Esophageal Cancer

Symptoms and risk factors of esophageal cancer

Esophageal cancer in its earliest, most treatable stages typically causes no signs or symptoms, which is why physicians recommend you schedule preventive screenings of the esophagus.

If caught early, esophageal cancer can be treated and potentially cured. A procedure called an esophagectomy eliminates the need for chemotherapy, radiation therapy, or traditional surgery.

Symptoms

At later stages of development, symptoms may include:

• Indigestion or heartburn
• Chest pain, pressure or burning
• Coughing or hoarseness
• Trouble swallowing (dysphagia)
• Frequent choking while eating
• Coughing up blood

Types of esophageal cancer

Two types of esophageal cancers account for more than 90% of all cases:

• Squamous cell carcinoma grows in the squamous cells that line the long tubular muscle connecting the throat to the stomach.
• Adenocarcinoma develops in the mucus-producing glands in the lower part of the esophagus. It spreads to the esophageal lining as precancerous lesions that are the hallmark of Barrett’s esophagus. Note that when caught early, Barrett's esophagus is completely treatable.

Esophageal cancer diagnosis at UCI Health

If you are concerned about esophageal cancer, the first step is to schedule a screening with an esophageal specialist at UCI Health.

Testing may include:

• Upper endoscopy
• X-rays with a contrast medium
• Biopsy

If cancer cells are found, your physician will determine the extent, or stage, of the cancer:

Stage I — Only the top layer of esophageal lining is involved
Stage II — Cancer cells have penetrated into the lining and may have spread to adjacent lymph nodes
Stage III — The cancer has spread to the deepest layers of the esophageal wall and to adjacent tissues or lymph nodes
Stage IV — The cancer has spread to other parts of your body

Esophageal cancer treatment at UCI Health

Treatment depends on the type and stage of your cancer, as well as your age and health. 

Options may include surgery to remove some or all of the esophagus, often in combination with radiation therapy and/or chemotherapy. 

You may be a candidate for a drug therapy that targets a protein called HER2 found in certain types of esophageal cancer cells.

Surgical measures

• Endoscopic mucosal resection (EMR)
  Early stage cancers that are small and limited to the top layer of the esophageal lining can be removed using an endoscope. You would then take drugs called proton pump inhibitors to reduce stomach acid production.
• Esophagectomy
  If the cancer has penetrated deeper layers and spread, your surgeon may recommend removal of the diseased part of the esophagus and nearby lymph nodes. The remaining part of the esophagus is reconnected to the stomach.
• Esophagogastrectomy
  Depending on the spread of the cancer, your surgeon may recommend removal of part of the esophagus and the uppermost part of the stomach, along with lymph nodes. The remainder of the esophagus is reattached to the remainder of the stomach, sometimes using a portion of the colon to rejoin the organs.

Endoscopic treatments

• Radiofrequency ablation (RFA)
  An endoscope equipped with electrodes delivers an electric current to the cancerous cells, killing them with heat. Regular screening for a recurrence is needed along with a drug regimen to block stomach acid production.  
  
• Laser ablation
  An endoscope equipped with a laser can help open the esophagus blocked by an advanced tumor. The laser can destroy the tumor, but it often grows back, requiring additional treatments.
• Photodynamic therapy (PDT)
  A light-activated drug is injected into a vein. After a few days, when the drug gathers in the cancerous tissue, an endoscope equipped with a special type of laser is passed down the throat into the esophagus. The laser light activates a chemical in the drug that destroys cancer cells. This procedure does little harm to healthy tissue but it cannot penetrate to deeper tumors.

Why choose UCI Health for esophageal cancer care

UCI Health was ranked one of America’s top hospitals for  2023-2024 in gastroenterology and GI surgery by U.S. News & World Report.

When surgery is required, our UCI Health esophageal disease specialists use the most advanced and least invasive techniques to achieve optimal results. Minimally invasive procedures have low complication rates and result in short hospital stays. 

Our board-certified physicians are leaders and pioneers in laparoscopic and endoscopic techniques.

They often train other physicians in the latest methods and technologies. Our specialists are also highly skilled at robot-assisted approaches when surgery is indicated.

Our UCI Health Chao Digestive Health Institute doctors work with you to develop a personal care plan. 

To ensure your health and quality of life, we treat you as a whole person and not just a collection of symptoms. Your treatment depends on the type and stage of the cancer, as well as your age and overall health.