Esophageal cancer is a disease in which malignant (cancerous) cells form in the tissues of the esophagus.
The esophagus is a hollow, muscular tube that carries food and fluid from the pharynx to the stomach. The esophageal wall is made up of multiple layers of tissue, including mucosa, muscle, and connective tissue. Esophageal cancer occurs in the innermost layer of the esophagus and spreads to the outer layers as the disease progresses.
The esophagus and stomach are part of the upper GI (digestive) system.
There are two types of esophageal cancer that are most common, and these two types are named for their malignant (cancer) cell types.
Squamous cell carcinoma: A cancer that forms in the thin, flattened cells of the lining of the esophagus. This cancer is commonly found in the middle and upper segments of the esophagus, but may occur anywhere in the esophagus. This is also known as epidermoid carcinoma.
Adenocarcinoma: Cancer that begins in glandular cells. Glandular cells in the lining of the esophagus produce and secrete fluid, such as mucus. Adenocarcinoma usually occurs in the lower part of the esophagus, near the stomach.
Smoking, alcohol abuse, and Barrett’s esophagus can increase the risk of esophageal cancer.
Any factor that may increase the risk of developing the disease is called a risk factor. Having a risk factor does not mean you will get cancer; not having a risk factor does not mean you will not get cancer. If you think you may be at risk for cancer, talk to your doctor. Risk factors include the following:
Smoking.
Alcohol abuse.
Barrett’s esophagus: A disease in which the cells lining the lower part of the esophagus are changed or replaced by abnormal cells that can lead to esophageal cancer. Gastric reflux (heartburn) is the most common cause of Barrett’s esophagus.
High age
For more information on esophageal cancer prevention, see the PDQ summary.
Symptoms of esophageal cancer are weight loss and difficulty or pain in swallowing.
These signs and symptoms can be caused by both esophageal cancer and other diseases. Contact your doctor if you experience any of the following symptoms:
Hard or painful swallowing.
Weight loss.
Pain behind the sternum.
Heartiness and cough.
Indigestion and heartburn.
Subcutaneous masses.
Examining the esophagus? Used to detect (find) and diagnose esophageal cancer.
The following tests and procedures may be used:
Physical examination and history: An examination of the body to check for general health signs, including signs of disease, such as lumps or other abnormalities. The patient’s health habits and past medical history and treatment will also be referenced.
x-ray chest radiograph: An x-ray of the internal organs and bones of the chest. X-rays are beams of energy that pass through the body and are projected onto film to take images of the internal areas of the body.
Esophagoscopy: This is a way to look inside the esophagus to examine abnormal areas. The esophagoscope is inserted through the mouth or nose and down the throat into the esophagus. The esophagoscope is a thin tube-like device with a light and a viewing lens. The esophagoscope is also equipped with a tool that allows for the removal of tissue samples, which can be examined by medical personnel under a microscope for signs of cancer. The procedure of using an esophagoscope to look at the esophagus and stomach is called upper gastrointestinal endoscopy. 
Esophagoscopy. A thin, lighted tube is inserted through the mouth and into the esophagus to examine the abnormal area.
Biopsy: Cells or tissues are removed and the pathologist examines them through a microscope for signs of cancer. A biopsy is usually performed during an esophagoscopy. Sometimes a biopsy can show changes that are not cancerous but may develop into cancer.
Several factors affect the prognosis (chance of recovery) and treatment options.
Prognosis (chance of healing) and treatment options depend on several factors:
The stage of the cancer (whether it involves part of the esophagus, involves the entire esophagus, or has spread to other parts of the body).
Whether the tumor can be completely removed by surgery.
The patient’s overall health.
When esophageal cancer is detected early, there is a better chance of recovery. Esophageal cancer is often advanced by the time it is diagnosed. Advanced esophageal cancer can be treated but is rarely cured. Consider participating in a clinical trial to improve the level of treatment. Information on clinical trials currently underway can be found through the NCI website.