Esophageal cancer is a rare cancer that begins in the cells that line the esophagus. Common types of esophageal cancer include adenocarcinoma and squamous cell carcinoma.

The esophagus is a hollow tube that links the throat and the stomach. It’s part of your digestive system. When certain types of cells in the esophagus lining grow rapidly, it is esophageal cancer.

About 1% of all cancers diagnosed in the United States are esophageal cancers. The American Cancer Society estimates there will be 21,560 new diagnoses in 2023, with 17,030 in men and 4,530 in women.

The two main types of esophageal cancer are adenocarcinoma and squamous cell carcinoma, which make up 95% of cases. The cell type where the cancer starts defines the type of cancer.

About 80% of esophageal cancers in the United States are adenocarcinomas. But squamous cell carcinoma is more common among African Americans.

Here’s an overview of the types of esophageal cancer and their treatments.

Adenocarcinomas start in the glandular cells of the esophagus. Glandular cells release fluids such as mucus into the digestive system. These cancers usually occur in the lower part of the esophageal tract, closer to the stomach.

Researchers think there may be a link between esophageal adenocarcinomas and conditions such as GERD and obesity. A condition called Barrett esophagus, which changes the cells in the lower part of the esophagus, can lead to esophageal cancer. Barrett esophagus may be the result of gastric reflux.

Squamous cell carcinomas start in the cells of the lining of the esophagus. Squamous cells are in the inner surface of organs and on the outer surface of the skin. When they become cancerous in the esophagus, tumors usually form in the upper and middle part of the esophageal tract, although they can form anywhere.

Esophageal squamous cell carcinomas are associated with risk factors like smoking and alcohol consumption.

Besides adenocarcinoma and squamous cell carcinoma, other rare types of esophageal cancer can occur. These cancers do not occur often but can include:

  • Lymphomas appear in the glands of the lymphatic system.
  • Sarcomas appear in the body’s connective tissues, such as muscles and tendons.
  • Melanomas start in the body’s melanocyte cells.

Sometimes, an adenocarcinoma develops in the part of the digestive tract where the esophagus joins the stomach. This area is called the gastroesophageal junction. Doctors treat these tumors the same as tumors of the esophagus.

Esophageal cancer symptoms

Esophageal cancer often does not have symptoms in the early stages. As it progresses, you may experience:

  • pain or difficulty when swallowing
  • unintentional weight loss
  • heartburn
  • frequent choking while eating
  • vomiting
  • food coming back up the esophagus
  • chest pain
  • chronic cough
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Esophageal cancer has a 5-year relative survival rate of 21.7% in the United States. However, survival rates are based on data from 2013–2019 that is averaged among large groups of people. The 5-year relative survival rate for cancers that have not spread beyond the esophagus at the time of diagnosis is 48.8%.

According to a 2018 study that examined the records of 14,394 people with esophageal cancer in Taiwan, the overall survival rate was lower for those with tumors in the upper third of the esophagus compared with the lower or middle third. Tumors in the upper third of the esophagus are usually squamous cell carcinomas, but these can form anywhere in the esophageal tract.

Treatment options are the same for esophageal squamous cell carcinoma and adenocarcinoma. They all involve removing cancerous tissue or killing cancer cells. Depending on the stage of the cancer, doctors may recommend one or a combination of treatments such as:

The most common treatment for esophageal cancer is a type of surgery called esophagectomy. During this procedure, the cancerous part of the esophagus is removed. The stomach is then rejoined to the remaining part of the upper esophagus.

In early stage cancer, one treatment option may be endoscopic resection. This involves the removal of the cancerous tissue without cutting out a section of the esophagus. A surgeon places a thin tube into the esophagus through the mouth or a small cut in the skin and removes cancerous tissue through the tube using surgical instruments.

Newer treatments for esophageal cancer include monoclonal antibody therapy, a type of targeted therapy where immune system proteins target a specific part of a cancer cell. This type of therapy is still in clinical trials.

Esophageal cancer is rare and accounts for about 1% of all cancer diagnoses in the United States. The two most common types are adenocarcinoma and squamous cell carcinoma.

Although these are different types of tumors, treatment options are the same for both. Most individuals will initially have surgery to treat esophageal cancer. Newer treatments like monoclonal antibody therapy are in clinical trials but may offer new hope for people with the condition.