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Understanding your risk

The risk of developing esophageal cancer is heightened after the age of 50. 

Like other cancers, your risk depends on many variables, including:

  • family history
  • lifestyle behavior (e.g. smoking and alcohol use)
  • general health
  • Obesity
  • Vitamin deficiencies (beta-carotene, vitamin E, selenium, or iron)
  • gender (esophageal cancer is more common in men than women)
  • Barrett’s esophagus (the long-term reflux of acid from the stomach into the esophagus)
  • Ingestion of lye (from accidental ingestion of cleaning liquids)

Optum’s oncology team offers comprehensive cancer risk assessments and hereditary cancer genetics evaluation programs to help you identify your risk.


  • Trouble swallowing: The most common symptom that worsens as the opening inside the esophagus becomes smaller.
  • Chest pain: Typically associated with the swallowing of food, causing a severe pressure in the middle of your chest.
  • Weight loss: Nearly 50% of people with esophageal cancer will lose weight due to lack of interest in eating (related to dysphagia), or an increase in overall metabolism.
  • Esophageal bleeding: If you are experiencing bleeding in your stool, along with any of the other potential symptoms above, contact your internist immediately.
  • Persistent cough or hoarseness: Usually a symptom of advanced esophageal cancer, hoarseness may be accompanied by frequent hiccuping or vomiting blood.

While many of the symptoms associated with esophageal cancer mimic other medical issues, it is important to be aware of any abnormalities in your health. If you are experiencing a number of symptoms and feel that you are at risk for esophageal cancer, contact your physician immediately for an appointment.

Diagnosing esophageal cancer

In order to properly diagnose esophageal cancer, the following steps may be taken:

  • Upper endoscopy: A type of image guided biopsy that allows doctors to look into the esophagus to determine the presence of cancer which can then be biopsied during the procedure.
  • Imaging Tests and Scans: such as X-Rays, PET scans (positron emission tomography), CT scans (computed tomography), and MRI scans (magnetic resonance imaging) may be ordered to better detect the presence of cancer.

Types of esophageal cancer

  • Adenocarcinoma: The most common form of esophageal cancer in the U.S., this type of cancer starts in the cells of the mucus-secreting glands inside the esophagus.
  • Squamous cell carcinoma: The most common type of esophageal cancer worldwide, this type of cancer begins in the upper and middle areas of the esophagus.
  • Rare types: In addition to the two main types mentioned above, there are other forms including small cell carcinoma, sarcoma, lymphoma, melanoma and choriocarcinoma.


After observing and diagnosing the type of cancer, you will be given treatment options with the guidance of your oncologist.

  • Surgery: including minimally invasive robotic esophagectomy (removal and reconstruction of part or all of the esophagus.)
  • Chemotherapy: chemicals administered in pill or IV form to kill and slow the growth of cancer cells.
  • Radiation therapy: high-powered beams of energy, such as X-rays and protons, that are used to kill and slow the growth of cancer cells.
  • Endoscopic mucosal resection (EMR): minimally invasive technique that may be used during upper endoscopy at very early stages of the cancer to remove the tumor without requiring removal of the entire esophagus.

Medical care and help

To find an esophageal cancer specialist near you, visit our providers page.

Click here to learn more about Optum’s minimally invasive robotic assisted surgery options.

Contact us if you have any questions.