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What is Esophageal Cancer?

To understand cancer of the esophagus, it’s first important to understand what cancer is: basically, the production of abnormal cells. Cells are the building blocks that make up tissue.

The body is programmed to routinely replenish cells in different organs. As normal cells age or get damaged, they die off. New cells take their place. Abnormal cell growth refers to a buildup of extra cells. This happens when:

  • New cells form even though the body doesn’t need them or
  • Old, damaged cells don’t die off.

These extra cells slowly accumulate to form a tumor. These abnormal cells can destroy normal body tissue and spread through the bloodstream and lymphatic system.

The first thing to understand is that a tumor can be either benign or malignant. You’ve probably heard these terms. Here’s exactly what they mean:

Benign: means not cancerous. A benign tumor can get larger but does not spread to other tissues or organs.

  • Malignant: means cancerous. The cells of a malignant tumor can invade nearby tissues and organs and spread. They are destructive.

Look at the chart below to learn more about the difference in benign and malignant.

Benign tumors:

  • Can be removed
  • Usually don’t grow back
  • Are rarely fatal
  • Don’t spread to other tissues or body parts

Malignant tumors:

  • Can often be removed
  • Sometimes grow back
  • Can invade other tissues and organs and cause damage
  • Can spread to other body parts
  • Can be fatal

The esophagus is part of the digestive system. It is the muscular tube in the throat that food passes through on the way to the stomach.

Esophageal cancer is 3-4 times more common in men. Your esophagus is a tube that connects your mouth to your stomach.  It is made up of several layers of muscles and an innermost layer of mucosa. These muscles contract and push liquids and solid foods down into the stomach.  When cancer occurs, it starts in inner layers and grows outward into deeper layers.

There are 2 types of cancer of the esophagus. Cancer either grows:

  • In cells that form the inside layer of the esophagus lining. These are called squamous cells. They are part of the upper part of the esophagus. Cancer in this part of the esophagus is squamous cell carcinoma. Half of all esophageal cancers are squamous cell carcinomas.
  • In glandular cells. These are adenocarcinomas and start mainly in the lower esophagus.

With Your Healthcare Team

When going through cancer treatment, your healthcare team is very important. Every member plays an important role. Use the tips below for talking with your healthcare team:

  • Establish your main point of contact.
    • Your main point of contact will probably be a nurse navigator or physician, but it may be another member of your healthcare team. Who should you contact first with questions?
    • It’s important to always be open and honest with your healthcare team about your physical and emotional well-being.
  • Do not be afraid to ask questions.
    • There is time to ask your healthcare team any questions you may have, and to consider your treatment options.
    • Write your questions down before your appointments. Take a pen and paper to write down the answers.
  • Before beginning treatment, ask your healthcare team the following:
    • What are all my treatment options?
    • What are the long-term and short-term side effects of treatment, and how can I manage them?
    • Will my fertility or ability to have children be affected?
    • Am I eligible for clinical trials?
    • If you develop any new problems or symptoms during treatment, tell your healthcare team immediately. You are not complaining. This is valuable information for your doctors.
    • Do not change your diet, start an exercise program, or take any new medications, including vitamins and supplements, during treatment without talking to your healthcare team first.

With Your Caregiver

Your primary caregiver may be with you when you receive your diagnosis. Your primary caregiver may be your spouse, partner, adult child, parent, or friend. Your primary caregiver is the person who may come with you to appointments, take care of you after surgery or treatment, and support you throughout your cancer journey.

  • Everyone reacts to the news of cancer differently. You may feel upset, shocked, or angry. It may take you some time to process the information. Your caregiver may react the same way you do, or your caregiver may not. Even if your caregiver does not react the same way you do, it does not mean that he or she does not care deeply.
  • Establish your role and your caregiver’s role early. For example, will your caregiver be the one scheduling most of your appointments, or do you prefer to take an active role? Find what works best for you and your caregiver.
  • Be open and honest with each other about how you both feel. Overly positive attitudes may hinder honest communication. It’s okay to be upset.
  • Encourage your caregiver to take time to care for his or her own physical and emotional well-being. Being a caregiver comes with its own hardships.
  • If your primary caregiver is your spouse or partner, your intimate and physical relationship may change.

With Your Children

Children are very perceptive, no matter their age. While you may wish to protect your children by not telling them about your diagnosis, even young children may be able to tell that something is wrong. Not knowing what is wrong may create more stress and anxiety. Here are some tips to talk to your children and teens about your cancer diagnosis:

  • Wait until your emotions are under control and decide what to say ahead of time.
    • Tell the truth and answer questions honestly. Depending on your children’s ages, it may not be appropriate to give them all the details, but do be truthful.
    • Let them know what to expect. For example, let them know that after surgery you will need a lot of rest and may need to stay in the hospital. If your chemotherapy may cause you to lose your hair, let them know. Keep your children in the loop as much as possible.
  • Explain to your children, especially younger children, that they cannot “catch” cancer.
    • Let your children know that it is okay to cry or be upset. This may be especially important for your teens to hear.
    • Tell teachers, babysitters, and others with responsibilities with and around your kids about your diagnosis in case they see behavior changes you may need to know about.
    • Maintain normal schedules as much as possible.
    • Let your kids help. Allow them to help with chores, and let them know that their help is important. Teens may want to take an active caregiver role. Let them do so, at appropriate levels.
    • Look for support groups in your area. Many places offer support groups for children and teens whose parents have a cancer diagnosis.
    • Know when to seek professional help. If your child begins to demonstrate unusual behavior such as angry outbursts, nightmares, or poor grades in school, ask your healthcare team for a recommendation for a counselor.

With Family and Friends

You may choose to keep your cancer journey private, or you may choose to share your story with others. The choice is yours. Remember when family, friends, coworkers, or other acquaintances ask about your diagnosis, they are genuinely concerned about your well-being. You can share with them as much or as little information as you like. These suggestions may help you talk about your diagnosis:

  • Decide how much information you want to share before you start telling people about your diagnosis.
  • If you choose to keep your journey private, make sure to let people know that you appreciate their concern, but you hope they respect your privacy.
  • Choose someone close to you, like your caregiver, to spread the word about updates and treatment progress. After a long day of treatment, you may not feel like calling and texting people, but your friends and family will probably want to know how you are.
  • If you want to share your story, consider starting an email chain or a Facebook group. This way you can update everyone with one message instead of needing to answer a lot of emails and phone calls.
  • You can also create your own private website at MyLifeLine.org.
  • When people offer to help with things, let them. Your family and friends could cook dinner, drive you to an appointment, or babysit.
  • If you lose your hair due to treatment or have visible surgical scars, strangers may ask about your diagnosis. Have a response prepared. Again, you may share as little or as much as you like.
How Esophageal Cancer Spreads

Before you can understand how esophageal cancer cells can spread, it's important to have a clear picture of the anatomy of your esophagus.

Esophageal Cancer Diagram