What is cancer of the esophagus?

Cancer of the esophagus, also called esophageal cancer, is an uncommon cancer in the tube that connects your throat to your stomach. This tube is called the esophagus.

Cancer of the esophagus occurs most frequently in men over age 60.

How does it occur?

The exact cause of esophageal cancer is not known. Alcohol abuse and smoking appear to increase the risk for this disease.

What are the symptoms?

Often the first symptom is increased difficulty swallowing. You may feel like food is stuck in your throat. First, you may have trouble swallowing solid foods. Later, soft foods may also give you difficulty. Eventually, even liquids may be hard to swallow.

As the tumor grows, your esophagus gets narrower. One of the early symptoms is chest pain. You may have heartburn when you drink hot liquids. Late symptoms may include drooling, spitting up pieces of undigested food, and weight loss. Respiratory infections are common. Hoarseness and coughing may also occur if other tissues near the esophagus are affected by the cancer.

How is it diagnosed?

Your doctor may use the following tests:

• A barium swallow x-ray allows your doctor to watch liquids move from your esophagus to your stomach.

• Procedures called endoscopies may be done to examine your esophagus and windpipe (trachea). After you are given a drug to make you sleepy, a slim, flexible tube is inserted into your esophagus, or into your windpipe and bronchial tubes. (The exam of your windpipe and bronchial tubes is called a bronchoscopy.)

• A sample of tissue may be removed from any areas that appear abnormal in the esophagus. The tissue is examined for the presence of cancer. This test is called a biopsy and is usually done during an endoscopy.

• Blood tests and other x-rays and scans may be done to see if the disease has spread beyond the esophagus.

How is it treated?

The treatment often involves a combination of surgery and radiation. Sometimes chemotherapy is also a part of the treatment. The choice of treatment depends on the size and location of the cancer within the esophagus and the degree of spread to surrounding tissues.

Sometimes nonsurgical treatments can be used, such as dilating or widening the opening of the esophagus to allow more comfortable swallowing. Radiation therapy may be done to try to make the tumor smaller.

How long will the effects last?

In most cases cure isn't possible. Cancer of the esophagus spreads rapidly and is often diagnosed in its later stages. However, improved surgery, radiation techniques, and chemotherapy have increased life expectancy and comfort for people with this disease.

How can I take care of myself?

Talk to your doctor about any concerns you have regarding the course of your illness and treatments. Ask about side effects you may have from radiation, chemotherapy, or prescription medicine. You may want to make a list of questions at home and take it with you when you visit your doctor. Ask a friend to go with you who can listen, too. If you don't understand a word or concept, ask your doctor to explain it. Take notes if you need to.

The following guidelines may help control your symptoms:

• Eat small, frequent meals.

• Follow your doctor's or dietitian's recommendations for foods to maintain your strength and to provide added nutrients to heal tissues after treatment.

• Get plenty of rest and sleep.

• Take pain medication if your doctor prescribes it.

• Maintain a hopeful and positive outlook throughout your treatment and recovery.

If possible, join a cancer support group.

For more information, call or write:

• AMC Cancer Information
  Phone: 1-800-525-3777

• American Cancer Society, Inc.
  1599 Clifton Road, NE
  Atlanta, Georgia 30329-4251
  Phone: 1-800-ACS-2345

How can I avoid getting esophageal cancer?

Because the causes of esophageal cancer are unknown, there is no sure way to prevent it. Avoid smoking completely and drink alcohol in moderation. Have periodic checkups and be aware of any change in your body functions.