gastrointestinal disorders
Esophageal Cancer
Key Points
Alcohol and tobacco are risk factors for squamous cell carcinoma; Barrett esophagus due to chronic reflux (often related to obesity) is a risk factor for adenocarcinoma. Early-stage cancer is typically asymptomatic; initial symptoms are usually progressive dysphagia, which results from significant encroachment on the lumen, and sometimes chest discomfort. Surgery for cure is extensive and often poorly tolerated by older patients and patients with comorbidities. Palliation may involve stenting or endoscopic laser therapy to reduce obstruction and allow oral intake. Overall, survival is poor (5-year survival:<5%) because many patients present with advanced disease. 