Sarah Cannon - March 25, 2021

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 epithelial cells that line the esophagus
  • Adenocarcinoma - from the glandular cells in lower part of the esophagus, near the stomach

According to the National Cancer Institute, esophageal cancer contributes to 1.0 percent of all new cancer cases in the United States. Also, the earlier it's caught, the better, with the 5-year survival rate for localized esophageal cancer currently sitting at greater than 47 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 syndromeand 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
  • Testing of tissue from a biopsy sample may be performed to test for biomarker expression, including HER2, PD-L1, and MMR/MSI

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

Find more information and resources for esophageal cancer, visit Esophageal Cancer on the Sarah Cannon website.

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, or visit askSARAH online.

It is important to know that the information in this post, including Sarah Cannon’s recommendations for screening, is accurate as of the publishing date.


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