The esophagus is a muscular tube that connects your throat to your stomach. It lies behind your windpipe (trachea) and in front of your spine, and carries food and liquids to your stomach.
There are two main types of esophageal cancer. One type grows in the cells that form the inside layer of the lining of the esophagus. These are called squamous cells, and cancer that starts there is called squamous cell carcinoma. Squamous cell cancer can grow anywhere along the length of the esophagus. It accounts for less than half of all cancers of the esophagus. Cancers that start in gland cells are called adenocarcinomas. This type of cell is not normally part of the inner lining of the esophagus. Before an adenocarcinoma can develop, glandular cells must replace an area of squamous cells, as happens with the condition Barrett's esophagus.
There are several risk factors for esophageal cancer. However, having a risk factor, or even several, doesn’t mean you'll get the disease. Many people with risk factors never get esophageal cancer, while others with this disease may have few or no known risk factors. Risk factors include:
The risk of this cancer goes up with age.
Men are more likely to get this cancer.
Long-standing reflux (or GERD: gastroesophageal reflux disease) increases your risk of developing this cancer even if it hasn't progressed to Barrett's esophagus. In many people, reflux causes symptoms such as heartburn or pain that seems to come from the middle of the chest. In some though, reflux doesn't cause any symptoms at all.
Tobacco and Alcohol Use
Using any form of tobacco raises your risk of developing this cancer. The longer you use tobacco, the greater your risk. Drinking alcohol also increases your risk of esophageal cancer, with your risk increasing the more you drink. Combining smoking and drinking alcohol raises your risk of esophageal cancer much more than using either alone.
The risk of esophageal cancer is higher for people who are overweight or obese. This may be because people who are obese are more likely to have esophageal reflux.
A diet high in fruits and vegetables is linked to a lower risk of esophageal cancer. The exact reasons for this aren't clear, but fruits and vegetables provide a number of vitamins and minerals that may help prevent cancer. It's also possible, although it has not yet been proven, that a diet high in processed meat may increase your risk of esophageal cancer.
With this disease, the muscle at the bottom of your esophagus doesn't relax to release food into your stomach, so the lower end of your esophagus expands. Food collects there instead of moving into your stomach. Over time, this raises your risk for esophageal cancer.
This is a rare, inherited disease that causes extra skin to grow on the palms of your hands and soles of your feet. People with Tylosis also develop small growths (papillomas) in their esophagus and are at a very high risk for esophageal cancer. They should be seen by a doctor regularly to monitor for this cancer.
A web is an abnormal bulge of tissue that causes the esophagus to become narrow. Most esophageal webs don't cause any problems, but larger webs may cause food to get stuck in your esophagus, which can lead to problems swallowing. People who have these webs may have a syndrome that causes other symptoms, too, like problems with the tongue, fingernails, spleen and other organs. About 1 in 10 people with this syndrome will get cancer of the esophagus.
Chemical fumes in certain workplaces may lead to an increased risk of esophageal cancer. Some studies have found that dry cleaning workers have a higher rate of cancer of the esophagus.
Lye Injury to the Esophagus
Lye is a chemical found in strong cleaners such as drain cleaners. Lye can burn and destroy cells. Sometimes small children mistakenly drink from a lye-based cleaner bottle. The lye causes a severe chemical burn in the esophagus. As the injury heals, the scar tissue can cause an area of the esophagus to become very narrow (called a stricture). People with these strictures have an increased rate of the squamous cell type of esophageal cancer as adults. The cancers occur on average about 40 years after the lye was swallowed.
People who have had certain other cancers such as lung cancer, mouth cancer, and throat cancer have a high risk of getting esophageal cancer, too. This may be because all of these cancers can be caused by smoking.
Surgery, chemotherapy and radiation are used to treat cancer of the esophagus. Other treatments may also be used for early cancers and pre-cancers of the esophagus. There are also treatments to help relieve symptoms such as pain and blockage.