Your esophagus is a muscular, hollow tube that moves your food from your mouth to your stomach. The wall of your esophagus consists of several layers of tissue that includes mucous membrane, muscle and connective tissue. Esophageal cancer begins on the inner lining of your esophagus and spreads through its other layers as the disease progresses.

The two most common types of esophageal cancer are:

• Adenocarcinoma – Adenocarcinoma is the most common and its incidence is increasing in the United States faster than any other cancers. It commonly develops in the lower part of your esophagus, near your stomach.
• Squamous cell carcinoma – Commonly develops in the mid-part of the esophagus.

Risk Factors of Esophageal Cancer

Adenocarcinoma, the most common type of esophageal cancer, is caused by gastroesophageal reflux disease (GERD). GERD can cause the development of Barrett’s esophagus which can put you at increased risk for the development of adenocarcinoma. Squamous cell carcinoma is linked to tobacco and heavy alcohol use.

At St. Elizabeth Healthcare, our multidisciplinary team works together to provide you with the highest level of healthcare available today. We take your health issues as seriously as you do and will work diligently to help you be the healthiest version of yourself you can be.

Symptoms of Esophageal Cancer

Esophageal cancer is often advanced when diagnosed because it has few signs and symptoms in its early stages. If there are symptoms, they may include:

• Difficulty swallowing 
  
• Unintentional weight loss 
  
• Chest pain 
  
• Hoarseness
• Lingering cough
• Indigestion and heartburn 

Diagnosing Esophageal Cancer

Our thoracic experts will give you a thorough physical examination to begin the diagnostic process. Tests that may be used to aid in your diagnosis include:

• Upper endoscopy (EGD)
• Barium swallow
• CT scan
• Endoscopic ultrasound – ultrasound done at the time of EGD
• PET scan

Treating Esophageal Cancer

Your thoracic team develops a treatment plan that addresses your individual health needs. 

Treatment may include one or a combination of the following:

• Chemotherapy – uses anticancer medication administered intravenously (with an IV) to eliminate cancer cells throughout your entire body.
• Radiation therapy – uses a machine to focus high-energy radiation rays at the specific areas of your body affected by cancer like your esophagus and surrounding lymph nodes.
• Endoscopic or endoluminal therapy – If caught early, esophageal cancer may be treated with several endoscopic procedures that use a small, flexible tube with a tiny camera and light to view and treat the upper portion of your digestive system. These procedures include:
  • Endoscopic mucosal resection (EMR) – is a minimally invasive procedure that allows your surgeon to remove abnormal or cancerous cells from your esophagus. 
  • Radiofrequency Ablation (RFA) – delivers heat energy to areas in the lining of your esophagus that contain cancer cells. A balloon is placed in your esophagus to deliver heat energy that eliminates any abnormal cells.
  • Cryotherapy using truFreeze – uses liquid nitrogen delivered via endoscope to freeze and destroy cancer cells .
  • Esophageal stent – metal or plastic device that can be placed in the esophagus to help with symptoms of swallowing and keep the esophagus open. This can be used before surgery or in patients who will not have surgery.
• Esophagectomy – Esophagectomy is surgical removal of all or a portion of your esophagus. Your stomach is then converted into a tube to make a new esophagus. When possible, a minimally invasive approach is used. This technique uses smaller incisions and results in reduced pain and shortened recovery time. There are several different types of esophagectomies, including:
  • 3-hole approach – Uses incisions in your abdomen, chest and neck to remove tumor tissue. 
  • Ivor-Lewis approach – An incision is made in your abdomen and chest to remove the lymph node tissue around the lower portion of your esophagus and lymph nodes. 
  • Trans-hiatal approach – An incision is made in your abdomen and neck and parts of your esophagus are disconnected and removed. 
  • Minimally invasive esophagectomy – involves making a few small incisions in the chest and abdomen. A camera is then used to complete surgery through these small incisions. Both the Ivor-Lewis and three-hole approaches can be performed using a minimally invasive technique.