Esophageal cancer and alcohol

What is esophageal cancer?

Esophageal cancer occurs when the cells lining the esophagus begin to grow out of control. This type of cancer begins in the inner lining of the esophagus and spreads throughout the other layers as it develops.

According to the NCI, there are two types of esophageal cancer:

• Squamous cell carcinoma: This type begins in the squamous cells that line the inside of the esophagus. It most often occurs in the upper and middle sections of the esophagus.
• Adenocarcinoma: This type begins in the glandular cells that line the esophagus and produce mucus and other fluids. It most often occurs in the lower section of the esophagus, close to the stomach.

Link between esophageal cancer and alcohol

Alcohol is a chemical substance in alcoholic beverages, such as wines, beers, and distilled spirits. The percentage of alcohol differs according to the type of beverage.

The liver metabolizes alcohol with the help of an enzyme called alcohol dehydrogenase, which converts alcohol into acetaldehyde. An accumulation of acetaldehyde can cause irreversible damage to a person’s DNA, which may result in cancer.

A second enzyme called aldehyde dehydrogenase 2 (ALDH2) helps metabolize acetaldehyde into nontoxic substances.

Alcohol consumption is an important risk factor for many types of cancer. It is responsible for about 6% of all cancers and 4% of cancer deaths in the United States.

According to the National Cancer Institute (NCI), alcohol consumption increases the risk of esophageal squamous cell carcinoma, which is the most prevalent type of esophageal cancer.

The risk of developing esophageal cancer is 1.3 times higher for people who consume one or two drinks per day and 5 times higher for those who consume four or more drinks daily.

The risk of esophageal cancer is also higher among individuals who consume alcohol and have an atypical form of ALDH2.

Other risk factors for esophageal cancer

According to a 2017 review, esophageal cancer is the eighth most common cancer globally.

Besides alcohol consumption, some factors that can increase a person’s risk of developing esophageal cancer include:

• Age: The risk of esophageal cancer increases with age, with more than 85% of diagnoses occurring in people over the age of 55 years.
• Gender: Rates of esophageal cancer are higher among males than among females.
• Tobacco use: Using tobacco products significantly increases the risk of both types of esophageal cancer. Examples of tobacco products include:
  • cigarettes
  • cigars
  • pipes
  • chewing tobacco
• Diet: Certain diets may increase the risk of esophageal cancer, such as those high in processed meats.
• Obesity: Being overweight increases the risk of gastroesophageal reflux disease, which increases the risk of adenocarcinoma.

Medical conditions and esophageal cancer

Some medical conditions that can increase the risk of esophageal cancer include:

• Barrett’s esophagus: This condition occurs due to chronic acid reflux, which is where stomach acid leaks into the lower esophagus. Over time, the acid damages the inner lining of the esophagus and replaces typical squamous cells with gland cells that may further develop into adenocarcinoma.
• Plummer-Vinson (PV) syndrome: People with PV syndrome develop webs in the upper part of the esophagus. Around 1 in 10 individuals with this syndrome develop esophageal squamous cell cancer, which is cancer of the lower throat.
• Achalasia: This rare swallowing disorder occurs when the muscles of the esophagus cannot contract properly, making them unable to move food down to the stomach. As a result, food can become stuck in the esophagus. Achalasia irritates the cells lining the esophagus, increasing the risk of esophageal cancer.
• Human papillomavirus (HPV) infection: HPV refers to a group of more than 100 viruses. In parts of Asia and South Africa, around one-third of people with esophageal cancer also have signs of HPV infection.
• Other cancers: People with cancer of the mouth, throat, or lung also have an increased risk of developing esophageal cancer.

Symptoms of esophageal cancer

According to the American Cancer Society (ACS), most esophageal cancers do not cause symptoms in the early stages.

Some common symptoms a person may experience during the more advanced stages of the disease include:

• difficulty swallowing
• chest pain
• chronic cough
• hoarse voice
• vomiting
• weight loss
• bleeding into the esophagus, which may lead to dark stools and anemia

When to contact a doctor

The ACS notes that the symptoms relating to esophageal cancer are more likely attributable to other, less serious, conditions. Nonetheless, they advise anyone experiencing symptoms to consult a doctor for a diagnosis.

Early detection of esophageal cancer can help prevent the cancer from spreading, and this can improve outcomes.

If a person has a diagnosis of Barrett’s esophagus, their doctor may advise them to undergo an upper endoscopy on a regular basis. This procedure involves using an endoscope, which is a flexible tube with a light, to check for cancer or other abnormalities inside the esophagus.

Outlook 

The outlook for esophageal cancer depends on whether and to what extent the cancer has spread at the time of diagnosis.

The overall 5-year survival rate for esophageal cancer is approximately 20%. This figure ranges from 5% to 47%, depending on the stage of the cancer during diagnosis. The survival rate is higher if a doctor diagnoses and treats the condition in its early stages when treatments are likely to be more effective.

Prevention

Esophageal cancer is not always preventable. However, people can follow the steps below to help reduce their risk of developing this disease:

• avoiding smoking and drinking, if applicable
• eating a nutritious diet rich in fruits and vegetables
• exercising regularly
• consulting a doctor about symptoms, such as swallowing difficulties or chronic heartburn

Summary

Esophageal cancer affects the esophagus, which is the muscular tube connecting the throat and stomach. There are two main types of esophageal cancer; squamous cell carcinoma and adenocarcinoma. Both begin in the lining of the esophagus.

Alcohol consumption is a major risk factor for various types of cancer, including esophageal cancer. This is because alcohol partially converts to acetaldehyde during metabolization. Acetaldehyde can cause irreversible damage to a person’s DNA, and these changes may lead to cancer.

Esophageal cancer is more treatable during the early stages of the disease. As such, anyone who experiences symptoms of esophageal cancer should consult a doctor promptly for a diagnosis.