50-8e3e8e597629217b77e9-2302-48af-b484-4c87b6e6fd08 They will also conduct a biopsy (tissue sample collection and analysis) to determine if you have esophageal cancer. Upon confirming you have esophageal cancer, your provider will conduct one or more tests to stage the cancer or determine how far it has spread. Additional tests may include: Endoscopic ultrasonography, an endoscopy combined with an ultrasound, which produces images using high-frequency sound wavese60dc2a1-f33c-4a05-9b50-8e3e8e597629d0b1f744-d71e-4d01-b254-2a7185524c7e Barium swallow, a procedure that involves drinking a solution containing barium, which coats the inside of your esophagus and appears clearly in X-ray imagese60dc2a1-f33c-4a05-9b50-8e3e8e59762984c50560-84b9-4dd3-aa75-e21005d1d734 CT (computerized tomography) scans that produce cross-sectional pictures of your bodye60dc2a1-f33c-4a05-9b50-8e3e8e597629217b77e9-2302-48af-b484-4c87b6e6fd08 PET (positron emission tomography) scans that help identify tissue in the body undergoing high metabolism, which may be indicative of cancere60dc2a1-f33c-4a05-9b50-8e3e8e597629a8283e18-8231-4340-9585-a43cf867f4d3 MRI (magnetic resonance imaging) scans, which produce detailed images of the body’s soft tissuese60dc2a1-f33c-4a05-9b50-8e3e8e597629217b77e9-2302-48af-b484-4c87b6e6fd08 There are no recommended screening tests for those who have an average risk of esophageal cancer because such tests have not been shown to reduce your risk of dying from the disease.e60dc2a1-f33c-4a05-9b50-8e3e8e59762923de86ad-582f-4c3a-b6b7-3b5cf9f816ef But experts recommend that you regularly undergo tests for esophageal cancer if you are at a high risk for the disease, such as if you have Barrett’s esophagus or genetic conditions that increase your risk.
Treatment and Medication Options for Esophageal Cancer Treatment There are various treatment options available for esophageal cancer. The stage and extent of your cancer, the size of your tumor, where it’s located, and your personal preferences determine your treatment plan. Surgery Surgery to remove the tumor is typically the recommended treatment for esophageal cancer if it’s still small and localized.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8fb0ecd-6861-4b21-adc1-4c2847138329 However, catching esophageal cancer this early is uncommon. Esophagectomy is the primary surgical technique to treat esophageal cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8fb0ecd-6861-4b21-adc1-4c2847138329 During this procedure, your surgeon will remove some or most of your esophagus (and nearby lymph nodes) and then attach your remaining esophagus to your stomach. Your surgeon will operate either through one or more large incisions (open surgery) or through several smaller incisions using a laparoscope (similar to an endoscope). Surgery carries a risk of serious complications, including infection, bleeding, and leakage from the area your esophagus is reattached to your stomach.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d2888bb-85a5-486b-bde2-d4ac4f7b76dd Radiation Therapy Often combined with other therapies, particularly surgery and chemotherapy, radiation therapy kills cancer cells using high-energy rays like X-rays.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293fdaec7a-556d-4f4f-9a68-a264297283e5 Radiation therapy, typically used along with chemotherapy, can be a treatment option for those who cannot have or do not want to have surgery, or in conjunction with surgery. Radiation therapy may also be recommended: Before surgery to shrink the size of the tumor and make it easier to remove After surgery to kill leftover cancer cells As a palliative treatment to reduce symptoms from advanced esophageal cancer, such as pain, bleeding, and trouble swallowing There are two types of radiation therapy used for esophageal cancer:e60dc2a1-f33c-4a05-9b50-8e3e8e5976293fdaec7a-556d-4f4f-9a68-a264297283e5 External beam radiation therapy (EBRT) is used more commonly for esophageal cancer and involves destroying cancer cells with radiation produced from a machine outside of the body.e60dc2a1-f33c-4a05-9b50-8e3e8e59762966b72073-6775-4d53-83c8-dfcba9cd7f4a Brachytherapy involves the use of an endoscope to place radioactive material close to the tumor.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293fdaec7a-556d-4f4f-9a68-a264297283e5 The radiation only travels short distances so it has little effect on nearby normal tissues. Brachytherapy is typically used as a palliative treatment for advanced esophageal cancer. Side effects from radiation therapy include gastrointestinal issues, fatigue, and painful swallowing.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293fdaec7a-556d-4f4f-9a68-a264297283e5 In rarer cases, it can also cause a narrowing of the esophagus or lung damage. Medication Options There are several types of drug therapies available to treat esophageal cancer, including: Chemotherapy Like radiation therapy, chemo drugs such as paclitaxel (Taxol) and irinotecan (Camptosar) are used before surgery, after surgery, or to relieve symptoms in advanced esophageal cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e59762994f4f3c9-ad6d-4dfd-b6c0-2531540791f0 These drugs can cause a range of mild-to-severe side effects such as hair loss, increased risk for infections, and nerve damage. Targeted Drug Therapy Sometimes used with chemotherapy, these drugs target specific changes in cells that cause cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fe749a69-a34e-4fbb-a4ed-72b199d28986 For example, trastuzumab (Herceptin) zeros in on cancer cells with too much of the protein HER2 on their surface while ramucirumab (Cyramza) blocks a protein called VEGF that tumors need to make new blood vessels. Each targeted drug has its own set of side effects, some of which can be serious. Immunotherapy This treatment aims to help the body’s immune system more effectively find and destroy cancer cells, such as by using immune checkpoint inhibitors, drugs that target specific proteins that cancer cells use to evade the immune system.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fe59cba1-4322-43f4-bc1d-2b75888c598a Examples include pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy). Because these intravenous drugs affect the immune system, they can cause some life-threatening side effects affecting the lungs, intestine, kidneys, and other organs.
Prevention of Esophageal Cancer Prevention Not all esophageal cancers can be prevented, but you can reduce your chances of getting esophageal cancer by avoiding or mitigating various risk factors, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f4fcf9e9-44fe-4f7b-bd56-90218f828bc4 Avoiding tobacco and alcohol use Maintaining a physically active lifestyle and healthy body weight Eating a balanced diet rich in fruits and vegetables Getting treated for GERD and Barrett’s esophaguse60dc2a1-f33c-4a05-9b50-8e3e8e59762958fb6a4d-fd26-4c5b-b43f-cbb7b7110a86
Lifestyle Changes for Esophageal Cancer Lifestyle Changes If you have esophageal cancer, it’s important to avoid habits that could exacerbate the issue and make lifestyle changes to improve your quality of life. These changes may include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299da0ff38-b881-48d3-9c3e-a04d622ac9e5 Drinking beverages after they have cooled Avoiding foods that trigger acid reflux, such as fried food, processed snacks like potato chips, and tomato-based sauces Eating high-fiber foods such as whole grains, root vegetables, and green vegetablese60dc2a1-f33c-4a05-9b50-8e3e8e5976299de3999d-6f2f-4725-9c8f-249f56ecb157 Eating small, more frequent mealse60dc2a1-f33c-4a05-9b50-8e3e8e5976299da0ff38-b881-48d3-9c3e-a04d622ac9e5 Staying physically active Maintaining a healthy weight
Esophageal Cancer Prognosis Prognosis and Outlook The overall five-year survival rate for esophageal cancer is 22 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e9331773-a0eb-4912-be79-345ad5d03aab But survival rates can be further broken down by how far the cancer has spread: 48 percent for localized cancer that’s only growing in the esophagus 28 percent for regional cancer that has spread beyond the esophagus to nearby lymph nodes or tissues 5 percent for distance cancer that has spread to organs or lymph nodes away from the main tumor It’s important to keep in mind that every case is different and these statistics do not take into account factors specific to you, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e9331773-a0eb-4912-be79-345ad5d03aab Your age and sex Your overall health How early in the disease course you were diagnosed How quickly the tumor is growing How the cancer responds to treatment Lifestyle factors
Complications of Esophageal Cancer Complications Esophageal cancer can lead to an array of potential complications — either from the tumor itself or treatments — that can affect your quality of life.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298b61a068-e7d2-42e3-a036-e74a7c9ae02a These can include: Esophageal obstruction, making it difficult to swallow Aspiration, the inadvertent inhalation of food or liquids into the lungs, which can lead to pneumonia, lung abscesses, or acute respiratory distress syndrome Bleeding in the esophagus Fistulas connecting the esophagus to the trachea or bronchi, leading to pneumonia, lung abscesses, or sepsis Perforations in the esophagus that can cause sepsis and even death Malnutrition Anxiety and depression
Research and Statistics: Who Has Esophageal Cancer Research and Statistics The American Cancer Society estimates that there will be more than 22,000 new esophageal cancer diagnoses and more than 16,000 deaths from it in 2025.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293ce54949-a4bd-4107-a527-75ebe450ccd7 Almost 80 percent of these cases and deaths will occur in men. The median age of diagnosis for esophageal cancer is 68 years, and the cancer affects non-Hispanic American Indian/Alaska Native and non-Hispanic white people at higher rates than others.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ef448db-9b5f-4aee-bc05-ac6f6f61b2ba
Related Conditions and Comorbidities of Esophageal Cancer Related Conditions Several conditions are linked to an increased risk of esophageal cancer, including: Barrett’s esophagus GERD Achalasia Plummer-Vinson syndrome
The Takeaway Esophageal cancer is most common in older adults and men, with survival rates varying depending on the stage at diagnosis and personal health factors. Early detection of esophageal cancer is crucial for improving survival rates, so if you experience persistent swallowing difficulties or other symptoms, seek medical attention promptly. Managing risk factors, such as quitting smoking, maintaining a healthy diet, and treating acid reflux, can significantly reduce the likelihood of developing this cancer. Cancer treatments, including those for esophageal cancer, are continuously advancing and can improve your quality of life.
Resources We Trust Mayo Clinic: Why Early Treatment of Esophageal Cancer Is CriticalCleveland Clinic: The Sobering Truth: How Alcohol Affects Cancer RiskNational Cancer Institute: New Technology Gives Patients Access to a 5-Minute, Office-Based Test to Identify Risk for Esophageal CancerAmerican Cancer Society: What Is Cancer of the Esophagus?MD Anderson Cancer Center: 10 Things to Know About Esophageal Cancer
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