patient undergoing exam

Esophageal Cancer

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. The esophagus is the muscular tube that moves food and liquid from the throat to the stomach. Esophageal cancer starts at the inside lining of the esophagus and spreads outward through the other layers as it grows.

UVA Cancer Center has a multidisciplinary team dedicated to caring for patients with esophageal disease, from benign esophageal conditions through the most advanced stages of esophageal cancer. Many of the patients that come through our doors are referred by outside physicians for a second opinion because of our extensive knowledge of these diseases, approaches to treatment, advanced surgical procedures and the latest in minimally invasive and nonsurgical therapies. 

The two most common forms of esophageal cancer are named for the type of cells that become cancerous:

  • Squamous cell carcinoma: Cancer that forms in the thin, flat cells lining the esophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
  • Adenocarcinoma: Cancer that begins in glandular (secretory) cells in the lining of the esophagus that produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.
Side view cutaway of the esophagus showing an area of esophageal cancer.
Esophageal Cancer. Copyright © Nucleus Medical Media, Inc.

Risk Factors & Symptoms

Risk factors include the following:

  • Heavy alcohol or tobacco use
  • Barrett esophagus
  • Older age
  • Male gender
  • African-American ethnicity

Symptoms of esophageal cancer may include:

  • Difficulty swallowing
  • Weight loss
  • Pain in the chest
  • Hoarseness and cough
  • Indigestion and/or heartburn

Diagnosis & Treatment 

The following tests and procedures may be used:

  • Physical exam and history
  • Chest X-ray with or without barium contrast
  • Esophagoscopy
  • Biopsy

Certain factors, such as the size of the tumor, the stage of the cancer and your general health will affect your treatment options and recovery. Recovery is better when esophageal cancer is found very early; however, it is often at an advanced stage when it is diagnosed. At later stages, esophageal cancer can be treated but rarely can be cured. You may want to consider participating in a clinical trial.

Treatment options

  • Surgery: The most common treatment. Part of the esophagus may be removed during an operation called an esophagectomy.

  • Radiation therapy: Uses high-energy X-rays or other types of radiation to kill cancer or keep it from growing. 
  • Chemotherapy: Uses drugs to stop the growth of cancer cells, either by killing them or by stopping them from dividing. 

  • Chemoradiation therapy: Combines chemotherapy and radiation therapy.

  • Laser Therapy: Uses a laser beam (a narrow beam of intense light) to kill cancer cells.

  • Electrocoagulation: Uses an electric current to kill cancer cells. 

 

Our Approach to Esophageal Cancer Care

Minimally Invasive Surgery

UVA Cancer Center was among the first to perform thoracoscopic surgery and uses the most minimally invasive surgical approach whenever possible. Through the extensive experience of our surgical team, we are well-suited to determine when a minimally invasive surgical approach or video-assisted thoracic surgery (VATS) procedure is appropriate, and in cases where more invasive surgery is required, we are well-equipped to perform the necessary procedures.

Top Thoracic Surgeons

Collectively, our thoracic surgeons at the University of Virginia perform more than 150 major operations for diseases of the esophagus annually. The significant experience of our surgeons in managing esophageal cancer and benign esophageal conditions directly improves patient outcomes and is one of the primary reasons that we continue to treat more of these patients every year.

Team-Based Model

The key to successful management of esophageal cancer is a multidisciplinary approach to care. Evaluation of every case is performed in a group setting with experts in surgery, radiology, medical oncology, pathology, gastroenterology and more looking at each patient from all critical angles. By using this approach, we're positioned to deliver the most individualized treatment plans possible for our patients.