Esophageal Cancer - Risk Factors

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Do you have any of the risk factors for esophageal cancer? What are they, and what are your concerns?

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What are the causes or risk factors for esophageal cancer?

Esophageal cancer occurs because changes occur in the DNA of cells that line the esophagus. The exact reason for these changes or mutations is uncertain, but there are known risk factors for developing these cancers.

  • Squamous cell cancer of the esophagus is related to the use of alcohol and tobacco products, both smoke and smokeless. When the two are used together, the risk of this type of cancer increases.
  • Adenocarcinoma involves the lower third of the esophagus and is thought to be related to gastro-esophageal reflux disease (GERD). When acid backwashes from the stomach into the lower esophagus, inflammation and cell damage may occur. Over a period of time, abnormal cells begin to form (metaplasia) and if the GERD is not treated and inflammation continues, the lining of the esophagus begins to change the way it looks and functions (dysplasia).
  • Barrett's esophagus describes abnormal dysplasia and is thought to perhaps be a precursor to the development of further cell mutations and adenocarcinoma.
  • Smoking increases the risk of adenocarcinoma.
  • Other potential risk factors for esophageal cancer include esophageal burns due to accidental or intentional swallowing of caustic materials such as bleach; unusual infections with yeast, fungi, or human papillomavirus (HPV); and certain unusual foods (for example betel nuts that are prominent in some Asian diets).
  • Achalasia, a motility disease of the esophagus where it does not contract appropriately, increases the risk of esophageal cancer.
  • There are some chromosome and gene abnormalities that are associated with an increased risk of esophageal cancer.
  • There has been a shift in the type of esophageal cancer that is now prevalent in the United States and Western Europe. In the past, squamous cell cancer was the most common worldwide, but that has changed. Adenocarcinoma is more common than squamous cell cancer in western countries, including the U.S. The reason for this change has yet to be determined.
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See what others are saying

Comment from: suzshopr, 45-54 Female (Patient) Published: January 14

I have suffered with acid reflux for the last 5 to 6 years. Being self-employed, medical Insurance was not a luxury at the time. After being forced to obtain Insurance, I received my first esophagus scope. No surprise; I had severe ulcers, several cancer poll-ups, thankfully a negative biopsy for cancer and Barrett's. Doctors treated the ulcer with several medications and prescription antacids, but on my return scope, to their surprise, it had worsened. This highly accredited doctor was telling me it was the worst he had ever seen. And on this scope I tested positive for Barrett's Esophagus. Nothing helps the acid. Third scope found a severe ulcer in my stomach that they are preparing to operate on in three weeks. I sleep sitting up, I have changed my diet so much over the years, but even water seems to cause acid. There is not one day of my life that I do not feel acid rising in my throat, even when I'm sitting up. I feel like there has to be something else that is the culprit of this acid. The doctors seem stumped, and are treating the obvious, but it isn't helping. There has to be something else.

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Comment from: myownsaviour1144, 25-34 Male (Patient) Published: January 16

Well, I'm not a patient for esophageal cancer, but since this is listed under the "risk factors" section and it's asking about them I will answer. At age 20 I was diagnosed with GERD (gastroesophageal reflux disease) and was told that it was so bad that it was eating away at my esophagus and that, if I had not gotten treatment when I did, I would have developed Barrett's esophagus (which, as this site mentions, is the most statistically significant precursor to the development of esophageal adenocarcinoma). So whenever I have chest pain, or I spit up blood (which happens very rarely and only immediately after I eat, which gets me wondering if I'm not somehow biting my tongue or something when I'm eating and I'm not noticing it) I start to wonder: is it cancer? GERD should not cause people to spit up blood, regardless of how bad it is. If a person is on a PPI (proton pump inhibitor), as I am and have been for years, this is especially true. Last endoscopy was done in February 2008 and the doctor said everything was great and the Nexium was doing wonderfully because there was no erosion in the esophagus. Yet, symptoms of GERD continue, which makes me wonder if reflux isn't still happening anyway (i.e., when experiencing strong emotions, whether anxiety or joy does not seem to matter). And if the reflux is still happening, then every day that goes by is another day closer to esophageal adenocarcinoma, since GERD has been shown to be such a huge risk factor for this disease.

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