Esophageal Cancer: Symptoms, Risk Factors, and Prevention

Esophageal cancer, a devastating ailment affecting an individual’s esophagus, is on the rise! Worldwide, cancer of the esophagus is the eighth most common cancer and the sixth leading cause of death. It remains a significant public health problem.

Understanding signs and symptoms, and preventing the occurrence of this deadly cancer affecting the gastrointestinal tract is crucial. Scroll below to explore the risk factors that you should be aware of, and the smart choices that you can make to live a healthy life and alleviate the risk of getting tumors in the esophagus.

Highlights

• What is esophageal cancer and its types?
• Symptoms of esophageal cancer
• Risk factors for esophageal cancer
• How to prevent esophageal cancer?

What is esophageal cancer and its types?

Esophageal cancer affects the food pipe/esophagus-a muscular, hollow, long, thin tube that connects the throat to the stomach. This type of tumor begins in the inner lining of the muscular tube and spreads outward through the layers of the esophagus as it grows. Types of esophageal cancer include:

(i) Squamous cell carcinoma: It affects the upper and middle part of the esophagus

(ii) Adenocarcinoma: It affects the lower part of the esophagus near the stomach.

Symptoms of esophageal cancer

In its early stages, esophageal tumors often do not cause any prominent symptoms. However, as it advances, patients can experience painful and difficulty swallowing (dysphagia), vomiting, persistent coughing, weight loss, worsening indigestion or heartburn, hoarseness, chest pain, pressure or burning, and esophageal bleeding leading to black tarry stools and anemia.

Risk factors for esophageal cancer

• Tobacco: Use of tobacco in any form like cigars, cigarettes, pipes, chewing tobacco, and snuff makes you more prone to esophageal tumor.

• Alcohol: Alcohol consumption is associated with cancer risk. Excessive consumption of alcohol over a prolonged period raises the risk of esophageal tumor, especially when combined with tobacco usage. Compared to the risk of adenocarcinoma, the risk of squamous cell carcinoma is higher with alcohol intake. 

A meta-analysis and systematic review by Farhad Islami et al. depicted a link between alcohol drinking and esophageal squamous cell carcinoma.

• Age: The risk of getting an esophageal tumor increases with age. People between the age of 45 and 70 are more prone to develop esophageal tumors.

• Gastroesophageal reflux disease (GERD): Individuals having GERD are at raised risk of suffering from esophageal cancer. This risk appears to be greater in individuals having more frequent symptoms.

• Obesity: Having too much body fat can enhance the odds of getting esophageal adenocarcinoma since obese people are more likely to have GERD. A report indicated a 48% increased risk of esophageal adenocarcinoma for every 5 unit rise in body mass index.

• Barrett’s esophagus: Gastric reflux may irritate the esophagus and trigger Barrett’s esophagus (a precancerous condition in which the cells lining the lower part of the esophagus become abnormal). If you have been diagnosed with Barrett’s esophagus, the chances of getting an esophageal tumor is greater.

• Bulimia:  A case report published in “Journal of Medical Case Reports” indicated bulimia (psychological eating disorder in which a person consumes a large quantity of food in one sitting and later on try inappropriate ways to lose weight ) to be a risk factor for adenocarcinoma of the esophagus.

• Achalasia: In patients suffering from achalasia (a disorder in which the muscle at the lower end of the esophagus does not relax during swallowing of food), the swallowed food and liquid pass with difficulty into the stomach.

They tend to collect in the lower esophagus, which becomes stretched out over time.  Due to exposure to foods for an extended period, it may result in irritation of the cells lining the esophagus in that area. This may boost esophageal cancer risk.

• Gender: Males are more likely to suffer from cancer of the esophagus compared to females.

• High intake of red meat: Consuming red meat is also a significant cancer risk factor. In a meta-analysis published in “World Journal of Gastroenterology”, a greater consumption of red meat was found to be linked with a raised risk of esophageal cancer.

• Drinking very hot liquids: Having a habit of frequently drinking very hot liquids may trigger long-term damage to the cells lining the esophagus. This may raise the risk for esophageal tumors.

• Diet/nutrition: If you do not eat enough fruits and vegetables, then you may be at risk of suffering from esophageal cancer. Also, a diet low in vitamins and minerals can put you at risk of suffering from esophageal cancer.

• Hypertension: A nationwide population-based study by Jae-Hyun Seo et al. portrayed hypertension to be an important risk factor for esophageal cancer.  
             
• Ingestion of lye: Accidental swallowing of cleaning liquids (such as drain cleaners) containing lye can result in a severe chemical burn in the esophagus.  As it heals, the scar tissue can make an area of the esophagus very narrow that can put you at risk of getting an esophageal tumor.

• Plummer-Vinson syndrome: This rare condition is characterized by dysphagia, esophageal webbing, and iron-deficiency anemia. Anemia is a common problem in cancer patients. To know more, read here!

Patients having this condition face trouble in swallowing due to small growths of tissue that partially obstruct the esophagus. This raises the danger of squamous cell carcinoma of the esophagus and pharynx.

• Inherited gene mutations: Several genetic syndromes such as Tylosis with esophageal cancer (sometimes called howel-evans syndrome), Bloom syndrome, Fanconi anemia, and Familial barrett’s esophagus may make you more prone to the esophageal tumor.

How to prevent esophageal cancer?

(a) Quit smoking: Smoking is a known risk factor not only for lung cancer, but also for esophageal cancer. Avoiding smoking is one of the best ways of limiting the risk of getting an esophageal tumor. Counseling and medications are available to aid you to quit smoking.

(b) Diet: Eat a balanced diet. Add a wide array of colorful fruits and green leafy vegetables (super anti-cancer foods) to your everyday meal. Avoid drinking very hot liquids. Avoid eating red meat.

(c) Reduce alcohol consumption: Cut down your alcohol intake to reduce the odds of developing cancer of the esophagus.

(d) Watch your weight: If you are overweight, talk to your healthcare professional about strategies to maintain a healthy weight. Exercise regularly and aim for a steady weight loss of one or two pounds per week. Follow a healthy lifestyle and be physically active.

(e) Eat white meat: A case-control study published in Nutrition and Cancer indicated that white meat intake protects from squamous cell carcinoma of the esophagus.

The incidence of esophageal tumors is drastically rising. Identifying, exploring, and intervening on all potential risk factors may exhibit a pivotal impact on the incidence rates of esophageal cancer. Regular screening should be done for conditions that may trigger cancer of the esophagus.

Individuals suffering from acid reflux diseases such as GERD or Barrett’s esophagus should get themselves treated to mitigate the risk of developing esophageal cancer. Talk to a gastroenterologist if you witness persistent heartburn, that may be a sign of GERD. For early detection of esophageal cancer, people with acid reflux diseases need to be closely monitored.

Also, read Nivolumab receives FDA approval to treat esophageal squamous cell carcinoma