While esophageal cancer is not as common as some cancers, it’s important to be familiar with the common conditions associated with it, including acid reflux, gastroesophageal reflux disease (GERD) and obesity.
As with all cancers, treatment for esophageal cancer is more successful when caught early, says the American Cancer Society and cancer experts. The ACS is among the organizations that recognize April as esophageal cancer month.
An interview with Yale expert Harry Aslanian, MD, professor of medicine (digestive diseases) at Yale School of Medicine and information from national cancer sources informed this Q&A. Dr. Aslanian is a nationally recognized expert in identifying and treating disorders of the esophagus, stomach, pancreas, bile duct, small bowel, and colon.
Is esophageal cancer rare?
Esophageal cancer accounts for about 1% of all cancer cases in this country, which makes it less common that some more prevalent cancers, including lung, breast, prostate and colorectal. But it still is not considered rare. There are two types of esophageal cancer: adenocarcinoma, which makes up about 80 percent of all esophageal cancers in the United States, and squamous cell carcinoma. The key to controlling both is early diagnosis.
Are there any causes of the disease?
Adenocarcinoma is linked to acid reflux, GERD, and changes in the cells lining the lower esophagus (Barrett’s esophagus), which may predispose to dysplasia (pre-cancerous change) and cancer. Squamous cell carcinoma has been linked to heavy alcohol consumption, and both types are increased with smoking.
What are warning signs that should not be ignored?
Symptoms that may indicate a more serious problem and warrant prompt discussion and evalution with your doctor include difficulty swallowing, pain while swallowing, loss of appetite, significant weight loss; and signs of bleeding, such as black, tarry stools or vomiting with blood.
How is Barrett’s esophagus diagnosed?
It is diagnosed via endoscopy, a procedure involving a camera inserted in the mouth to examine the esophagus. Dr. Aslanian says an ongoing consideration is when to perform an endoscopy. “Since almost everyone has heartburn sometimes, identifying which patients would benefit from endoscopy can be challenging. Chronic acid reflux occurring regularly over several years, trouble swallowing, weight loss and signs of bleeding are important to report to your doctor, as endoscopy is warranted. Most cases of Barrett’s esophagus are low risk and when caught early, early cancer changes may be treated with endoscopy.”
Are there preventative approaches?
Barrett’s esophagus and esophageal cancer can take years to develop, so taking pre-emptive steps is advisable. Acid reflux and injury to the esophagus can be modified by healthy eating, exercising to maintain a reasonable weight, quitting smoking and lowering or eliminating alcohol consumption. Dr. Aslanian says individuals should remain vigilant and aware of changes in patterns of acid reflux and the development of new symptoms that warrant discussion with your doctor.
How is esophageal cancer treated?
Interventions include endoscopy, surgery, radiation, and chemotherapy. “I am encouraged to report that targeted drug therapies, also known as precision medicine, are showing promise in improving outcomes for some patients. Various drugs are being tested to upend chemical pathways thought to be involved in the growth and spread of esophageal cancer cells,” Dr. Aslanian said.