Esophageal Cancer

Esophageal Cancer

The esophagus is the hollow muscular tube that connects the mouth to the stomach. Esophagus cancer, or esophageal cancer, begins in the inner layer and grows outward when the cells in your esophagus develop abnormally due to alterations at the genetic level. Eventually, cancerous cells accumulate and grow.

There are two main types of esophageal cancer classified according to the type of cells involved: adenocarcinoma and squamous cell carcinoma. Adenocarcinomas begin in the cells of the mucus glands, usually in the lower part of the esophagus. This type of cancer may develop in people with Barrett’s disease (when glandular cells replace normal squamous cells in the presence of gastroesophageal reflux disease). Squamous cell carcinomas begin when the normal squamous cells that line the surface of the esophagus transform into cancerous cells. This type of cancer may develop in people with certain environmental exposures, including tobacco use. This type of esophagus cancer usually begins in the middle of the esophagus, but it can occur anywhere.

Causes and Risks of Esophageal Cancer

A risk factor is anything that will affect the likelihood of getting a disease. There are several risk factors specifically associated with developing esophagus cancer, but simply having a risk factor, does not necessarily mean that you will get esophagus cancer. Generally, advanced age, male gender, longstanding gastroesophageal reflux disease, Barrett’s esophagus, achalasia, tylosis, esophageal webs, obesity, use of tobacco, and alcohol are some of the risk factors associated with the development of esophageal cancer.

Symptoms of Esophageal Cancer

Common symptoms among patients with esophageal cancer include problems with swallowing and unintended weight loss. These are not the only symptoms and a variety of other symptoms and signs are possible.  Simply having symptoms does not necessarily mean that you have esophageal cancer. 

Diagnosing and Staging Esophageal Cancer

If diagnosed with esophageal cancer, the surgeons will pursue a workup to evaluate for the spread of the esophageal cancer. This process is also known as staging. Esophageal cancer staging is complex. Sometimes this may include additional procedures with and without a biopsy, and other times it may include proceeding directly to an operation. In general, there are four stages of esophageal cancer.

Please visit the National Cancer Institute for more information. By determining the specific stage, our thoracic surgeons can develop an optimal treatment plan that may include surgery. The staging workup and treatment plan will be made by our surgeons in conjunction with other lung cancer experts on our multidisciplinary team.

Treatment for Esophageal Cancer

Treatment for esophageal cancer has continued to improve throughout the past few decades and our surgeons at Yale Thoracic Surgery have been at the leading edge of this progress. When aiming for a cure, surgery sometimes is the sole form of therapy; other times, it is part of a therapy plan that includes chemotherapy with or without radiation therapy. Surgery in these “curative-intent” plans typically involve the removal of the esophagus, otherwise referred to as an esophagectomy. In this operation, the affected portion of the esophagus is removed and the remaining portion is reconnected to the stomach, which has been fashioned to join the remainder of the normal esophagus. 

An open esophagectomy is a complex procedure. Our surgeons are highly skilled, using muscle-sparing incisions during open surgeries for less postsurgical pain and faster recoveries. This technique uses incisions in the abdomen and chest or abdomen and neck. Minimally invasive esophagectomy (MIE) involves removing the esophagus through a series of small incisions, instead of a few large ones. This type of procedure may allow patients to leave the hospital sooner and recover more quickly. It is not an option for everyone and is best determined by your surgeon as well as with the multidisciplinary esophageal cancer team.

At the time of surgery, your surgeon will remove the lymph nodes to determine if the cancer has spread. By examining the lymph nodes, our thoracic team can learn more about the way your cancer has developed and make strategic decisions in terms of further treatment following surgery.

Esophageal cancer is a complicated, aggressive disease that demands the attention from experienced and highly trained surgeons. Our nationally renowned surgeons have continually excelled in caring for patients with esophageal cancer. They have extensive experience in all esophagectomy techniques, including open esophagectomy and minimally invasive esophagectomy (MIE). This is a complex surgery that demands the skill that our world-class surgeons bring.

At Yale Thoracic Surgery, our focus is on you as a person, not just your cancer. As our patient, you will receive personalized care from surgeons and specialists who care deeply about your immediate and future emotional and physical well-being. Using a multidisciplinary approach and the latest technology, our expert team will create a comprehensive treatment plan that considers your specific condition and individual needs.