Having persistent difficulty swallowing or feeling like something’s stuck in your throat? It could be more than indigestion—these may be early signs of esophageal cancer.

Esophageal cancer starts in the lining of the esophagus — the muscular tube that carries food from your throat to your stomach. It develops when abnormal cells begin to grow uncontrollably.

Often called a “silent” disease, esophageal cancer is the 10th most common cancer in the world and can go unnoticed in its early stages. If diagnosed early, there are effective treatment options available, tailored to the type and stage of the cancer.

Types of Esophageal Cancer

Esophageal cancer is classified into the following types:

1. Adenocarcinoma: It usually develops in the lower part of the esophagus and often arises from mucus-producing glandular cells.
2. Squamous cell carcinoma: This begins in thin, flat squamous cells lining the esophagus and grows uncontrollably.
3. Small cell carcinoma: The rare and aggressive type, which starts in neuroendocrine cells, a type of cell that releases hormones into the bloodstream in response to signals from nerves.

Stages of Esophageal Cancer

Staging refers to how far the cancer has spread in the body. The following are the stages of the cancer. 

• Stage 0–I (Localized): Cancer is confined to the inner layers of the esophagus.
• Stage II–III (Regional): Cancer has spread to nearby lymph nodes or surrounding tissues.
• Stage IV (Distant): Cancer has spread to distant organs such as the liver or lungs.

Symptoms of Esophageal Cancer

In the early stages, you may not notice any symptoms. However, as the disease progresses, the first and most common sign is difficulty swallowing (dysphagia). Other symptoms may include:

• Chest pain or discomfort
• Unintended weight loss
• Hoarseness or chronic cough
• Indigestion or heartburn
• Vomiting or regurgitation of food
• Feeling like food is stuck in the throat or chest
• Fatigue or weakness
• Frequent hiccups

Does Difficulty Swallowing Always Mean Cancer?

No, not always. Difficulty swallowing (dysphagia) isn’t necessarily a sign of cancer. It can also be caused by non-cancerous conditions like acid reflux (GERD), esophageal spasms, infections, or even food allergies.

However, if the symptom is persistent or gets worse over time, it’s important to consult a doctor to rule out serious conditions such as esophageal cancer.

Causes of Esophageal Cancer

The exact cause of esophageal cancer is not known yet. Abnormal cell growth is caused by mutations (changes) in the DNA of esophageal cells. However, certain risk factors may increase the chance of its occurrence. This may include:

• Chronic Acid Reflux (GERD): Long-term acid reflux can damage the esophageal lining, leading to Barrett’s esophagus, a major risk factor for adenocarcinoma.
  
• Smoking and Tobacco Use: Tobacco is a well-known carcinogen and a leading cause of esophageal squamous cell carcinoma.
  
• Heavy Alcohol Consumption: Excessive drinking, especially when combined with smoking, significantly raises cancer risk.
  
• Obesity: Increases pressure on the stomach, contributing to acid reflux and inflammation in the esophagus.
  
• Diet Low in Fruits and Vegetables: Poor nutrition may lower protection against cell damage and mutation.
  
• Frequent Consumption of Hot Liquids: Regular intake of very hot beverages may injure the esophagus and raise cancer risk.
  
• Age and Gender: Risk increases with age (especially over 50) and is more common in men.
  
• Family History: A genetic link may play a role in some cases.
  
• Achalasia: A rare condition that affects the esophageal muscles and increases the risk of squamous cell carcinoma.
  
• Previous Radiation Therapy: Especially radiation to the chest or upper abdomen.

Diagnosis of Esophageal Cancer

If your doctor suspects esophageal cancer based on symptoms and physical examination, they may recommend the following diagnostic tests:

• Barium Swallow (Esophagram): You swallow a barium-containing liquid, and X-rays are taken to outline the esophagus and detect abnormal narrowing or masses.
  
• Computed Tomography (CT) Scan: Produces detailed cross-sectional images of the body to help detect tumors and check if cancer has spread to nearby tissues or lymph nodes.
  
• Endoscopy: A thin, flexible tube with a camera (endoscope) is inserted down the throat to view the inside of the esophagus and take tissue samples (biopsy).
  
• Endoscopic Ultrasound (EUS): Combines endoscopy with ultrasound to provide detailed images of the esophageal wall and surrounding structures, helping to assess cancer depth and lymph node involvement.
  
• Positron Emission Tomography (PET) Scan: Helps detect cancer spread throughout the body by highlighting active cancer cells using a small amount of radioactive sugar.
  
• Biopsy: The only definitive way to confirm cancer, in which a tissue sample is taken  (usually during endoscopy) and examine it under a microscope to confirm the presence and type of cancer cells.

Treatment Options for Esophageal Cancer

Treatment for esophageal cancer depends on several factors, including the patient’s age, overall health, cancer stage, and tumor grade. The main options include:

• Surgery: To remove part or all of the esophagus (esophagectomy), often used in early-stage cancer.
  
• Chemotherapy: Uses drugs to kill cancer cells; may be given before or after surgery, or in advanced cases.
  
• Radiation Therapy: High-energy beams target and destroy cancer cells, often combined with chemotherapy.
  
• Targeted Therapy: Focuses on specific genetic or molecular changes in cancer cells to block their growth.
  
• Immunotherapy: Helps the immune system recognize and attack cancer cells, especially in advanced stages.
  
• Endoscopic Submucosal Dissection (ESD): Used to treat very early-stage esophageal cancer by removing deeper layers of abnormal tissue from the esophagus wall.
  
• Endoscopic Mucosal Resection (EMR): Removes small, superficial tumors from the mucosal lining of the esophagus, often used for early-stage cancers.
  
• Endoscopic Laser Therapy: Helps relieve symptoms like difficulty swallowing by shrinking tumors that obstruct the esophagus.

Recovery depends on the stage, treatment type, and overall health. Patients may face swallowing issues, fatigue, or appetite changes. Regular follow-ups, dietary support, and a healthy lifestyle are key to healing and reducing recurrence. 

What is the Survival Rate of Esophageal Cancer?

The five-year survival rate is about 20%, meaning 1 in 5 patients survives for at least five years post-diagnosis. However, survival can vary widely depending on multiple factors such as:

• Stage at diagnosis
• Type of esophageal cancer
• Age and overall health
• Response to treatment
• Other existing health conditions
• Access to timely, specialized care

Here is the breakdown of the survival rate based on the stages: 

How to Prevent Esophageal Cancer?

While esophageal cancer may not always be preventable, you can lower your risk by following these steps:

• Quit smoking and avoid all forms of tobacco
• Limit alcohol consumption
• Maintain a healthy weight through a balanced diet and regular exercise
• Manage acid reflux (GERD) with lifestyle changes or medication
• Eat a diet rich in fruits and vegetables
• Avoid very hot beverages that can irritate the esophagus
• Treat conditions like Barrett’s esophagus with regular monitoring

Also Read:- Cancer Treatment Cost in India

Key Takeaway

Esophageal cancer is called a “silent disease” because it rarely shows symptoms in its early stages. Warning signs like difficulty swallowing, chronic acid reflux, and unexplained weight loss often appear later. 

If you experience these symptoms—especially with risk factors like smoking or alcohol use—consult an experienced oncologist. Early diagnosis and timely treatment can make a big difference. Consult a top oncologist in India for timely care and the right treatment plan. Stay alert, act early, and prioritize your health.