Esophageal cancer may not get the attention, or cause the fear, of other higher-profile cancers, but the threat is real – and growing. Experts predict almost 18,000 new diagnoses this year and more than 15,000 deaths.
“The incidence of the most common type of esophageal cancer in America (adenocarcinoma) has been increasing faster than any other cancer over the last 30 years,” says Jae Kim, M.D., interim chief of the Division of Thoracic Surgery at City of Hope. “No one knows the exact reasons for this, but we do know that heartburn is the main risk factor for this type of esophageal cancer.”
More on heartburn later. But first, some basics, courtesy of the National Cancer Institute. (And what better time than Esophageal Cancer Awareness Month, in some states anyway.) The esophagus, part of the digestive tract, is a muscular tube through which food moves from the throat to the stomach. Esophageal cancer begins in cells in the inner layer of tissues lining this tube; over time it may spread into deeper layers and nearby tissues.
There are two types:
-The most common in this country is adenocarcinoma, which begins in the lower part of the esophagus, near the stomach, in cells that make and release fluids.
-Most common in other parts of the world is squamous cell carcinoma, which begins in the esophagus’ flat cells, in the upper part of the esophagus.
Now back to heartburn, which is a symptom of acid reflux. This reflux occurs when stomach acid backs up into the esophagus. Some people have the symptom of heartburn, some don’t. But over time, the acid can damage the esophageal tissues, which may in turn lead to adenocarcinoma.
Other risk factors for esophageal cancer are age (most people diagnosed with the disease are 65 and older), being male (men are three times as likely as women to be diagnosed with the disease), smoking, heavy alcohol use and, small surprise perhaps, obesity. Now for the symptoms: a tendency for food to get stuck in the esophagus, pain when swallowing, pain in the chest or back (behind the breastbone or between the shoulder blades, hoarseness or a chronic cough, vomiting and coughing up blood.
Treatment doesn’t have to be as grueling as you might fear, says Kim.
“Newer treatments allow us to treat early stage cancers endoscopically, without the need for incisions,” he says. “More advanced cancers can be treated with robotic surgery, with faster recovery than traditional surgery.”
The important factor, as with most cancers, is to get diagnosed and treated as early as possible.