Esophageal cancer starts in the inner layer (the mucosa) and grows outward (through the submucosa and the muscle layer). There are two main types of esophageal cancer:
- Squamous Cell Carcinoma - The surface of the esophagus is normally lined very flat, thin cells called squamous cells. Cancer starting in these cells is called squamous cell carcinoma. This type of cancer that can occur anywhere along the esophagus, but most often occurs in the middle of the esophagus. According to the American Cancer Society, squamous cell carcinoma was once the most prevelant type of esophageal cancer in the U.S. - now it makes up less than half of esophageal cancers.
- Adenocarcinoma - Cancers that start in mucus-secreting glands in the esophagus are called adenocarcinomas. Adenocarcinoma most often occurs in the lower portion of the esophagus, where the esophagus joins the stomach. This is due to the fact that this type of cell is not normally part of the inner lining of the esophagus. Before an adenocarcinoma can develop, gland cells must replace an area of squamous cells, which is what happens in Barrett’s esophagus.
Barrett’s esophagus is a pre-cancerous condition affecting the lining of the esophagus: the swallowing tube that carries foods and liquids from the mouth to the stomach. Barrett’s esophagus is most often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus.
Gastroesophageal reflux disease (GERD) is a disorder in which stomach acid and enzymes cause injury to the esophageal lining, producing symptoms such as heartburn, regurgitation, and chest pain. In some patients with GERD, the normal esophagus cells are damaged. Over time, this damage can result in inflammation and genetic changes that cause the cells to become altered. The tissue takes on a different appearance and microscopically is no longer esophageal tissue, but rather becomes intestinal tissue. This is called “intestinal metaplasia” or Barrett’s esophagus.
Left untreated, it can progress to a dangerous type of esophageal cancer. Garnet Health Medical Center offers Radio Frequency Ablation to patients to treat Barrett’s Esophagus.
Diagnosing Esophageal Cancer
Endoscopic Ultrasound (EUS) is the most common diagnostic procedure for esophageal cancer. This procedure combines ultrasound technology with endoscopy and has become an integral part of the management of a variety of gastrointestinal conditions.
The procedure is similar to an upper endoscopy exam, but the scope is additionally equipped with ultrasound technology to help assess tissues below the surface of the esophagus. The ultrasound component uses sound waves to create a picture of the inside of the body and is used to assess possible tumors of the esophagus, stomach, pancreas, gall bladder and liver, and chest cavity tumors. It is also used to evaluate abdominal pain and diseases of the pancreas, such as pancreatitis, and gallbladder, like gallstones and bile duct obstructions.
The combined medical techniques enhance the physician’s ability to accurately stage gastrointestinal tumors and lung cancers up to 90% and help the patient plan treatment options.