Esophageal Cancer

Esophageal cancer starts in the esophagus, which is the muscular tube that connects the stomach and throat. There are more than 17,000 new cases of esophageal cancer diagnosed in the United States each year, according to the American Cancer Society. While this type of cancer is rare in the U.S., it is more common in Asia, Africa and France.

There are two different types of esophageal cancer:

Squamous cell carcinoma
Adenocarcinoma

Adenocarcinoma is more common in North America and most of the western countries. Its rates have been increasing among men and women.

The Gastrointestinal Oncology disease team at Penn State Health Milton S. Hershey Medical Center is committed to the early detection and effective treatment of esophageal cancer.

Our team works closely with palliative care providers, social workers, nutritionists, physical therapists, artists and music therapists, psychologists and others to support and improve the health of our patients.

Treatment

There are many different treatment approaches to esophageal cancer. Your doctor and medical team will work closely with you to create a plan that is best for your type of esophageal cancer, its stage and your medical history. Treatment may include:

Surgery
Chemotherapy
Radiation
Targeted therapy
Immunotherapy
Clinical trials

Surgery

If your esophageal cancer is detected in its early stages and hasn't yet spread, the tumor may be removed through surgery. The most common surgical approach is a minimally invasive endoscopy-guided resection. During this procedure, a long, narrow tube, equipped with a light and camera at the end (endoscope), is slowly inserted into the esophagus from your mouth. Your surgeon will carefully guide the tube to the abnormal cells and remove precancerous or early-stage cancerous cells.

You may be a candidate for surgery even if esophageal cancer has spread to the deeper layers of the esophagus or surrounding lymph nodes. Your treatment will likely also include chemotherapy and radiation therapy.

Advanced Treatment

Palliative care options may be offered for individuals with metastatic cancer, which means the cancer has spread to other areas of the body. Palliative care may include systemic chemotherapy, targeted therapy, immunotherapy and clinical trials.

Your doctor may also recommend genetic counseling. Learning more about and understanding your risk and your family’s risk of developing cancer is the first step in managing your care. Your doctor may refer you to our genetics counselor Maria Baker, PhD, for additional insight and advice.

Prevention and Screening

Prevention

You may not be able to completely prevent esophageal cancer, but there are steps you can take to lower your risk. Those include:

Avoid tobacco.
Limit alcohol.
Maintain a healthy weight.
Treat and manage gastroesophageal reflux disease (GERD) and Barrett’s esophagus.

Screening

If you are at risk for developing esophageal cancer or have a family history, your doctor may collect a tissue sample of your esophagus through an esophagogastroduodenoscopy.

Symptoms and Diagnosis

Esophageal cancer starts in the esophagus, which is the muscular tube that connects the stomach and throat.

Symptoms

Symptoms of esophageal cancer may include:

Dysphagia (impaired swallowing)
Weight loss
Nausea/vomiting
Chest pain
Bloody vomit
Esophageal obstruction

Diagnosis

An upper endoscopy is required to accurately diagnose esophageal cancer. Your doctor will insert a small tube into your mouth to view the inner lining surface of the esophagus. A small biopsy of suspicious lesions will also be taken. These results will enable your gastroenterologist to determine the presence and location of esophageal cancer.

Staging to determine the extent of the tumor, including size and if it has spread to other areas of the body, will require an endoscopic ultrasonography, CT scans and PET/CT scans.