Esophageal Cancer

Experts from the Penn Medicine | Virtua Health Cancer Program offer groundbreaking treatments for esophageal cancer, including proton therapy, immunotherapy, and robotic surgery.

Esophageal Cancer Symptoms and Risk Factors

Esophageal cancer affects the esophagus, the muscular tube that carries food from your mouth to your stomach. While it's a serious diagnosis, early detection can lead to successful treatment.

What are the symptoms of esophageal cancer?

Early-stage esophageal cancer often has no symptoms. However, as it progresses, you might experience:

• Trouble swallowing (dysphagia): This can start with feeling like food gets stuck in your throat, gradually progressing to difficulty swallowing liquids.
• Heartburn and indigestion: Often, these symptoms will persist and worsen.
• Chest pain: This can be a burning or squeezing sensation, especially when swallowing or lying down.
• Weight loss: Difficulty swallowing can make eating a challenge, leading to unintentional weight loss.
• Chronic cough or hoarseness: These symptoms can occur if the tumor irritates the vocal cords or airways.

If you’ve been experiencing these symptoms, see your primary care provider (PCP) or gastroenterologist for further evaluation.

Who is at risk for esophageal cancer?

The cause of esophageal cancer is often unknown. However, certain factors increase your risk of developing the disease:

• Age: Your risk increases if you’re age 55 or older.
• Barrett's esophagus: This precancerous condition develops in some people with GERD.
• Being overweight or obese: Excess weight is associated with an increased risk of esophageal cancer.
• Gender: Esophageal is more common in men than women
• GERD (gastroesophageal reflux disease): Chronic heartburn and acid reflux can damage the esophageal lining, increasing your cancer risk.
• Heavy alcohol consumption: Excessive alcohol intake, especially combined with smoking.
• Smoking and tobacco use: These significantly increase your risk for esophageal cancer.

Types of Esophageal Cancer

Esophageal cancer most frequently occurs in the inner lining of the esophagus. The two most common types of esophageal cancer include:

• Adenocarcinoma: These cancers usually form in the cells in the lower part of the esophagus.
• Squamous cell carcinoma: These cancers usually form in the upper part of the esophagus and are linked to lifestyle factors such as smoking and alcohol use.

Esophageal Cancer Diagnosis at Virtua

If you have any of these symptoms or risk factors, your doctor might recommend testing, including:

• Endoscopy: Examining the esophageal lining by inserting a thin, flexible tube with a camera into your esophagus.
• Biopsy: Taking a small tissue sample during endoscopy for examination under a microscope.
• Imaging tests: Using PET scans to help stage cancer and detect metabolic changes in a tumor.

If cancer is found, you’ll be connected with a Virtua oncology nurse navigator. Our nurse navigators provide personalized support before, during, and after cancer treatment to help you understand your diagnosis, streamline communications and scheduling, and connect you to supportive services.

Esophageal Cancer Treatment at Virtua

Diagnosing and treating esophageal cancer requires a coordinated team of experts to collaborate on all aspects of your care.

Virtua’s esophageal cancer care team includes gastroenterologists, interventional gastroenterologists, thoracic oncologic surgeons, medical oncologists, radiation oncologists, physician assistants, and advanced practice nurses, all specializing in thoracic patient care.

This team reviews your case and works together to develop comprehensive treatment options that work best for you.

What are the treatment options?

Your treatment plan depends on the cancer stage, location, and your overall health.

Common treatment options include:

• Surgery: This may involve removing part of the esophagus or the entire organ, followed by reconstruction. Virtua thoracic surgeons are experts in the latest minimally invasive approaches, including robotic and laparoscopic surgery, which offer benefits like smaller incisions, less pain, shorter hospital stays, and faster recovery.
• Chemotherapy: Chemotherapy uses drugs to destroy cancer cells that may have spread throughout the body. It may be used before or after surgery.
• Radiation therapy: Treatment that uses high-energy X-ray beams to precisely target and destroy cancer cells and shrink tumors.
• Proton therapy: This advanced radiation treatment may be used for tumors near highly sensitive areas or if surgery cannot completely remove a tumor.
• Endoscopic therapies: Minimally invasive procedures like laser ablation or radiofrequency ablation are often used for early-stage esophageal cancer or to keep the esophagus open if you have trouble swallowing.
• Immunotherapy: This treatment uses your body’s immune system to fight cancer. It works by giving the immune system an overall boost or training the immune system to attack specific parts of the cancer cells.

You also may see a registered dietitian who can help ensure you get proper nutrition before, during, and after treatment or work with a speech therapist to help evaluate and care for swallowing issues.