October 18, 2023
October 18, 2023

Esophageal Cancer Symptoms, Risk Factors, and Treatment Options

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Esophageal Cancer Symptoms, Risk Factors, and Treatment Options

Esophageal cancer is a rare cancer affecting the esophagus, which is the long muscular tube connecting your throat to your stomach. Currently, there aren’t any routine screenings for esophageal cancer in the United States. 

It's important to note that the Ezra Scan does not evaluate for esophageal cancer, but that doesn't mean there’s nothing you can do. Here, we’ll reveal why early detection is critical, explore esophageal cancer symptoms, discuss risk factors, and shed light on treatment options. You’ll have actionable steps to reduce your risks and potentially detect health issues at the earliest symptoms of esophageal cancer.

Where Does Esophageal Cancer Usually Start?

The esophagus plays a major role in the digestive process by transporting food from the throat to the stomach. Esophageal cancer happens when cells in the esophagus continue to grow and divide uncontrollably and form tumors. There are two common types of esophageal cancer: adenocarcinoma and squamous cell carcinoma.

Adenocarcinoma is a type of cancer that often develops in esophageal submucosal glands. These glands are primarily in the distal or lower portion of your esophagus, especially in the region where the esophagus meets the stomach. 

Squamous cell carcinoma often begins in the flat, thin cells that line your esophagus. While these are the most common types of esophageal cancer, there are also other, rarer forms.

How Long Can You Have Esophageal Cancer Before Symptoms?

For esophagus cancer, the five-year survival rate is around 20%, according to the American Cancer Society. However, catching it early means there’s a better chance to treat it successfully and it’s less likely to have spread.

The problem is that esophageal cancer can grow slowly for many years before it causes major symptoms. This happens because the esophagus is a very flexible tube and can expand around the tumor as it grows. As a result, people with esophageal cancer often don't have symptoms until the cancer is in an advanced stage. Once symptoms develop, advanced cancer can spread rapidly.

What Is Esophageal Cancer Early Warning?

Recognizing the signs of esophageal cancer may help with detection and prompt medical care. While symptoms may vary from person to person, several common indications warrant attention. 

As you read these esophageal cancer symptoms, remember that having one or more of these doesn't mean you have cancer. However, if these symptoms occur often or worsen over time, don't delay. Make an appointment with your doctor for a complete evaluation.

Trouble Swallowing

One of esophageal cancer's earliest and most noticeable symptoms is difficulty swallowing, also called dysphagia. This symptom can feel like food getting stuck in your throat, painful swallowing, or the sensation of not passing smoothly down your esophagus. When you have this symptom, food may enter your trachea (breathing tube) and cause coughing or choking.

Frequent Indigestion or Heartburn

Chronic indigestion and not responding to usual heartburn remedies may be an esophageal cancer symptom. Suppose you experience frequent episodes of acid reflux or a burning sensation in the chest, especially after meals or when lying down. In that case, it’s important to consult a healthcare provider as this can also be a risk factor for developing cancer of the esophagus.

Unintended Weight Loss

Unintentional weight loss without changes in diet or physical activity can be an early symptom of various underlying health conditions, including esophageal cancer. If you notice a significant decrease in your body weight and you haven't been dieting or trying to lose weight, seek a medical evaluation promptly.

Chronic Cough or Hoarseness

Don't ignore a persistent cough, scratchy throat, or hoarseness that lasts longer than three weeks, particularly if you have other symptoms like difficulty swallowing or a burning chest pain. These symptoms together may indicate the presence of esophageal cancer or other serious problems.

Chest Pain or Discomfort

While chest pain can have various causes, it’s a common esophageal cancer symptom. To be safe, if you experience chest pain or discomfort, you should always consult a healthcare professional ASAP.

Fatigue and Weakness

Cancer and its impact on the body's energy levels can contribute to feelings of tiredness and reduced stamina. Feeling tired and weak are common esophageal cancer symptoms and other illnesses. It's important to note that fatigue is more than feeling drowsy. Fatigue makes it difficult to perform everyday tasks. Fatigue is present even after you've had a full night's sleep.

Who Is Most Likely to Get Esophageal Cancer?

Esophageal cancer symptoms: family happily sitting on the groundd

Several factors can increase your risk of getting esophageal cancer. Having one or more risk factors doesn't mean that you will develop cancer. However, it helps to understand these factors so you can be proactive to make better choices and eliminate risks.

Gastroesophageal Reflux Disease (GERD) and Barrett's Esophagus

Chronic gastroesophageal reflux disease (GERD) is caused by the frequent backward flow of stomach acid into the esophagus. GERD causes you to feel persistent heartburn and discomfort. Over time, untreated GERD can lead to a condition called Barrett's esophagus. When this happens, the cells lining the lower esophagus change and increase the risk of developing esophageal cancer.

Obesity and Poor Diet

Maintaining a healthy weight and a well-rounded, balanced diet are key to health. Obesity, particularly excess weight around your abdomen, is linked with a higher risk of esophageal cancer. Additionally, a diet lacking in fruits and vegetables, high in processed foods, and low in fiber may contribute to the development of various cancers, including esophageal cancer.

Smoking, Tobacco, and Alcohol Use

Tobacco use, smoking, and smokeless tobacco are significant risk factors for many illnesses, including lung cancer and esophageal cancer. Similarly, excessive alcohol consumption, especially when combined with tobacco use, further increases the risk. 


Esophageal cancer is more common in individuals aged 60 and older, highlighting the importance of regular health screenings as you age. Additionally, men are more likely to develop esophageal cancer than women. 

There’s no definitive answer for why men have a higher risk. However, studies have found that some men diagnosed with esophageal cancer also had higher than average amounts of male hormones like testosterone and luteinizing hormone circulating in their blood. Other theories are that men are more prone to drink alcohol, smoke tobacco, and have conditions like GERD. More research needs to be done to better understand this connection.


As people age, their cancer risks generally increase. Possible reasons include the cumulative effect of wear and tear on body tissues, prolonged exposure to environmental factors, and a decreased ability of cells to repair damaged DNA.

Other Risk Factors

Other factors that may increase the risk of esophageal cancer include a history of head and neck cancer, occupational exposure to certain chemicals, and human papillomavirus (HPV) infection. Inherited or genetic conditions like tylosis (also called Howel-Evans syndrome) and Bloom syndrome may also increase risk. 

Which Procedures Are Used to Diagnose Esophageal Cancer?

If you have symptoms or signs of esophageal cancer, your healthcare provider will begin the diagnostic process with a thorough physical exam and review of your medical history. This includes discussing symptoms, risk factors, and any relevant family history. You may take specific diagnostic tests to determine the presence and extent of cancer and inform treatment options. 

Note: The Ezra Scan does not evaluate for esophageal cancer, but these diagnostic tests do.


Endoscopy allows a healthcare professional to examine inside the esophagus using a thin, flexible tube with a light and camera lens attached. This procedure, known as esophagoscopy or upper endoscopy, enables the visualization of any abnormalities or suspicious areas that may require further investigation.


During an endoscopy, your doctor may perform a biopsy or remove a small tissue sample from the esophagus. The tissue sample is then sent to a laboratory to look at under a microscope for the presence of abnormal cancer cells.

Advanced Imaging Studies

Imaging scans like X-rays, computed tomography (CT scans), and endoscopic ultrasound (EUS) may help assess for abnormal tissue, identify any metastasis (cancer that has spread), and guide cancer treatment or planning. Once cancer of the esophagus has been diagnosed, a PET (positron emission tomography) scan can help show how far the cancer has spread.

Barium Swallow

A barium swallow is a special X-ray procedure in which you drink a liquid containing barium, a contrast material. This lets your radiologist see the esophagus and assess any abnormalities or blockages.

Blood Tests

Your doctor may order blood tests to evaluate overall health, check for anemia (low amounts of red blood cells), and check for specific tumor markers that may indicate the presence of esophageal cancer.

What Are the Treatment Options for Esophageal Cancer?

The treatment approach for esophageal cancer depends on a few factors, including which stage of cancer the tumors are in, your overall health, and your preferences. Here’s a closer look at the treatment options for cancer of the esophagus.

Surgical Treatment

Surgery is a common type of early-stage esophageal cancer care. There are two main types of surgeries.

  • Transhiatal esophagectomy: Removes part of the esophagus through an incision made in the neck and one in the abdomen. 
  • Thoracoabdominal esophagectomy: Removes sections of the esophagus through incisions in the chest and abdomen. 

Surgery aims to remove the cancerous portion of the esophagus and potentially nearby lymph nodes. In some cases, the remaining healthy portion of the esophagus is reconnected to the stomach or another part of the digestive system.

Radiation Therapy

High-energy beams are utilized in radiation therapy to destroy cancer cells and reduce tumors. This treatment may be administered before surgery to decrease the tumor size, after surgery to eliminate any remaining cancer cells, or to alleviate symptoms in advanced cases.


Chemotherapy is a potent treatment that eradicates cancer cells in the body. It’s often combined with surgery or radiation therapy to maximize the treatment's efficacy and keep cancer from spreading.


Immunotherapy is an innovative technique that utilizes the natural immune system of the body to combat cancer. It can either activate the immune system or employ synthetic immune system proteins to specifically attack and eradicate cancer cells. Immunotherapy has demonstrated encouraging outcomes in selected forms of esophageal cancer and is currently the subject of extensive investigation.

Prioritize Your Health By Promoting Early Detection

Father hugging his kids

By the time you recognize symptoms, you might already be in the advanced stages of esophageal cancer. Instead of focusing only on symptoms, reduce your chances of getting cancer by understanding and addressing risk factors. 

Never smoking or stopping if you do, and curbing alcohol use can significantly reduce your risk of developing esophageal cancer. Seek treatment for acid reflux, chronic heartburn, and other digestive problems. Also, make eating a healthy diet and getting regular exercise a priority.

The Ezra Scan doesn’t evaluate for esophageal cancer but if you’re interested in understanding your risks for developing cancer, Ezra offers a risk calculator that is free and easy to use.