Cervical esophageal cancer (CEC) affects the upper esophagus. Smoking and heavy drinking are major risk factors for this condition. Treatment may involve chemotherapy, radiation therapy, surgery, or a combination.

CEC is a type of cancer that begins in the upper esophagus, from the bottom of the throat to the indentation between the collarbones. According to a review in the journal Annals of Oncology, the condition is uncommon, making up 2–10% of esophageal cancers.

This article discusses the symptoms, causes, and risk factors of esophageal cancer. It outlines how doctors diagnose and treat CEC and the outlook for people with this condition.

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As cancer develops, it may start affecting bodily functions. The National Cancer Institute lists the following symptoms of CEC:

  • weight loss
  • pain or difficulty when swallowing
  • pain in the area behind the breastbone
  • indigestion
  • heartburn
  • hoarseness
  • a cough
  • a lump or growth under the skin

Research notes that a person may not experience symptoms in the early stages of the disease.

Scientists are unsure how genetic changes cause CEC. All cancers arise due to genetic changes, which cause cells to grow and divide abnormally. People can inherit these changes or acquire them during their lifetime.

Although the genetic basis of CEC remains unknown, scientists have identified several risk factors. These factors increase the risk of developing this cancer, although it is not inevitable.

CEC risk factors include:

CEC is more prevalent in certain parts of the world, including Iran, Central Asia, and Northern China, suggesting that nutritional and environmental factors may play a role.

Learn more about esophageal cancer risk factors.

Doctors may recommend the following tests if they suspect CEC:

  • Endoscopy: Doctors use an endoscope to examine the esophagus for any signs of cancer. An endoscope is a thin tube with a camera and light at one end.
  • Biopsy: A doctor removes a sample of cells that look irregular from the esophagus before sending it to a laboratory for identification.
  • Endoscopic ultrasonography: This test uses an endoscope with an ultrasound probe. Doctors use this to form detailed ultrasound images of the cervical esophagus. This test helps determine how deeply tumors have grown into the cervical esophagus and its lymph nodes.
  • CT scan: Doctors use a CT scan to check whether cancer has spread to nearby organs or distant lymph nodes.
  • Bronchoscopy with endobronchial ultrasound: This involves placing a bronchoscope within a person’s lungs. Bronchoscopes are thin tubes that can enter the airways. When doctors attach an ultrasound probe to the bronchoscope, they can determine whether cancer has spread to the lungs.

Doctors can also use these tests to stage CEC. Because this cancer can be asymptomatic, 55% are either stage 3 or 4 at the time of diagnosis. Roughly 27% are stage 2.

Learn more about tests for esophageal cancer.

Cancer resources

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Several treatment options are available for those with CEC, which doctors may recommend in combination.

  • Radiation therapy: Radiation therapy uses radiation beams to kill cancer cells. A radiographer directs the radiation toward the tumor, aiming to avoid healthy cells. According to a 2018 review, radiation therapy can cure CEC while maintaining good esophageal function.
  • Chemotherapy: As a 2021 study explains, doctors can also use chemotherapy to treat CEC. Chemotherapy uses medications that rapidly kill cancer cells to stop them from growing and multiplying.
  • Surgery: Surgeons can remove tumors from the upper esophagus. According to a 2022 study, surgery alone improves the long-term survival of people with CEC, compared with combined chemotherapy and radiation therapy.

Learn more about esophageal cancer treatments and their success rates.

The survival rate for CEC is relatively low. An older 2016 review reports that if treatment is initially successful, the 2-year survival rate is 60%, meaning 60% of people will be alive 2 years after diagnosis. The 5-year survival rate is 40%.

The same review reports that individuals may not survive longer than 20 months if treatment is unsuccessful.

Learn more about the life expectancy for esophageal cancer.

CEC begins in the upper esophagus and can cause various symptoms, such as weight loss, indigestion, and coughing. It can also be asymptomatic until the later stages.

Scientists do not know what causes this condition. Risk factors include smoking, alcohol consumption, chemical exposure, and HPV infection.

Doctors use endoscopies, biopsies, and imaging scans to diagnose CEC. People with CEC may need surgery, chemotherapy, radiation therapy, or a combination of treatments.

The outlook for CEC is relatively low as diagnosis may not happen until the cancer is advanced.