Cancer starts when cells in the body change (mutate) and grow out of control. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them and die when your body doesn't need them any longer.

Cancer is made up of abnormal cells that grow even though your body doesn't need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasize).

Esophageal cancer is cancer that starts in the cells that make up the lining of your esophagus.

The esophagus is a tube that's part of the digestive tract. It carries food and liquid from your mouth to your stomach. In adults, it’s about 10 to 13 inches (25 to 33 centimeters) long. The esophagus is behind the windpipe (trachea) and in front of your spine.

When you swallow, the esophagus tightens and relaxes. This causes “waves” along the tube. This motion moves food down into your stomach. Glands in the esophagus make mucus to keep the lining moist and make swallowing easier.

The wall of the esophagus has many layers that include connective tissue and muscle. The innermost lining is called the mucosa. It is made up mainly of thin, flat cells called squamous cells.

If stomach acid backs up into the lower part of the esophagus (acid reflux) over a long time, the squamous cells can be replaced by glandular cells. These cells make mucus and other fluids to try to protect the lower part of the esophagus. This change is called Barrett's esophagus.

The lower end of the esophagus connects to the stomach at the gastroesophageal junction (GEJ).

There are 2 main types of esophageal cancer:

• Adenocarcinoma. These are cancers that start in glandular cells. In the U.S. and other Western countries, most esophageal cancers are adenocarcinomas. These cancers normally start in the lower third of the esophagus where gland cells have replaced squamous cells. (This is what happens in Barrett's esophagus.)

• Squamous cell carcinoma.  These cancers start in squamous cells. This type of cancer can start anywhere along the esophagus.

There are other types of esophageal cancer, but they are very rare.

Adenocarcinoma of the esophagus often starts in people with Barrett's esophagus. Still, most people with Barrett's esophagus never get esophageal cancer.

Over time, the gland cells that replace the squamous cells can develop dysplasia. This is when glandular cells start to look abnormal and grow in an abnormal way. Esophageal dysplasia is a precancer. If not treated, over time these cells can become cancer.

Both types of esophageal cancer start in the inner lining of the esophagus. As these cancers grow, they often narrow the opening in the center of the esophagus. (This opening is called the lumen.) This can cause problems with swallowing.

The cancer can also grow outward, through the layers of the esophagus to nearby tissues. These include nearby lymph nodes and the windpipe. Once the cancer has grown outside the esophagus, it can also spread to other parts of your body. It may spread to other organs, like your spine, liver, or lungs.

If you have questions about esophageal cancer, talk with your healthcare provider. They can help you understand more about this cancer.

Esophageal cancer often doesn’t cause symptoms in its early stages, when it's small and hasn't spread. When this cancer does cause symptoms, they’re often like those you might have with other health issues, such as indigestion.

Early symptoms of esophageal cancer might be:

• Trouble swallowing. Swallowing dry solid foods, such as meat, bread, or raw vegetables may be especially hard.

• Pain when swallowing

• Pressure or burning in your chest (behind your breastbone)

• A feeling that food is stuck in your throat

• Weight loss

• Heartburn

• Indigestion

• Frequent choking

As esophageal cancer gets worse and the tumor grows, symptoms can become more severe. You may have:

• Trouble swallowing liquids

• Trouble swallowing saliva

• Hoarseness

• Coughing

• Vomiting

• Black stool, which is caused by bleeding in the esophagus

Many of these symptoms can be caused by other health problems. It’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have esophageal cancer or some other problem that may need to be treated.

You may have questions and concerns about your treatment choices. You may also want to know how you’ll feel, how your body will look and work after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. Your provider can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. Your healthcare provider may suggest a specific treatment. Or you may be offered more than one choice and have to decide on which you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your choices. You may want to get a second opinion before deciding on your treatment plan. And you may want to involve your family and friends in this process.

For some esophageal cancers, the goal of treatment is to cure the cancer. If a cure isn’t possible, you may get treatment to help shrink the tumor. Or treatment may keep it under control for as long as possible. Treatment can also improve your quality of life. It does this by helping to control the problems caused by the cancer, like bleeding or trouble swallowing. The goals of treatment include:

• Removing or destroying the cancer in the esophagus

• Removing or destroying tumors in other parts of your body

• Killing or stopping the growth or spread of esophageal cancer cells

• Preventing or delaying the cancer's return

• Easing symptoms from the cancer. These can include pain, trouble swallowing, or pressure on other organs.

Many kinds of treatment can be used for esophageal cancer. You may get a combination of different treatments. The treatments used depend on a number of factors, such as: 

• The type of esophageal cancer

• Where the cancer is in the esophagus

• The stage (extent) of the cancer (how big it is and if it has spread)

• Your age

• Your overall health

• Your concerns and preferences

Some of the most common treatments used are listed below.

Researchers are always looking for new ways to treat esophageal cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.

Thinking about treatment choices may seem overwhelming. Ask how you can learn more about your choices. Talk with your healthcare team and loved ones. Make a list of questions. Think about the benefits, risks, and side effects of each choice. Talk about your concerns with your healthcare provider before making a decision.