What is an Esophageal Adenocarcinoma?

Esophageal adenocarcinoma is a common type of cancer which develops in the distal or lower portion of the esophagus. The esophagus, part of the digestive system, is a long tube connecting the mouth and the stomach, and functions as a passageway for food and liquid. This cancer usually originates in the glands located along the junction of the esophagus and the stomach. This type of cancer is more common in men than in women, and most esophageal adenocarcinomas are seen in older people between the ages of 60 and 70.

There are many factors which increase the risk for the development of esophageal adenocarcinoma. These include smoking, drinking alcoholic beverages, and ingestion of toxic substances such as acids or alkalis. The most important risk factor however, is gastroesophageal reflux diseases (GERD), which can complicate into Barrett's esophagus.

In GERD, stomach acids move up into the esophagus, causing irritation in the cells of the lining. When this occurs frequently, Barrett's esophagus can develop. This condition is diagnosed when cells lining the esophagus have been altered abnormally by frequent irritation, and have transformed to look more like the cells lining the stomach. With Barrett's esophagus, the esophagus can bleed and ulcerate, and worse, it can progress into an esophageal adenocarcinoma.

Dysphagia, or difficulty swallowing solid foods and eventually liquids, is commonly seen in patients with esophageal adenocarcinoma as the disease progresses. Other symptoms include pain when swallowing, hoarseness of voice, regurgitation of food, and weight loss. Some patients also vomit blood and have blood in the stool.

Tests frequently done in the evaluation of patients suspected of having esophageal adenocarcinoma include computed tomography (CT) scan, endoscopic ultrasound, and barrium swallow. An esophagogastroduodenoscopy, a procedure where an endoscope or a thin tube with light and camera is inserted in the mouth, may also be performed. This is usually done to visualize the esophagus and collect tissue samples for staging of the cancer.

Treatment for esophageal adenocarcinoma usually depends on the stage of the cancer. If the cancer has not spread to other parts of the body, the ideal treatment is surgery to remove the section of the esophagus where the cancer is found. Chemotherapy and radiation therapy are frequently beneficial after surgery. Most patients, however, are diagnosed late in the disease when the cancer has spread, and this often presents with a poor prognosis. The course of treatment at this stage is often focused on relieving symptoms and providing comfort for the patient.