Esophageal cancer is considered rare, but it has become more common in recent years. Our team is one of few in south Florida experienced in its treatment. We offer complete care, from advanced imaging techniques for diagnosis and staging, to the latest proven treatment options, such as:

  • A multimodality approach combining chemotherapy, radiation and surgery. This combination therapy has been shown to offer better outcomes than surgery followed by adjutant (additional) therapy.
  • Endoscopic and advanced robotic surgery that preserves function of the esophagus and stomach.
  • Proton therapy, a form of radiation therapy that offers fewer side effects and less tissue damage than conventional radiation therapy. Miami Cancer Institute was among the first in the nation to offer proton therapy.

We’re also committed to sharing and applying new knowledge to improve treatment now and in years to come. Miami Cancer Institute is a member of the Memorial Sloan Kettering Cancer Alliance, which aims to improve the lives of cancer patients through dynamic partnerships with other cancer centers and cancer care providers.

What is esophageal cancer?

Esophageal cancer affects the esophagus, a hollow, muscular tube that carries food and liquids from your throat to your stomach. It develops when cells in the lining of the esophagus begin to grow and divide abnormally, forming a tumor, usually in the innermost layer. Esophageal cancer can metastasize (spread) to lymph nodes and other organs.

What are the types of esophageal cancer?

Different types of esophageal cancer begin in different types of cells and can be classified as:
Adenocarcinoma
More than half of new cases of esophageal cancer are adenocarcinoma, and esophageal adenocarcinoma has been becoming more common since the 1970s. It starts in glandular cells, which are not normally present in the lining of the esophagus but can grow there due to a condition called Barrett’s esophagus. Adenocarcinoma occurs mainly at the lower end of the esophagus and the upper part of the stomach.
Squamous cell carcinoma
Squamous cell carcinoma begins when squamous cells (thin, flat cells in the lining of the esophagus) begin to grow uncontrollably. It’s usually located in the upper or middle part of the esophagus.
Small cell carcinoma
By far the rarest kind of esophageal cancer, small cell carcinoma begins in neuroendocrine cells which release hormones into the blood in response to signals from nerves.

What are the risk factors for esophageal cancer?

Some common risk factors are:

  • Age - Esophageal cancer is more common in people aged 50 and older.
  • Gender - Esophageal cancer is more common in men than women.
  • Tobacco use - Use of tobacco in any form, including smokeless tobacco, can increase your risk of esophageal cancer, especially squamous cell cancer.
  • Race - Esophageal adenocarcinoma is more common in white men than men of other races, while squamous cell cancer of the esophagus is more common among blacks.
  • Excessive use of alcohol - Heavy drinking is usually defined as more than 14 drinks per week for men or more than seven for women.
  • Obesity - Being severely overweight increases your risk for esophageal adenocarcinoma.
  • Vitamin deficiencies - Some studies have linked esophageal cancer to deficiencies in beta-carotene, vitamin E, selenium or iron.
  • Ingestion of lye - Accidentally drinking cleaning liquids containing lye may increase your risk of squamous cell esophageal cancer, especially if the accident occurred in childhood.

Certain conditions can increase your risk, including:

  • Barrett’s esophagus - This precancerous condition is often linked with longstanding acid reflux disease and can cause heartburn, regurgitation, difficult swallowing, a chronic dry cough and hoarseness. If you’ve been diagnosed with Barrett’s esophagus, talk to your doctor about how to take care of yourself to help prevent esophageal cancer.
  • Gastroesophageal reflux disease (GERD) - In GERD, the ring of muscle between the esophagus and stomach does not work properly and allows acid and other stomach contents to leak back into the esophagus. Chronic inflammation of the esophagus can result. Severe GERD over many years increases your risk for esophageal adenocarcinoma.
  • Human papillomavirus (HPV) - This group of viruses causes warts and increases the risk of certain kinds of cancer. It can be sexually transmitted. A vaccine is now available that can help prevent HPV if it’s given in early adolescence.
  • Achalasia - In this rare, chronic condition, the valve between the esophagus and stomach does not open properly. Food becomes backed up, which causes the esophagus to stretch and become enlarged.
  • Esophageal webs - These abnormal bands of tissue extend inward into the esophagus, making it difficult to swallow.

What can you do to prevent esophageal cancer?

Although there is no sure way to prevent esophageal cancer, you can take steps to reduce your risk:

  • Quit using tobacco - Smoking and other forms of tobacco use contribute to many health problems, including most cancers. If you need help quitting, talk to your doctor.
  • Limit alcohol use - Quit drinking, or have no more than a drink or two each day.
  • Talk to your doctor about frequent reflux or heartburn - Treating chronic reflux, as in GERD, has been shown to help reduce the risk of esophageal cancer.
  • Maintain a healthy weight - Stay active and eat healthy foods in the right amounts. Your doctor can help you lose weight if needed.

What screening tests are available for esophageal cancer?

Most people don’t need to be screened for esophageal cancer, but if you have Barrett’s esophagus, we recommend screening every three years. The screening uses a long, flexible tube called an endoscope to examine your esophagus. In some cases, we may be able to remove precancerous tissue. We also offer long-term monitoring and support for anyone at high risk for esophageal cancer.

Innovative device targets tumor cells in certain patients with rare and aggressive cancers. Miami Cancer Institute is the first in Florida to receive FDA approval for its use with pleural mesothelioma.
Dr. Rupesh Kotecha Radiation Oncologist
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