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Esophageal Cancer
(Cancer of the Esophagus)

Doctor to Patient

Esophageal Cancer Linked to Heartburn

Medical Revising Editor: Jay W. Marks, MD

Learn about the connection between GERD and cancer of the esophagus.Esophageal cancer is the eighth most common type of cancer and causes 12,000 deaths per year in the U.S. (2% of all cancer deaths). One type of esophageal cancer, adenocarcinoma, accounts for 50% of esophageal cancers and occurs primarily in Caucasian men. The incidence of adenocarcinoma and deaths from esophageal cancer have been increasing steadily in the U.S. and western Europe.

Gastroesophageal reflux disease (GERD), in which acid refluxes from the stomach into the esophagus (known primarily for causing heartburn) is a condition that afflicts 20% of the populations of the U.S. and western Europe.

It has been hypothesized that GERD is an important cause of adenocarcinoma of the esophagus. Specifically, the hypothesis is that chronic reflux of acid into the esophagus causes changes in the cells lining the lower esophagus--changes that are referred to as Barrett's esophagus--that ultimately lead the cells to become cancerous. It is estimated that ½ to 1% of patients with Barrett's esophagus develop adenocarcinoma each year they are followed. (This means that during 20 years a patient with Barrett's esophagus has a 10 to 20% risk of developing adenocarcinoma.) Therefore, it has been recommended that patients with Barrett's esophagus undergo regular and frequent endoscopy (every year) and biopsy of the esophagus so that early malignant changes can be detected and treated early before cancer spreads.


Top Searched Esophageal Cancer Terms:

symptoms, treatment, Barrett's esophagus, staging, statistics, adenocarcinoma, surgery
Doctor to Patient

What is the esophagus?

The esophagus is a hollow tube that carries food and liquids from the throat to the stomach. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and makes swallowing easier. The esophagus is located just behind the trachea (windpipe). In an adult, the esophagus is about 10 inches long.

What is cancer?

Cancer is a disease that affects cells, the body's basic unit of life. To understand any type of cancer, it is helpful to know about normal cells and what happens when they become cancerous.

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells when they are needed. This process keeps the body healthy and functioning properly. Sometimes, however, cells keep dividing when new cells are not needed. The mass of extra cells forms a growth or tumor. Tumors can be benign or malignant.

    Benign tumors are not cancer. They usually can be removed and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely a threat to life.

    Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. These cancer cells can invade and destroy the tissue around them. Cancer cells can also break away from a malignant tumor and enter the bloodstream or lymphatic system (the tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases). This process, called metastasis, is how cancer spreads from the original (primary) tumor to form new (secondary) tumors in other parts of the body.

Cancer that begins in the esophagus (also called esophageal cancer) is divided into two major types, squamous cell carcinoma and adenocarcinoma, depending on the type of cells that are malignant. Squamous cell carcinomas arise in squamous cells that line the esophagus. These cancers usually occur in the upper and middle part of the esophagus. Adenocarcinomas usually develop in the glandular tissue in the lower part of the esophagus. The treatment is similar for both types of esophageal cancer.

If the cancer spreads outside the esophagus, it often goes to the lymph nodes first. (Lymph nodes are small, bean-shaped structures that are part of the body's immune system.) Esophageal cancer can also spread to almost any other part of the body, including the liver, lungs, brain, and bones.



Next: What are the causes and risk factors of cancer of the esophagus? »

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Esophageal Cancer - Symptoms and Signs

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Esophageal Cancer

What Causes Esophagitis?

Esophagitis is caused by an infection or irritation in the esophagus. An infection can be caused by bacteria, viruses, fungi, or diseases that weaken the immune system. Infections that cause esophagitis include:

  • Candida. This is a yeast infection of the esophagus caused by the same fungus that causes vaginal yeast infections. The infection develops in the esophagus when the body's immune system is weak (such as in people with diabetes or HIV). It is usually very treatable with antifungal drugs.
  • Herpes. Like Candida, this viral infection can develop in the esophagus when the body's immune system is weak. It is treatable with antiviral drugs.

Irritation causing esophagitis may be caused by any of the following:

  • GERD, or gastroesophageal reflux disease
  • Vomiting
  • Surgery
  • Medications such as aspirin and other anti-inflammatory drugs
  • Taking a large pill wi...

Read the Esophagitis article »











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