Types of Esophageal Cancer

There are two main types of esophageal cancer that are based on the type of cell it starts in.

Squamous CellCarcinoma

The inner layer of the esophagus is lined with squamous cells. Cancer starting in these cells is called squamous cell carcinoma. This type of cancer can occur anywhere along the esophagus but is most common in the neck region and in the upper two-thirds of the chest (thoracic) cavity. 

Adenocarcinoma

Cancers that start in gland cells are called adenocarcinomas. Adenocarcinomas are often found in the lower third of the esophagus, where the esophagus and stomach come together. In some conditions, such as Barrett’s esophagus, gland cells begin to replace the squamous cells in the lower part of the esophagus and may lead to adenocarcinoma.

Gastroesophageal (GE) junction tumors are adenocarcinomas that start at the area where the esophagus joins the stomach, known as the GE junction. Such tumors tend to behave like cancers in the esophagus and are treated similarly.

Who is at Risk for Esophageal Cancer?

Risk factors include:

• Age: Fewer than 15 percent of cases are found in people younger than age 55.
• Gender: Men are more likely than women to get esophageal cancer.
• Tobacco and alcohol use: Tobacco use is a major risk factor. Also, the more alcohol a person drinks, the higher their chance of getting esophageal cancer.
• Gastroesophageal reflux disease (GERD): The stomach normally makes strong acid and enzymes to help digest food. In some people, acid can escape from the stomach up into the lower part of the esophagus. When this happens, it is known as GERD or reflux. People with more frequent symptoms of GERD are at higher risk for esophageal cancer.
• Barrett’s esophagus: If reflux of stomach acid into the lower esophagus goes on for a long time, it can damage the inner lining of the esophagus. This can cause the squamous cells that normally line the esophagus to be replaced with gland cells that are more resistant to stomach acid. This condition is known as Barrett’s esophagus. People with Barrett’s esophagus are at a much higher risk of developing adenocarcinoma of the esophagus than people without the condition.
• Being overweight: Often times, people who are overweight or obese are more likely to have reflux.
• History of certain other cancers: People who have had certain other cancers, such as lung cancer, mouth cancer and throat cancer, have a high risk of getting squamous cell carcinoma of the esophagus.

Diagnosis and Testing

If esophageal cancer is suspected, imaging tests and a biopsy to collect a sample of esophagus cells will be done to confirm the diagnosis. If cancer is found, further testing may be done to help determine the stage of the cancer. You may also be referred to a gastroenterologist who specializes in digestive system diseases for a further testing and a treatment plan.

Barium Swallow Test

If you’re having trouble swallowing, sometimes a barium swallow is the first test performed. You will be asked to swallow a thick liquid called barium to coat the walls of your esophagus. A barium swallow test with X-rays can show any abnormal areas in the otherwise smooth inner lining of the esophagus.

Upper Endoscopy with Biopsy

This test is important for diagnosing esophageal cancer. The doctor passes a thin flexible tube with a light and a small video camera on the end down your throat and into the esophagus and stomach. Special instruments are then inserted through the scope to remove (biopsy) tissue samples from any abnormal areas. These samples are sent to a lab to be checked for cancer.

Upper endoscopy can provide vital information about the size and spread of a tumor if one is found. It is useful for determining if the tumor can be removed with surgery.

Clinical Trials: Collaborating for a Cure

In a joint effort to find the best cure for esophageal cancer, Texas Health along with several of the area’s largest oncology groups of providers, are able to offer certain qualifying patients diagnosed with esophageal cancer participation opportunities to relevant clinical trials. Participating in clinical trials may provide patients with an option to receive proposed new treatments that may help increase the chances for a better outcome for the patients.

Sources:
American Cancer Society
Cancer.net