Esophageal Cancer | Miami Cancer Institute | Baptist Health South Florida
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 Esophageal Cancer

At Miami Cancer Institute, we diagnose and treat all stages of esophageal cancer. Our team will provide you with a personalized plan to meet your unique healthcare needs.

Cancer of the esophagus is rare in the U.S., making up only about 1 percent of all cancer cases.  It is more prevalent in men than in women, and it starts in the lining of the esophagus, the passageway that carries food from your throat to your stomach. There are two main types of esophageal cancer: Squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma can happen in any part of the 10-13 inches that comprise the esophagus, and it begins in the thin flat cells that line the esophagus. Adenocarcinoma starts in the gland cells, most often in the lower part of the esophagus near the stomach. Cancers such as lymphomas, melanomas and sarcomas can also occur in the esophagus, but are extremely rare.

Causes of Esophageal Cancer

Like in many cancers, the causes of esophageal cancer are not completely clear. Researchers believe that repeated irritation of the esophagus can increase the risk of cancer. Some of the irritants are alcohol, hot liquids, smoke from cigarettes or cigars, gastroesophageal reflux disease (GERD), reflux and being obese. People with Barrett’s esophagus—precancerous changes in the esophagus’ cells caused by chronic acid reflux—are at a greater risk for cancer of the esophagus.

Symptoms of Esophageal Cancer

Symptoms may vary significantly from patient to patient. The most common are:

  • Difficulty swallowing
  • Burning sensation, pressure or pain in the chest
  • Weight loss that cannot be explained
  • Worsening of heartburn or indigestion
  • Chronic cough, hoarseness and hiccups
  • Fatigue caused by anemia as a result of bleeding inside the esophagus.
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Your medical team at Miami Cancer Institute will request a wide range of tests to confirm your diagnosis of esophageal cancer. The team will be happy to answer any questions you may have regarding your tests and your diagnosis.

The most common tests are:

  • Physical exam – Your doctor will examine you and will perform a full body scan looking for signs of disease or anything that might seem abnormal or out of the ordinary.
  • Imaging tests, such as X-rays, CT, MRI, and PET scans.
  • Biopsy – A sample of cells or tissue is collected and examined by a pathologist under a microscope to check for signs of cancer.
  • Barium swallow test – The patient drinks a liquid that covers the esophagus lining and through X-rays shows the shape of this lining.
  • Endoscopic ultrasound – A thin tube with a camera on the end is inserted through the throat into the esophagus and the stomach. This allows doctors to clearly see the esophagus walls and to obtain tissue samples for a biopsy.
  • Bronchoscopy – Sometimes used to determine whether the cancer has spread from the esophagus to the trachea.
  • Laparoscopy or thoracoscopy – Under general anesthesia, doctors look for lymph nodes in your chest (through a thoracoscopy) or in your abdomen (laparoscopy). Some tissue may also be obtained for a biopsy.

Doctors will also determine the stage of your cancer—from stage I, which happens in the outer layers of the esophagus, to stage IV, which means the cancer has spread to other areas of your body. Once your healthcare team reviews the results of all your tests, they will discuss all your treatment options with you.

If you’ve been diagnosed with esophageal cancer, you’ve already had several tests that help your care team determine the best course of treatment.  Every person is different, and even two people with the same diagnosis may have very different treatment plans. Your plan will depend on several factors, including the location of your tumor, its growth rate and your overall health.

Miami Cancer Institute offers unique treatments for esophageal cancer, including robotic surgeries that allow doctors to spare the function of the esophagus and stomach. Another very promising breakthrough is the proton therapy. This type of advanced radiation therapy spares healthy tissue and eliminates many of the side effects of conventional radiation treatment (also known as photon therapy or external beam therapy). While traditional X-rays pass through healthy tissues and organs on the way in and out of the body, protons travel through the body and release most of their energy within the tumor.  The use of proton therapy reduces the risk of damage to bones and soft tissue, reduces side effects, and the likelihood of developing other tumors later in life. Soon, with the opening of the Proton Therapy Center at Miami Cancer Institute, the Center will become the only in its class in the region, and only one of 14 in the United States.

Other treatments may include (alone or in combination):

  • Surgery – To remove even the tiniest tumors, part of the esophagus or a part of the esophagus together with the upper portion of the stomach
  • Radiation therapy – Proton and photon treatments
  • Chemotherapy
  • Targeted therapy with drugs that destroy specific types of cancer cells
  • Clinical trials – Every day, scientists are working to develop new and innovative treatment options for esophageal cancer. Your healthcare team will discuss with you if a clinical trial is a good option for you.
  • During your treatment you will likely have a lot of questions. Long-term follow up is important and our team at Miami Cancer Institute will be with you every step of the way.