Metastatic esophageal cancer starts in the esophagus and then spreads or metastasizes to other distant areas of the body. Esophageal cancer is metastatic at stage 4.

Metastatic tumors are the same type of cancer as the primary tumor. This means that even if esophageal cancer metastasizes to another area, such as the lungs, doctors will classify this cancer as metastatic esophageal cancer rather than lung cancer.

Esophageal cancer begins in the inside lining of the esophagus and grows outward. When cancer cells break away from their primary source and travel through the blood or the lymphatic system, they can metastasize and form tumors in other body areas.

This article examines metastatic esophageal cancer, the most common metastasis sites, and the disease’s diagnosis, treatment, and outlook.

A person with metastatic esophageal cancer in a hospital bed talking to a doctor.Share on Pinterest
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Esophageal cancer begins in the esophagus, the soft tube connecting the stomach and mouth. Doctors stage esophageal cancer from stages 0–4B.

At stage 4B, the latest stage of esophageal cancer, cancerous cells have traveled through the blood or lymphatic system and metastasized to other organs, distant lymph nodes, or both.

There are two main types of esophageal cancer:

  • Adenocarcinoma: This cancer begins in the gland cells, which are mainly in the lower part of the esophagus, close to the stomach.

Both SCC and adenocarcinoma esophageal cancers can metastasize to other areas of the body.

Learn more about esophageal cancer here.

The most common metastatic sites for esophageal cancer are:

The liver and lungs are the most common metastatic sites for esophageal cancer. According to research, 23% of metastatic esophageal cancer spreads to the liver and 31% to the lungs.

Scientists believe the liver and lungs may be the most common metastatic sites for esophageal cancer due to how the organs interact with each other through the vascular system and because of the rich blood supply that travels between them.

Learn more about the vascular system and vascular disease.

Doctors diagnose esophageal cancer with tests that examine the esophagus. Once they have diagnosed the cancer, they will perform further tests to determine whether cancerous cells have spread to other areas of the body, and if so, where.

For initial diagnosis, doctors may administer the following tests and procedures:

  • physical examination
  • chest X-ray
  • esophagoscopy, in which a doctor inserts a thin tube with a camera and light through the nose or mouth into the esophagus
  • upper endoscopy, a procedure similar to esophagoscopy, in which the doctor also examines the stomach
  • biopsy, which a doctor may perform during the esophagoscopy

Once a doctor has diagnosed esophageal cancer, they will order further testing to determine whether cancer cells have spread to other areas of the body. This process is called staging.

Tests may include:

Learn more about tests for esophageal cancer.

Treatments for metastatic esophageal cancer may include:

  • Chemotherapy: Chemotherapy treatment uses drugs to kill cancer cells and prevent them from dividing.
  • Radiation therapy: Radiation uses high-energy X-rays and other radiation sources to prevent cancer cells from growing or destroying them.
  • Chemoradiation therapy: Chemoradiation combines chemotherapy and radiation therapy to boost the effects of both.
  • Immunotherapy: Immunotherapy is a type of biological therapy that involves the immune system. Doctors use substances that the person’s body makes naturally or that technicians make in a lab to increase the body’s defense against cancer cells.
  • Electrocoagulation: Electrocoagulation involves the use of electric currents to destroy cancer cells.
  • Laser therapy: Laser therapy involves using an intense beam of light to destroy cancer cells.
  • Endoscopic cryotherapy: This involves using an endoscope to apply liquid nitrogen or another cryogen to a target area, which kills cancer cells.
  • Surgery: Surgery may involve an esophagectomy, in which surgeons remove part of the esophagus and reconnect the healthy part to the stomach.

Where possible, doctors may opt to treat esophageal cancer with surgery to eradicate the cancer. However, metastatic esophageal cancer is “unresectable,” meaning it is not localized and straightforward to remove surgically.

Nonsurgical treatments are typically better options, although these may aim to improve symptoms rather than cure the cancer.

Learn more about esophageal cancer treatments.

Metastatic esophageal cancer is the latest possible stage of the disease. It means that the cancer that has spread from the esophagus to other organs or lymph nodes.

The outlook for metastatic esophageal cancer is generally poor.

The 5-year relative survival rate for metastatic esophageal cancer that has spread to distant areas of the body, such as the lungs or liver, is 6%.

This means that people with this stage of esophageal cancer are, on average, 6% as likely as people without the cancer to be alive 5 years after diagnosis.

Learn more about esophageal cancer life expectancy here.

Metastatic esophageal cancer starts in the esophagus and then travels through the blood or lymphatic system to other organs or lymph nodes. Cancer cells then form tumors in other areas of the body.

The most common metastasis sites for esophageal cancer are the lungs and the liver. This may be because the organs share a rich blood supply with the esophagus and interact via the vascular system.

The cancer cells remain esophageal cells, and doctors refer to the metastasized cancer as esophageal, regardless of where in the body it has spread to.

Surgery is ineffective for metastatic esophageal cancer, and doctors typically opt for other treatments, such as chemotherapy, radiation therapy, and immunotherapy.

The outlook for metastatic esophageal cancer is typically poor, with low survival rates.