The esophagus is a hollow, muscular tube, about 10 inches long which connects the throat to the stomach. When a person swallows, the walls of the esophagus contract to push food down into the stomach. Esophageal cancer (also called esophagus cancer) begins when cells divide, unregulated by the normal processes that decide cell growth and death, and eventually form tumors.

Cancer of the esophagusbegins in the inner layer of the esophageal wall and grows outward. If it spreads through the esophageal wall (called metastasis) it can invade lymph nodes, blood vessels in the chest, and other nearby organs. Esophageal cancer can also spread to the lungs, liver, stomach and other parts of the body.

There are two types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinomas arise in squamous cells that line the esophagus. These cancers usually develop in the upper and middle part of the esophagus. Adenocarcinomas begin in the glandular tissue in the lower part of the esophagus. Treatment is similar for both types.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Cancer of the esophagus is also called esophageal cancer. Each year, about 11,000 Americans find out they have cancer of the esophagus. Cancer can develop in any part of the esophagus. If the cancer spreads outside the esophagus, it usually shows up in nearby lymph nodes (sometimes called lymph glands). In many cases, the cancer also spreads to the windpipe, the large blood vessels in the chest, and other nearby organs. Esophageal cancer can also spread to the lungs, liver, stomach, and other parts of the body.

Cancer that spreads is the same disease and has the same name as the original (primary) cancer. When cancer of the esophagus spreads, it is called metastatic esophageal cancer.

What causes cancer of the esophagus?

Cancer of the esophagus is fairly common in some parts of the world. But in the United States, this disease accounts for only about 1 percent of all cancers.

The exact causes of cancer of the esophagus are not known. Researchers are trying to solve this problem. The more they can find out about what causes this disease, the better the chance of finding ways to prevent it.

Studies in the United States show that esophageal cancer is found mainly in people over age 55. It affects men about twice as often as women, and it is more common in black people than in white people. Why one person gets esophageal cancer and another doesn't cannot be explained.

It is established that no one can "catch" esophageal cancer from another person. Cancer is not contagious.
Also, it is known that certain risk factors increase a person's chance of getting esophageal cancer. In the United States, smoking and excessive use of alcohol are the major risk factors for this disease. Heavy users of both alcohol and tobacco are much more likely to develop esophageal cancer than are people who do not drink or smoke.

Cutting down on the use of alcohol reduces the chance of getting esophageal cancer, as well as cancers of the mouth, throat, and larynx. By not smoking, people can lower their risk of cancers of the esophagus, lung, mouth, throat, larynx, bladder, and pancreas. Also, it is very important to know that people who develop cancer due to smoking are at risk of getting a second cancer. Most doctors urge esophageal cancer patients to stop smoking to cut down the risk of a new cancer and to reduce other problems, such as coughing.

The risk of cancer of the esophagus is also increased by long- term irritation of esophageal tissues. Tissue at the bottom of the esophagus can become irritated if the contents of the stomach frequently "back up" into the esophagus, a problem known as reflux. When cells in the irritated part of the esophagus change and begin to resemble the cells that line the stomach, doctors call this condition Barrett's esophagus. In some cases, Barrett's esophagus leads to esophageal cancer.

Other kinds of irritation or damage to the lining of the esophagus can also increase the risk of cancer. For example, people who have swallowed lye or other caustic substances have a higher-than-average risk because these substances damage esophageal tissue.

Poor nutrition is another factor that can increase a person's risk of esophageal cancer.Scientists are not sure exactly how diet changes the risk of developing this disease, but they think that it is important to have a well-balanced diet that includes generous amounts of fruits and vegetables.

Often, patients with esophageal cancer have no clear risk factors. In most cases, the disease is probably the result of several factors (known or unknown) acting together.

People who think they might be at increased risk for cancer of the esophagus should discuss this concern with their doctor. The doctor may be able to suggest ways to reduce the risk and can suggest an appropriate schedule of checkups.