Esophageal cancer introduction

Esophageal cancer is the abnormal growth of cells in the esophagus, the tube that carries food and drink from your throat to your stomach. There are two types of esophageal cancer:

Squamous cell carcinoma starts in the cells that line the esophagus. This type of esophageal cancer can occur anywhere in the esophagus.

Adenocarcinoma starts in the lower portion of the esophagus near the opening to the stomach. It starts when cells in the lining transform into glandular type cells, a condition called Barrett's esophagus.
Esophageal cancer is common in Asia, Africa and Latin America, but less common in the United States. However, the number of cases of adenocarcinoma of the esophagus is increasing faster than almost all other cancers in the United States. No one is certain what causes esophageal cancer, but risk factors include the following:

Age - Most people who develop esophageal cancer are over 50.

Sex - Both types of esophageal cancer occur about three times more often in men than women.

Race - Squamous cell esophageal cancer is three times more common among African-Americans than whites. However, Caucasians have a higher incidence of adenocarcinomas of the lower esophagus than African-Americans.

Tobacco use - Tobacco consumed in any form increases the risk of esophageal cancer. The longer you smoke and the more you smoke each day, the greater the risk. This is primarily true for squamous cell esophageal cancer.

Alcohol consumption - Chronic or excessive consumption of alcohol, especially when combined with tobacco use, increases the risk. Again, this is primarily true for squamous cell esophageal cancer.

Barrett's esophagus - Irritation caused by chronic acid reflux is believed to cause the cells at the bottom of the esophagus to transform into glandular cells similar to cells in the stomach lining. These glandular cells are more likely to become cancerous. This is the strongest known risk factor for cancer of the lower esophagus, adenocarcinoma.

Chemical irritation - Damage to the esophagus from swallowing lye, most often during childhood, or from prior radiation increases the risk of esophageal cancer. Chemical irritation also can occur in a condition called achalasia, where part of the esophagus is dilated (expanded) and collects partially digested foods.

Diet - A diet low in fruits and vegetables and certain minerals and vitamins has been associated with a higher risk of esophageal cancer. Nitrates in foods and fungal toxins from pickled vegetables also have been associated with esophageal cancer.

Medical conditions - Two conditions are associated with a higher risk of esophageal cancers: Plummer-Vinson, also called Paterson-Kelly syndrome, and tylosis.

Symptoms

Early esophageal cancer may not cause any symptoms. As the cancer progresses, it usually causes one or more of the following symptoms:

Difficult or painful swallowing or difficulty swallowing only solid foods (called dysphagia or odynophagia)
Pain in the chest or between the shoulder blades
Frequent heartburn or acid reflux
Severe weight loss
Hoarseness or chronic cough
Vomiting
Coughing up blood
Other conditions can cause these symptoms. If you experience any of these, you should see your doctor. If you have chest pain or vomit blood, seek medical attention immediately.