News & Events

Esophageal cancer: Rare, rising and deadly


By Rhonda Mann, Tufts Medical Center Staff

It represents just one percent of all new cancer cases in the U.S. each year, but it is often found too late for a cure. Some 17,000 people will be diagnosed with esophageal cancer in 2018, according to the American Cancer Society. The most serious form of this cancer, adenocarcinoma of the esophagus, is extremely aggressive and the incidence has continued to grow over the past few decades. The good news is there are things you can do to decrease your risk.

We asked Director of Endoscopy at Tufts Medical Center, Robert F. Yacavone, MD, to answer questions about this dangerous disease.

How dangerous is it?

Survival rates are getting better than they were, but it still a deadly disease. Fifty years ago, only about 5 percent of people diagnosed with esophageal cancer survived at least five years. Now that rate is up to 20 percent. The earlier the cancer is caught, the better the chance we can treat and cure it.

What are the early signs?

Signs can include:

  • Difficulty swallowing
  • Unexplained weight loss
  • Chest pain, pressure and burning
  • Chronic coughing or hoarseness

Worsening indigestion or chronic heartburn can also be an early sign. When the contents of the stomach continue to back up into the lower part of the esophagus over a long period of time, it can damage the lining of the esophagus, making it ripe for cancer formation. This condition, called Barrett’s esophagus, is serious, but it can be treated. That’s why it’s critical to not ignore chronic heartburn. There are good medications to keep it under control.

What are other risk factors for esophageal cancer?

This is a disease of older people – predominantly those over 55. Men are four times more likely to get it than women. Smoking significantly increases the risk. A person who smokes a pack or more of cigarettes a day is twice as likely to get esophageal cancer. Drinking excess alcohol also increases the risk. Those who are overweight or obese are much more likely to get the disease. Exposure to chemical fumes in the workplace may also play a role.

Is it genetic?

It does appear that certain gene abnormalities are more common in people with Barrett’s esophagus. Researchers are working on new tests that can help identify people at increased risk. This may also help us develop new targeted therapies that overcome these genetic variants.

What can I do to prevent esophageal cancer?

I tell my patients that the best thing they can do is lead a healthy lifestyle.  Don’t smoke. Drink alcohol in moderation. Eat a diet high in fruits and vegetables and low in processed meat. If you are overweight, talk to your doctor about the best way to shed some pounds. Importantly, if you’ve had chronic heartburn or acid reflux over a long period of time, see your doctor. 

The above content is provided for education purposes by Tufts Medical Center. It is free for educational use. For information about your own health, please contact your physician.