Esophageal Cancer

Esophageal cancer is rare, and its nonspecific symptoms — like coughing and difficulty swallowing — make it difficult to diagnose. But early diagnosis of cancer of the esophagus is crucial to improve your outcome and life expectancy.

At the UCLA Gastrointestinal Oncology Program, experts will carefully diagnose your condition and provide every available treatment for esophageal cancer. We support patients at every stage, from first symptoms through palliative care.

What Is Esophageal Cancer?

Esophageal cancer is the development of cancerous cells anywhere in the esophagus, the tube that connects the mouth to the stomach. There are two types of esophageal cancer:

• Adenocarcinoma: Most esophageal cancer is adenocarcinoma. It develops lower in the esophagus or where the esophagus connects to the stomach (the gastroesophageal junction, or GEJ). 
• Squamous cell cancer: This type of cancer usually develops in the upper part of the esophagus.

Risk factors for esophageal cancer include:

• Barrett’s esophagus
• Acid reflux/GERD (gastroesophageal reflux disease)
• Heavy alcohol use
• Smoking
• Achalasia (trouble swallowing because of a rigid esophageal sphincter muscle)
• Drinking very hot liquids

What Are the Symptoms of Esophageal Cancer?

Early in its development, esophageal cancer usually doesn’t cause symptoms. Later, people may notice coughing or trouble swallowing. Other symptoms include:

• Swallowing problems (dysphagia)
• Coughing or hoarseness
• Heartburn or indigestion that gets increasingly worse
• Losing weight without trying
• Painful or burning feeling in the chest

How Is Esophageal Cancer Diagnosed?

Your UCLA doctors will thoroughly examine you to understand your stage of esophageal cancer. Then your team will discuss your options with you to create a customized care plan. Our program offers:

• Endoscopy: Your doctor may order an endoscopic ultrasound (EUS), which uses an endoscope, a thin tube inserted in the throat, to check shapes in the walls of the esophagus and surrounding organs. During some types of endoscopy, UCLA’s advanced endoscopists can remove suspicious polyps or cells. Read more about interventional endoscopy.
• Biopsy: Your doctor removes a small sample of cells for laboratory analysis. If the cells are cancerous, your doctor will recommend the best course of treatment.
• Imaging: Specialized imaging tests can identify cancerous cells (lesions) in the esophagus. Your doctor may order X-rays, CT scans or MRI scans to help understand your tumor’s location and type.Learn more about our imaging technology.

How Is Esophageal Cancer Treated?

Most people with cancer of the esophagus have surgery to remove the tumor and surrounding cells. Your doctor may also recommend other treatments. Your care may include:

Esophagectomy

Surgery to remove part or all of your esophagus is called esophagectomy. It is a major surgical procedure. Esophagectomy may be an open surgery or a minimally invasive laparoscopy. After removing the tumor, your doctor connects the remaining parts of the esophagus or replaces it with a section of intestine. After the surgery, some people are cancer-free.

Chemoradiation

You may get chemoradiation on its own or along with surgery. Chemoradiation uses radiation and chemotherapy at the same time.

Chemotherapy medicines travel throughout your body to destroy cancer cells. Radiation uses intense X-rays to target cancer cells for destruction. Read more about radiation oncology.

Endoscopic mucosal resection (EMR)

This minimally invasive procedure uses an endoscope inserted through your throat to reach the tumor. With a tool attached to the endoscope, your doctor uses a thin wire to “lasso” the tumor.

An electrical current removes the tumor and some surrounding cells and seals the cut at the same time. Read more about EMR .

Photodynamic therapy (PDT)

Your doctor may suggest PDT to remove cancer cells near the surface of the esophagus. For more advanced cancer, PDT can relieve discomfort or make swallowing easier. PDT happens in two stages:

1. You receive an injection of photosensitizing drugs. These medicines leave healthy cells but make cancer cells more sensitive to light.
2. Then your doctor uses an endoscope to expose the esophagus to a laser light that destroys the cancer cells.

Targeted therapy

Targeted therapy uses biologics, medicines that attack proteins or other parts of cancer cells to stop their growth. Not all esophageal cancer can be treated with targeted therapy. Targeted therapy may work for some esophageal cancer near the GEJ. Read more about targeted therapy for esophageal cancer.

Treatment for late-stage esophageal cancer

Unfortunately, many cases of esophageal cancer are not identified until the cancer has advanced. Some of these tumors cannot be removed surgically. Treatment for advanced esophageal cancer include:

• Chemotherapy: For advanced cancer, chemotherapy can help control the growth of cancer cells to keep you more comfortable and make swallowing easier.
• Esophageal stents: If a tumor is blocking your esophagus and it cannot be removed surgically, your doctor might recommend an esophageal stent. A stent is a tube made of metal, silicone or plastic. Your doctor will use an endoscope to place it in the esophagus to hold it open so that you can swallow soft foods and liquids.

Contact Us

To schedule an appointment with the UCLA Gastrointestinal Oncology Program, please call the UCLA Cancer Hotline at 888-ONC-UCLA (888-662-8252) Monday through Friday, 9am to 5pm, or our Physician Referral Service at 1-800-UCLA-MD1 (310-825-2631).