Sarah Cannon - April 17, 2019

Esophageal cancer occurs when cancer cells develop in the esophagus - the tube that carries food from the mouth to the stomach. There are two main types of esophageal cancer:

  • Squamous cell cancer - from the cells that line the upper part of the esophagus
  • Adenocarcinoma - from the cells in lower part of the esophagus, near the stomach

According to the National Cancer Institute, esophageal cancer contributed to 1.0 percent of all new cancer cases in 2018. Also, the earlier it's caught, the better, with the 5-year survival for localized esophageal cancer currently at 45.2 percent.

Esophageal Cancer Risk Factors

Having specific risk factors can increase your chance of developing esophageal cancer. These include:

  • Use of tobacco (including smokeless types)
  • Excess alcohol use - risk increases with combined alcohol and tobacco use
  • Diagnosis of Barrett esophagus, which itself can be caused by gastric reflux
  • Achalasia - chronic dilation of the esophagus
  • Radiation therapy
  • Obesity
  • Damaged esophagus from toxic substances, such as lye
  • History of head and/or neck cancer
  • Human papilloma virus (HPV) infection
  • Certain rare genetic conditions, such as Plummer Vinson syndrome and tylosis

Sex, race and age are also factors. Men are more likely to develop esophageal cancer. It's also more common in people ages 65-74.

While there are no current recommendations regarding screening for esophageal cancer, those at higher risk are often watched more closely, and may undergo regular upper endoscopies.

Symptoms of Esophageal Cancer

Esophageal cancer may cause:

  • Trouble swallowing
  • Painful swallowing
  • Weight loss
  • Cough (from aspiration)
  • Hoarse voice
  • Pain in the throat, back, chest
  • Nausea, vomiting
  • Coughing up blood
  • Black tarry stools
  • Hiccups
  • Indigestion or heartburn
  • Pressure or burning in the chest

"I always urge people to listen to their bodies and take action when something isn't right," said Rachelle Moore, RN, nurse navigator specializing in complex GI oncology at Sarah Cannon Cancer Institute at TriStar Health. "Many patients tell me that they noticed a tickle or hoarseness in their throat that accelerated to difficulty swallowing but didn't seek a doctor's care right away. If you notice that something isn't right, always consult your physician."

Esophageal Cancer Testing

If esophageal cancer is suspected, your doctor may view your esophagus, using any of the following methods:

  • CT scan
  • PET-CT scan
  • Barium swallow - use of contrast material to examine the esophagus with X-ray
  • Esophagoscopy with biopsy - examination of esophagus with a lighted scope, and removal of a small sample of esophageal tissue
  • Bone scan if spread to the bones is suspected
  • Endoscopic ultrasound
  • Bronchoscopy
  • If the thyroid cancer is too advanced for surgery,lab tests on a biopsy sample may be conducted to test for HER2 protein

Treatment for esophageal cancer can include chemotherapy, radiation therapy, surgery, laser therapy or photodynamic therapy.

Find more information and resources for esophageal cancer at

If you have questions about the signs and symptoms of esophageal cancer, call askSARAH at (844) 482-4812 to speak to a nurse who is specially-trained to help with your cancer questions.


U.S. National Library of Medicine MedlinePlus
National Center for Advancing Translational Services