Esophageal cancer begins when abnormal cells in the esophagus grow and divide in an uncontrolled way. Because every patient’s situation is unique, our team at Illinois CancerCare focuses on early detection, accurate diagnosis, and personalized treatment plans designed to give you the best possible outcome. The two most common types are adenocarcinoma and squamous cell carcinoma, which tend to occur in different parts of the esophagus and have different risk factors.  

Understanding the Esophagus 

The esophagus is a muscular tube that carries food and liquids from the throat to the stomach. Its wall has several layers—mucosa, submucosa, muscle, and connective tissue—and cancer typically begins in the inner lining, growing outward over time. 

  • Squamous cells line the upper and middle esophagus. 
  • Glandular cells near the lower esophagus can become adenocarcinoma, often associated with chronic acid reflux or Barrett’s esophagus. 

Types of Esophageal Cancer 

Adenocarcinoma

Most common in the U.S., usually forming in the lower esophagus near the stomach. 

Squamous cell carcinoma  

More common in the upper and middle portions of the esophagus. 

Rare types

Small cell carcinoma, sarcoma, lymphoma, melanoma (very uncommon). 

Signs & Symptoms

Early esophageal cancer may cause no symptoms. As the tumor grows, symptoms can include: 

  • Difficulty or painful swallowing (dysphagia) 
  • Unexplained weight loss 
  • Chest discomfort or pain after swallowing 
  • Chronic cough or hoarseness 
  • Indigestion or persistent heartburn 

These symptoms can be caused by other conditions, but should be discussed with your clinician. 

Risk Factors

  • Tobacco use 
  • Heavy alcohol use 
  • Barrett’s esophagus (due to chronic gastroesophageal reflux disease / GERD) 
  • Obesity 
  • Older age 
  • Male sex 
  • Diet low in fruits/vegetables; high in processed meat

The most common risk pattern in the U.S. is adenocarcinoma linked to longstanding reflux and Barrett’s esophagus, especially in men. 

Prevention

Many colorectal cancers are preventable:

  • Avoid tobacco and limit alcohol 
  • Maintain a healthy weight 
  • Manage acid reflux/GERD and follow your clinician’s recommendations for surveillance of Barrett’s esophagus 
  • Eat a diet rich in fruits and vegetables 

Screening

There is no standard screening test for people at average risk. Screening may be recommended if you have: 

  • Barrett’s esophagus 
  • Chronic, longstanding GERD 
  • Certain other risk factors 

Screening evaluations may include upper endoscopy to assess the lining of the esophagus. 

Diagnosis

To diagnose esophageal cancer, your care team may use: 

(often polyp removal at the same time)

(gold standard for diagnosis) 

to evaluate tumor depth and lymph nodes

to assess spread. These tests help determine cancer type, stage, and treatment planning.

Staging

Esophageal cancer is staged using the TNM system (tumor size/depth, lymph node involvement, and metastasis). Broadly: 

Stage 0

Highgrade dysplasia; abnormal cells limited to inner lining 

Stage I

Tumor limited to shallow layers of the esophagus

Stage II-III

Deeper growth into the wall, nearby nodes may be involved

Stage IV

Cancer has spread to distant organs

Your care team will explain your stage and what it means for treatment. 

Treatment Options

Treatment is personalized based on stage, cancer type, location, overall health, and your goals. Care is coordinated by a multidisciplinary team. 

EarlyStage Cancer or HighGrade Dysplasia 

  • Endoscopic therapies:  
  • Endoscopic mucosal resection (EMR) 
  • Ablation procedures 
  • Esophagectomy (in select cases) 

Locally Advanced Cancer 

Often treated with multimodality therapy, such as: 

  • Chemoradiation, followed by surgery 
  • In some cases, chemoradiation alone if surgery isn’t an option 

Advanced/Metastatic Disease 

  • Chemotherapy 
  • Targeted therapies (depending on tumor biomarkers) 
  • Immunotherapy, especially for certain tumor types 
  • Palliative interventions (stents, radiation, or systemic therapy) to relieve symptoms 

Your Illinois CancerCare team will discuss the benefits, risks, and timing of each treatment—and whether a clinical trial may be appropriate for you.  

Prognosis

Prognosis depends on stage at diagnosis, tumor type, location, overall health, and response to treatment.  Across the U.S., the 5year relative survival is approximately 22%, with significantly better outcomes for earlystage disease.

Your physician will explain what your individual factors mean for your outlook.

Follow Up Care

After treatment, follow-up typically includes: 

  • Physical exams 
  • Symptom review 
  • Imaging 
  • Endoscopic evaluation when appropriate 

Your followup schedule is personalized based on your diagnosis and treatment plan.Shape 

Living With Esophageal Cancer 

Illinois CancerCare offers comprehensive support, including: 

  • Counseling and psychosocial support 
  • Nutrition consultations (important for swallowing and weight maintenance)
  • Survivorship programs 
  • Caregiver resources 
  • Access to clinical trials 

National cancer organizations (including ACS) also offer education, support groups, and practical resources.  

Why Choose Illinois CancerCare

  • Experienced multidisciplinary team specializing in GI cancers 
  • Advanced diagnostic imaging and endoscopic capabilities 
  • Access to innovative treatments and clinical trials 
  • Compassionate, patient-centered care focused on your goals and quality of life 

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).