Esophageal Cancer: Types, Risk Factors, and Treatment Overview

Esophageal carcinoma arises from the esophageal mucosa. It is the 8th leading cause of cancer death globally, with male predominance.

Histologic Types

• Squamous cell carcinoma (~90% globally): upper/mid esophagus; linked to smoking, alcohol, hot beverages, HPV.
• Adenocarcinoma (rising in West): distal esophagus/GE junction; linked to GERD, Barrett's esophagus, obesity.
• Rare: Small cell, sarcoma, melanoma.

Risk Factors

Tobacco, alcohol, obesity, poor diet (low fruit/veg), achalasia, caustic injury, genetic syndromes (tylosis).

Treatment by Stage

• Early: Endoscopic resection (EMR/ESD) or surgery.
• Locally advanced: Neoadjuvant chemoradiation → surgery (trimodal).
• Metastatic: Systemic chemo ± targeted therapy (trastuzumab for HER2+, ramucirumab) ± immunotherapy (pembrolizumab for PD-L1+).

Prognosis depends heavily on stage at diagnosis; early detection via endoscopy in high-risk groups improves survival.