Types of Esophageal Cancer

Esophageal cancer has 2 main types. Each type is categorized by how the cancer cells look under a microscope:

Esophageal Adenocarcinoma
This type of cancer forms in the gland cells that live in the lining of the esophagus and make mucous for the esophagus. Adenocarcinomas typically begin in the bottom third of the esophagus. It is the most common type of esophagus cancer, accounting for about 75% of cases in the United States.  It is associated with obesity and acid reflux.

Squamous cell carcinoma
Squamous cell carcinomas begin in the thin, flat squamous cells that line the esophagus. While they can occur anywhere in the esophagus, they tend to develop more often in the sections contained in the neck and upper chest compared to esophageal adenocarcinoma. These types of cancers account for about 25% of esophagus cancers in the United States, and are associated with conditions felt to cause chronic irritation of the esophagus such as smoking and alcohol use.  This type of cancer is also the type most commonly found in other parts of the world, such as in Asia.

Other factors in diagnosis and treatment planning
There are additional considerations beyond type and subtype that affect recommendations your care team may make for treatment.  The most important consideration that directs the treatment strategy is the stage, which is discussed in the section below.  However, other characteristics that can impact both treatment and prognosis include:

• Tumor size offers clues about how quickly the tumor may have developed and how likely it is to spread. Larger cancers are more likely to progress to the lymph nodes.
• Grade assigns a numeric value between 1 and 3 to describe how abnormal the cancer cells appear under the microscope. The the higher the number the more aggressive the cancer is. Lower numbers are usually is associated with a slower growth.