Esophageal cancer caused >0.6 million new cases and 0.54 million deaths globally in 2020 (11th most common cancer worldwide).
Types of Esophageal Cancer
• Adenocarcinoma: Most common in US. Arises in lower esophagus glandular cells; linked to GERD acid reflux & Barrett's esophagus.
• Squamous Cell Carcinoma (SCC): Most common in India & globally. Arises in upper/middle esophagus squamous cells; linked to tobacco, alcohol, and hot liquids.
Risk Factors & Red Flags
Risk factors: Age >55, Male (3X risk), hot beverage habit, GERD, Barrett's esophagus, low fruit/veg diet, obesity, chest radiation, dry cleaning solvent exposure, achalasia, tylosis.
Symptoms: Persistent cough/hoarseness, dysphagia (difficult swallowing), indigestion/heartburn, chest burning, unexplained weight loss, food regurgitation.
Diagnostics & Surgical Staging
Diagnostics: Upper endoscopy (EGD), Endoscopic Ultrasound (EUS), Biopsy, CT scan, Barium swallow X-ray study, Bronchoscopy, PET scan.
Treatment: Surgery (Esophagectomy, EMR/ESD endoscopic resection), Chemotherapy (neoadjuvant/adjuvant), Radiation therapy (External beam/IORT), Targeted TKIs, and Immunotherapy checkpoint inhibitors.