About Esophageal Cancer
Cause
The exact causes of cancer of the esophagus are not known, and researchers and doctors are actively working to identify them. The more they find out about what causes cancer of the esophagus, the better their chances of finding ways to prevent it. Avoiding tobacco entirely and drinking alcohol in moderation are lifestyle factors that may help to prevent the disease. Some factors that may place an individual at risk for the disease have been identified, but a direct cause is not yet known.
Risk Factors
The risk factors for esophageal cancer are still being investigated, but some correlation has been found among the following factors.
Statistics
Cancer of the esophagus is among the 10 most frequent cancers in the world, with over 300,000 new cases each year. One type of esophageal cancer, squamous cell carcinoma, is prevalent in Asia (Turkey, Soviet Union, Iran, Iraq, and China), parts of Africa, and France. Adenocarcinoma of the esophagus has been rising dramatically in the United States and Western Europe, and is the type found in over 80% of patients diagnosed with esophageal cancer. A data analysis from the National Cancer Institute's SEER program found that the number of new cases of adenocarcinoma of the esophagus in white males has doubled from the early 1970s to the late 1980s. The causes for this alarming increase are unclear. In the United States, approximately 13,000 new cases of esophageal cancer are diagnosed each year. Although cancer of the esophagus is fairly common in some parts of the world, in the United States it accounts for about 1 percent of all cancers. About 15% of whites and 8% of African Americans diagnosed with esophageal cancer are expected to survive five years.
Warning Signs
Unfortunately, diagnosis of esophageal cancer is usually made in advanced stages of disease when it becomes symptomatic. Diagnosis may be made at the time of an endoscopy for evaluation of symptoms such as heartburn, gastrointestinal bleeding, or surveillance of Barrett's esophagus. Early stage tumors rarely cause any symptoms and are therefore difficult to diagnose. The most common symptom is progressively worsening difficulty in swallowing, starting with solid foods and ultimately a complete blockage if untreated. The first symptom may be when food, often a piece of leafy lettuce or meat, gets "stuck" when trying to swallow. Difficulty in swallowing may present as a sensation of fullness, pressure or burning. These problems may be intermittent or they may get progressively worse over time. Initial difficulty may be seen when eating meats, bread or dry foods. In some patients swallowing may also become painful. Loss of appetite due to the cancer itself or symptoms associated with diagnosis will often lead to weight loss. This weight loss is often a reason that someone will see their doctor prior to a diagnosis of esophageal cancer. Patients may present with weakness, lack of energy, tiredness, or fatigue. Fatigue may be due to anemia caused by slow undetected bleeding from the tumor of to a compromised nutritional status. As tumors block the esophagus, they may cause coughing due to aspiration of retained food and secretions in the esophagus. Aspiration also may occur due to paralysis of the vocal cords when the nerves to the vocal cords are involved by the tumor. In very advanced stages, tumors involving the upper esophagus may develop a communication or "fistula" (a tubular passageway) between the esophagus and the windpipe. Cancer is just one potential cause of these symptoms. There can be a number of other, less serious medical conditions that may cause these symptoms. People with symptoms such as these should see their family doctor and a gastroentrologist. A gastroentrologist is a doctor who specializes in diseases of the digestive tract and is the appropriate medical professional to evaluate these symptoms.