Esophageal Cancer - a Rare, but Fatal Cancer

Written by Dr. Saumya Mittal and medically reviewed by iCliniq medical review team.

Image: Esophageal Cancer - a Rare, but Fatal Cancer

Carcinoma of the esophagus is a rare, but fatal carcinoma. It is more prevalent in the males than in females. It is commonly seen in the lower socioeconomic group.

Types of Esophageal Carcinoma:

The two main types of esophageal cancer are,

  1. Squamous cell carcinoma - incidence is reducing gradually.
  2. Adenocarcinoma - incidence is increasing gradually.


The causes of esophagus cancer are excess alcohol intake and smoking (synergist role), carcinogen exposure such as nitrates, smoked opiates and fungal toxins, mucosal damage like ingestion of tea, lye and exposure to radiation, chronic achalasia, chronic gastric reflux, Plummer-Vinson syndrome, tylosis palmaris et plantaris (palmoplantar keratosis), dietary deficiencies of zinc, molybdenum, and selenium and celiac disease.

Esophageal Carcinoma Predisposition:

  1. Cervical esophagus - 10%.
  2. Middle esophagus - 35%.
  3. Lower esophagus - 55%, the most common.

Clinical Features of Esophageal Carcinoma:

Progressive dysphagia and weight loss in short duration. Dysphagia more for solids than liquids and soft diet and odynophagia, the pain may radiate to chest or back. Also, emesis, aspiration pneumonia, lymphadenopathy (supraclavicular lymph node) and metastasis (lung, pleura, bone, liver) and hypercalcemia, a feature of squamous cell carcinoma.

Achalasia may have to be ruled out in cases of malignant tumor, due to the presence of ulcerations. Ulcerations are not commonly seen in benign tumors.


  • Chromoendoscopy- Lugol's iodine (for squamous cell carcinoma) and methylene blue (for adenocarcinoma) is recommended in areas of high prevalence of carcinoma of the esophagus.
  • Endoscopy (especially to rule out small resectable tumors) and cytological screening (multiple biopsies of at least 4-8 to increase the yield) are essential.
  • CT chest and abdomen and EUS (endoscopic ultrasound scan) are used to detect spread to mediastinum and lymph nodes.
  • USG neck to detect lymph nodes in the neck.
  • Bronchoscopy to detect tracheoesophageal fistulas that are commonly formed in this condition.
  • PET scan to help assess the resectability.


1) Surgical Resection:

  1. Endoscopic mucosal resection.
  2. Esophagectomy by various approaches.

2) Chemotherapy:

Cisplatin (platinum) containing chemotherapy.

3) Palliative Therapy:

  1. Management of malnutrition.
  2. Management of tracheoesophageal fistula.
  3. Management of dysphagia.
  4. Repeated endoscopic dilatation.
  5. Gastrostomy or jejunostomy.
  6. Expansive metal stent.
  7. Endoscopic fulguration of tumors by lasers.

Attempted chemoradiotherapy followed by a surgical resection may yield better results.

Barrett's esophagus:

Barrett's esophagus is a premalignant condition. There is no reliable non-histological marker of developing carcinoma or dysplasia. Bisphosphonates may increase the occurrence of Barrett's esophagus.

To know more about esophageal cancer, consult an esophageal cancer specialist online -->

Last reviewed at: 07.Sep.2018



Do you have a question on Cancer or Squamous Cell Carcinoma?
* guaranteed answer within 4 hours.

Related Questions & Answers

Is there any medicine to overcome the effects of alcohol?
Query: Hi doctor, I am contacting you regarding an uncle of mine. He is 40 years old. His health issues are related to alcohol (beer). He drinks quite a few times a week. When he starts drinking, he drinks a few liters before stopping. He also smokes, but only sometimes. He finds heavy breathing after ju...  Read Full »
Dr. Salah Saad Shoman
Internal Medicine Physician

Answer: Hi, Welcome to Alcoholism is now acknowledged as a disease that requires a combined treatment (medications, psychological and social intervention). Medications to increase tolerance of the patient to alcohol as Iomazenil are not very much recommended as they tend to increase the patien...  Read Full »
Cervical Cancer - Causes and Prevention
Article Overview: Estimates suggest that by 2025 more than 365 women will die due to cervical cancer everyday. Cervical cancer is caused by HPV (Human Papilloma Virus ) and mainly affects young women.  Read Article »
Dr. Kamalpreet Kaur Nagpal
Obstetrician And Gynaecologist

Trivia: Estimates suggest that by 2025 more than 365 women will die due to cervical cancer every day. Cervical cancer is the second largest cancer affecting women's health. What Causes Cervical Cancer? Cervical cancer is caused by HPV (Human Papilloma Virus ) and mainly affects young women. ...  Read Article »
What treatment can cure well-differentiated squamous cell carcinoma?
Query: Hi doctor,My mother is suffering from well-differentiated squamous cell carcinoma. Her age is between 55 to 60. What treatment can cure her?  Read Full »
Dr. Arshad Hussain Shah
Medical Oncologist

Answer: Hi, Welcome to I can understand your concern, the report of your mother is clearly showing a food pipe cancer (attachment removed to protect patient identity). This cancer has not been staged yet. So she will have to undergo some more investigations including PET/CT scan, transesophag...  Read Full »

Ask a Doctor Online

* guaranteed answer within 4 hours

Related Tags