Esophageal cancer forms in the esophagus, the muscular tube leading from the mouth into the stomach. All fluids and nutrients that we eat and drink must pass through this long cylinder before reaching the stomach to begin the digestive process.
Esophageal cancer is predominately of two types: squamous cell carcinoma of the esophagus and esophageal adenocarcinoma. Men are at least 3 times more likely to develop esophageal cancer than women. Esophageal cancer patients are generally older adults, with a median age in the 50’s - 60’s, but EC is being diagnosed more frequently in younger adults in recent years.
Squamous cell carcinoma is the most common type of esophageal cancer worldwide. Major risk factors linked with squamous cell carcinoma of the esophagus are smoking, alcohol abuse, and perhaps dietary factors. Squamous cell carcinoma is usually found in the upper half of the esophagus.
Esophageal adenocarcinoma is the most common type in the United States and in Western Europe. Esophageal adenocarcinoma now is the fastest increasing of all cancers in the United States, and has risen from approximately 10,000 cases in 2000 to more than 15,500 predicted in 2007. Unfortunately, esophageal adenocarcinoma also has the second highest death rate, with more than 13,500 deaths expected in 2007. Progress has been made in the last few years, however, in treating both types of esophageal cancer, and the survival rate is improving every year.
Esophageal adenocarcinoma usually develops where the esophagus joins the stomach, in the lower half of the esophagus.
One major factor thought to lead to esophageal adenocarcinoma is frequent exposure of the esophagus to stomach acid, or acid reflux. Acid reflux may give rise to gastric-esophageal reflux disease or GERD. In time, GERD may develop into a condition called Barrett’s esophagus in which the cells lining the esophagus are structurally altered by long term exposure to stomach acid.
Barrett’s esophagus itself does not affect the health of a person. However, in a small number of people there is a chance that these altered cells will develop into an early cancerous state and eventually into a tumor.
Individuals who have more than two consecutive weeks of acid reflux are urged to see their physicians immediately. Unfortunately, there may be few warnings these changes have occurred until swallowing becomes difficult. Many patients also may develop esophageal adenocarcinoma with no history of serious acid reflux or difficulty swallowing until the cancer is very advanced.
