Esophageal Cancer

Esophageal cancer affects nearly 18,000 people in the U.S. each year. Early detection is key, and recognizing the signs can make a difference in your treatment. 

At the UCI Health Chao Digestive Health Institute, we know that a diagnosis of esophageal cancer can be overwhelming. That's why we're here — to walk you through every step of the way, offering expert, compassionate care designed around you. 

Our team brings together leading-edge diagnostics, advanced treatment options and a deep commitment to healing — not just your condition, but your whole self. 

Symptoms of esophageal cancer

Esophageal cancer in its earliest, most treatable stages typically causes no signs or symptoms, which is why physicians recommend you schedule preventive screenings of the esophagus.

If you experience any of these, contact your physician. Early evaluation could change your outcome.

At later stages of development, symptoms may include:

• Persistent indigestion or heartburn
• Chest pain, pressure or burning
• Coughing or hoarseness
• Trouble swallowing (dysphagia)
• Frequent choking while eating
• Coughing up blood
• Unexplained weight loss

Risk factors for esophageal cancer

• Chronic acid reflux (GERD) or Barrett's esophagus
• Tobacco or alcohol use
• Obesity and diet-related concerns
• Prior radiation exposure to the chest or abdomen
• Male gender, particularly between ages 45 and 75

Types of esophageal cancer

Two types of esophageal cancers account for more than 90% of all cases:

• Squamous cell carcinoma grows in the squamous cells that line the long tubular muscle connecting the throat to the stomach.
• Adenocarcinoma develops in the mucus-producing glands in the lower part of the esophagus. It spreads to the esophageal lining as precancerous lesions that are the hallmark of Barrett’s esophagus. Note that when caught early, Barrett's esophagus is completely treatable.

Esophageal cancer diagnosis at UCI Health

If you are concerned about esophageal cancer, the first step is to schedule a screening with an esophageal specialist at UCI Health.

Testing may include:

• Upper endoscopy (EGD)
• Barium swallow imaging
• Endoscopic ultrasound
• Biopsy with expert pathology review
• Advanced imaging techniques like zoom magnification and endomicroscopy

If cancer cells are found, your esophageal disease expert will determine the extent, or stage, of the cancer:

Stage I — Only the top layer of esophageal lining is involved

Stage II — Cancer cells have penetrated into the lining and may have spread to adjacent lymph nodes

Stage III — The cancer has spread to the deepest layers of the esophageal wall and to adjacent tissues or lymph nodes

Stage IV — The cancer has spread to other parts of your body

Esophageal cancer treatment at UCI Health

Treatment depends on the type and stage of your cancer, as well as your age and health. 

Options may include surgery to remove some or all of the esophagus, often in combination with radiation therapy and/or chemotherapy. 

You may be a candidate for a drug therapy that targets a protein called HER2 found in certain types of esophageal cancer cells.

Surgical treatments

• Endoscopic mucosal resection (EMR): Early-stage cancers that are small and limited to the top layer of the esophageal lining can be removed using an endoscope. You would then take drugs called proton pump inhibitors to reduce stomach acid production.
• Esophagectomy: If the cancer has penetrated deeper layers and spread, your surgeon may recommend removal of the diseased part of the esophagus and nearby lymph nodes. The remaining part of the esophagus is reconnected to the stomach.
• Esophagogastrostomy: Depending on the spread of the cancer, your surgeon may recommend removal of part of the esophagus and the uppermost part of the stomach, along with lymph nodes. The remainder of the esophagus is reattached to the remainder of the stomach, sometimes using a portion of the colon to rejoin the organs.

Endoscopic treatments

• Radiofrequency ablation (RFA): An endoscope equipped with electrodes delivers an electric current to the cancerous cells, killing them with heat. Regular screening for a recurrence is needed along with a drug regimen to block stomach acid production.  
• Laser ablation: An endoscope equipped with a laser can help open the esophagus blocked by an advanced tumor. The laser can destroy the tumor, but it often grows back, requiring additional treatments.
• Photodynamic therapy (PDT): A light-activated drug is injected into a vein. After a few days, when the drug gathers in the cancerous tissue, an endoscope equipped with a special type of laser is passed down the throat into the esophagus. The laser light activates a chemical in the drug that destroys cancer cells. This procedure does little harm to healthy tissue, but it does not penetrate to deeper tumors.

Why choose UCI Health for esophageal cancer care?

Nationally recognized care

We are ranked among the best by U.S. News & World Report for gastroenterology and GI surgery. This means that you receive some of the highest-ranked care in the region provided by world-class physicians. 

Expertise in minimally invasive procedures 

Our UCI Health esophageal disease specialists use the most advanced and least-invasive techniques to help you feel better. This means lower complication rates, resulting in shorter hospital stays.

Our board-certified physicians are leaders in laparoscopic and endoscopic techniques. They train other physicians n the latest methods and technologies, including robot-assisted surgical procedures.

Collaborative team

Gastroenterologists, oncologists, surgeons, nurses and support staff work closely together — all centered on you. 

We treat you as a whole person and not a collection of symptoms. We determine the best treatment for you based on type and stage of the cancer you have, as well as your health and overall lifestyle goals.

Convenient locations

Expert care is available in both Orange and Irvine. Our medical offices include our newest facilities in Irvine: The Joe C. Wen & Family Center for Advanced Care and the Chao Family Comprehensive Care Center.