The American Cancer Society estimated in 2019 that about 17,650 new esophageal cancer cases will be diagnosed. In 2020 that rate has gone up to about 18,440 new esophageal cancer cases diagnosed (14,350 in men and 4,090 in women).

Cancer of the esophagus makes up 1% of all cancers diagnosed in the United States, but the rate of esophageal cancer continues to rise because of the increase in gastroesophageal reflux disease (GERD). April is Esophageal Cancer Awareness Month. Knowing the risks and symptoms of the disease can help someone get diagnosed and treated sooner.

In this post, we share:

  • The risks and symptoms of esophageal cancer.
  • Ways to prepare for your doctor’s appointment if you’re diagnosed with the disease.
  • Tips for coping with an esophageal cancer diagnosis

What’s Esophageal Cancer?

Esophageal cancer is cancer that strikes the esophagus—the long tube that runs from the throat to the stomach, also known as the food pipe. The organ aids digestion by moving food from your throat to your stomach.

The cause of esophageal cancer is unknown. We do know that it happens when esophagus cells develop mutations (errors) in their DNA, making the cells grow and divide abnormally. These cells form a tumor in the esophagus, and the cancer can spread to other places in the body. The disease affects more men than women.

In the United States, adenocarcinoma is the most common form of esophageal cancer. It begins in the cells of mucus-secreting glands of the esophagus. Learn more about adenocarcinoma and the other types of esophageal cancer.

What are the Symptoms of Esophageal Cancer?

Although the symptoms below can be caused by other conditions, please see your doctor if you experience any of the following:

  • Trouble swallowing or painful swallowing (solid foods first cause difficulty, followed by soft foods, then liquids)
  • Significant and unintended weight loss
  • Cough or hoarseness
  • Heartburn and indigestion
  • Burning in the chest or chest pain/pressure
  • Regurgitation (swallowed food comes back up)

What are the Risks for Esophageal Cancer?

The factors below cause irritation in the esophagus and increase cancer risk:

  • Heavy alcohol use
  • Smoking
  • Bile reflux
  • Gastroesophageal reflux disease (GERD)
  • Achalasia (difficulty swallowing due to an esophageal sphincter that won’t relax)
  • Barrett’s esophagus or precancerous changes in the esophagus cells
  • Plummer-Vinson syndrome (esophageal web)
  • Drinking very hot liquids
  • Poor nutrition or a lack of trace minerals, especially selenium
  • A diet with few vegetables and fruits
  • Obesity
  • Radiation treatment on the chest or upper abdomen
  • Cancer in another part of the body
  • Swallowing chemicals or lye

Please visit our Malignant Esophageal Disease page for more information on esophageal cancer.

Does Your Family Doctor Suspect Esophageal Cancer?

If your primary care doctor thinks you have cancer of the esophagus, you may be evaluated by a team of specialists. Your team could include gastroenterologists, oncologists, surgeons, and radiation oncologists. Below you will find tips for preparing for your first appointment.

How to Prepare for Your Upcoming Appointment

It’s important to be ready for your doctor’s appointment, so you get the most out of it. Here are some ways to prepare for meeting with your doctor:

  • Ask if there’s anything you need to do before your appointment, such as restricting your diet.
  • Keep a log of your symptoms and bring it to your appointment. Include symptoms that seem irrelevant to your condition.
  • Write down key personal information and include recent life changes and major stresses.
  • Prepare a list of all your medications, vitamins, and supplements.
  • Ask a friend or family member to attend the appointment with you. In addition to supporting you, that person may remember something you missed.
  • Prepare a list of questions to ask your doctor. You can ask the basic questions below, but don’t hesitate to ask ones not on this list:
  1. Where is my esophageal cancer?
  2. How advanced is it?
  3. Can you explain the pathology report to me?
  4. Do I need other tests?
  5. What are my options for treatment?
  6. What are the side effects of each treatment option?
  7. Is there one treatment option you feel is the best?
  8. If I were your friend or family member, what treatment would you recommend?
  9. Should I see a specialist?
  10. Can you give me printed material that I can take home? What resources and websites do you recommend?
  11. Should I plan for a follow-up visit?

Coping with Your Esophageal Cancer Diagnosis and Getting Support

Receiving a cancer diagnosis can be overwhelming and cause shock, fear, and sadness. It may take time to adjust. People cope and accept their diagnosis in different ways in their own time. Until you find what comforts you the most, consider trying to:

  • Learn enough about esophageal cancer to make decisions about your care. Ask your doctor the questions listed above to understand the specifics of your cancer. Be sure to ask about its type and stage. Your doctor can refer you to the best sources of information. The National Cancer Institute and the American Cancer Society are good resources.
  • Reach out to people who care about you. Your friends and family can be a support network for you during your cancer treatment. People may offer to help you with things such as making meals or driving you to an appointment. Think ahead to what you may like help with.
  • Talking to someone about your diagnosis may help you cope. Is there a close friend or family member that you feel comfortable talking to? You could also confide in a counselor, religious leader, or medical social worker.
  • Consider joining a support group. Being with people who are going through a similar situation may provide strength and comfort. Your doctor, nurse or social worker can give you information about groups in your area. If in-person support groups are not your thing, you could try an online community available through the American Cancer Society.

The team at the Saint John’s Cancer Institute is dedicated to providing the best care and treatment to individuals diagnosed with esophageal cancer. This post is an overview of the disease and its symptoms and risks. For additional information about our Division of Minimally Invasive Chest Surgery and Thoracic Surgical Oncology, please visit our Thoracic Center for more information.

Schedule an appointment today with one of our specialists to learn more.

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About the Authors

Dr. Robert McKenna

Robert McKenna, M.D., is the Professor of Surgery, and Director of the Minimally Invasive Chest Surgery and Thoracic Surgical Oncology Center at the Saint John’s Cancer Institute. Dr. Robert McKenna is an internationally renowned thoracic surgeon, who has dedicated over 2 decades in General Thoracic surgery research and clinical care. Learn More About Dr. Robert McKenna.

Osita, M.D., MBA Onugha,

Osita Onugha, M.D., MBA, is the Assistant Professor of Minimally Invasive Chest Surgery and Thoracic Surgical Oncology at the Saint John’s Cancer Institute. Dr. Onugha is a board-certified surgeon and assistant professor of thoracic surgery at the Saint John’s Cancer Institute. Dr. Onugha practices all aspects of thoracic surgery, including procedures for benign and malignant conditions of the lung, esophagus and mediastinum. Learn More About Dr. Osita Onugha.