Esophageal Cancer

Your esophagus (often called the food pipe) is a muscular tube that connects helps you move the food and liquid you swallow from your throat to your stomach.¹

Esophageal cancer can develop anywhere along the esophagus. The cancer typically starts in the inner layer of the muscular tube and then can grow deeper into the muscle but also the surrounding structures.¹

Worldwide over 600,000 people are diagnosed with esophageal cancer each year.² Men are more likely to develop esophageal cancer than women. Esophageal cancer is the 7th most common cancer type for men and 10th most common cancer type in women globally.²

Even though a large proportion of people with esophageal cancer are diagnosed in the locally advanced setting (before the cancer has spread into the body), the percentage of people who are alive 5 years after they were diagnosed is low.³,⁴

There are a number of risk factors associated with esophageal cancer. Some of these are linked to a person's lifestyle, such as tobacco and alcohol use.⁵,⁶ However, other conditions associated with the esophagus, like Barrett’s Esophagus, can make people higher risk for developing esophageal cancer.⁷

People who have esophageal cancer are often unaware of their disease, this is because the symptoms can be mild until the cancer advances. 

Symptoms can also be easily confused with other illnesses and digestive problems. These symptoms can include acid reflux, appetite loss and unexplained weight loss, feeling sick or being sick, indigestion, tiredness, problems or pain when swallowing and a persistent cough.⁸

These symptoms can have a significant impact on different aspects of a person’s quality of life.⁹ Increased awareness of the symptoms of esophageal cancer will lead to earlier diagnosis of the disease. If you are experiencing one or more of these symptoms it is important to speak with your doctor so that the cause of the symptoms can be found and treated.

The treatment options for people with esophageal cancer can depend on the size and location of the cancer and whether the cancer has spread beyond the esophagus.¹²

Esophageal cancer is often treated with therapies that aim to destroy the cancer cells or kick start the immune system into fighting cancer, these include:⁹

• Cancer immunotherapy – a type of treatment that aims to improve, target, or restore immune system function

• Chemotherapy – a type of drug that destroys cancer cells by stopping them from growing and dividing to make more cancer cells

• Radiotherapy – uses radiation, such as X-rays, to destroy cancer cells 

• Chemoradiotherapy – a combination of chemotherapy and radiotherapy 

If diagnosed early, the cancer can often be treated with surgery. However, most people are diagnosed when their disease is more advanced (as early esophageal cancer can have mild symptoms). Depending on the type of their cancer and the overall condition, people with locally advanced esophageal cancer are either given definitive chemoradiotherapy, or neoadjuvant chemoradiotherapy (a treatment given before surgery to shrink the tumour size), followed by surgery to remove the cancer. Sometimes people are given chemoradiotherapy or cancer immunotherapy  after surgery.¹³,¹⁴

Sometimes the cancer will be more advanced and will have spread to other parts of the body (known as metastatic cancer) or the cancer may have come back after a previous treatment (known as recurrent cancer). Treatment options for advanced cancer include surgery, chemotherapy, radiotherapy and chemoradiotherapy or a combination of these treatments.¹³,¹⁴ Cancer immunotherapies have also recently emerged as a treatment for people with advanced esophageal cancer.¹⁵ With advanced esophageal cancer the aim of treatment is to control the cancer and help improve the person’s quality of life and prolong survival. There is a significant need for new treatment options for people with esophageal cancer.

Information on how Roche is developing cancer immunotherapies is available. Roche is committed to providing improved long-term outcomes for more patients. One area under investigation is looking at whether combining two cancer immunotherapies together can amplify the effects of the treatments and delay recurrence and prolong survival. Roche has several ongoing clinical trials exploring more effective and tolerable treatment options for patients with esophageal cancer.

References 

1. American Cancer Society 2020. Available at 

2. Sung et al. CA Cancer J Clin 2021;71:209–49

3. American Cancer Society. Cancer Facts & Figures 2020. Available at

4. Siegel et al. CA Cancer J Clin 2021;71:7–33

5. Hussain et al. Cureus 2019;11:e3955

6. Abnet et al. Gastroenterology 2018;154:360–73

7. Kambhampati et al. Sci Rep 2020;10:4899

8. Cancer.Net American Society of Oncology 2021. Available at

9. Digestive Cancers Europe: The European Oesophageal and Gastric Cancer Roadmap - Improving the patient pathway, 2021. Available at

10. Daly et al. J Am Coll Surg 2000;190:562–72

11. Hu et al. Support Care Cancer 2015;23:733–40

12. Cancer.Net American Society of Oncology 2021. Available at 

13. Lordick et al. Ann Oncol 2016;27(Suppl 5):v50–7

14. Watanabe et al. Surg Today 2020;50(1):12-20

15. Kelly et al. N Engl J Med 2021;384:1191–1203