Cancer of the Esophagus (Esophageal Cancer)
The risk of cancer of the esophagus is increased by long-term irritation such as from smoking, heavy alcohol intake, and Barrett esophagitis. The risk of esophageal cancer rises with the number of cigarettes smoked per day and the duration of smoking. A history of radiotherapy to the area, such as for the treatment of breast cancer or lymphoma, also predisposes to esophageal cancer. Very small tumors in the esophagus usually do not cause symptoms. As a tumor grows, the most common symptom is difficulty in swallowing. There may be a feeling of fullness, pressure, or burning as food goes down the esophagus. Problems with swallowing may come and go. At first, they may be noticed mainly when the person eats meat, bread, or coarse foods, such as raw vegetables. As the tumor grows larger and the pathway to the stomach becomes narrower, even liquids can be hard to swallow, and swallowing may be painful. Cancer of the esophagus can also cause indigestion, heartburn, vomiting, and frequent choking on food. Because of these problems, weight loss is common. Esophageal cancer can be diagnosed through a barium X-ray study of the esophagus and endoscopy and biopsy of the tumor. Treatment includes chemotherapy and sometimes surgery. The prognosis (outlook) with esophageal cancer is guarded. At the time of the diagnosis, more than 50% of patients have unresectable (unremovable) tumors or evidence of metastases.