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A doctor exams a woman's throat for early signs of esophageal cancer

Esophageal cancer develops in the esophagus, a long, muscular tube that carries food from the throat to the stomach. Food does not simply fall through the esophagus; instead, the muscles in the esophageal walls rhythmically contract during digestion, creating strong waves that propel food forward and into the stomach.

Much like other cells found throughout the body, esophageal cells normally grow and divide in an orderly fashion to replace old and damaged cells. The progression is highly regulated, and once enough new cells are produced to replace the old cells, the growth and division stop. Cancer occurs when a DNA mutation interferes with the regulation of this process, allowing cells to grow and divide uncontrollably, eventually amassing into a tumor. Most esophageal tumors originate in the inner lining (mucosa) of the esophagus.

Esophageal cancer symptoms

Usually, esophageal cancer does not produce noticeable symptoms until the tumor has grown large enough to interfere with eating, swallowing or digesting food. In many cases, the first warning sign is difficulty swallowing (dysphagia), which can create a sensation that food is lodged in the throat.

Often initially mild, dysphagia typically worsens as the growing tumor causes the esophagus to become narrower, which limits the passage of food and can potentially lead to choking or an inability to swallow. To compensate, some people may change their eating habits, such as taking smaller bites, eating softer foods or avoiding solid foods altogether. It’s important to promptly talk with a physician about any swallowing issues or changes made to accommodate them.

Other warning signs of esophageal cancer can include:

Chest pain or discomfort

People who have chronic heartburn or gastroesophageal reflux disease (GERD) are all too familiar with the associated pain, which may feel like a burning sensation or pressure in the middle of the chest. Esophageal cancer can cause similar discomfort, which typically occurs a few seconds after swallowing, when the food reaches the tumor site in the esophagus.

Unintended weight loss

Many people with esophageal cancer lose weight for no apparent reason. This could be a result of eating less due to swallowing problems, because weight maintenance necessitates the consumption of enough calories to meet the body’s daily energy needs. Additionally, any type of cancer—including esophageal cancer—can cause loss of appetite or increased metabolism.

Vocal hoarseness or persistent coughing

As an esophageal tumor grows, it can damage the laryngeal nerves and disrupt neural impulses to the voice box, causing the vocal cords to become paralyzed. A hoarse, scratchy voice or a cough that doesn’t go away may indicate esophageal cancer.

The importance of an accurate diagnosis

It’s important to note that the warning signs of esophageal cancer can also have other, less serious causes. Additionally, some esophageal cancer patients experience none of these symptoms, while others experience different symptoms entirely. Therefore, the best course of action is to promptly discuss any unusual changes with a physician.

Individuals who are at heightened risk for esophageal cancer should be particularly vigilant. Some risk factors include:

  • Smoking and other tobacco use
  • Poorly controlled heartburn or gastroesophageal reflux disease (GERD), a chronic digestive disorder that causes stomach acid or bile to flow backward into the esophagus and irritate the mucosa
  • Excessive consumption of alcoholic beverages
  • Barrett’s esophagus, a type of damage to the lower portion of the esophagus due to repeated exposure to stomach acid
  • Achalasia, a type of nerve damage that prevents the esophagus from squeezing food into the stomach

Moffitt Cancer Center is a nationally recognized leader in the diagnosis and treatment of esophageal cancer. If you would like to discuss your risk profile or symptoms with a specialist in our Gastrointestinal Oncology Program, you can request an appointment by completing a new patient registration form online or calling 1-888-663-3488.