Can heartburn symptoms be a sign of esophageal cancer?

02/05/2024

When are heartburn symptoms a sign of esophageal cancer? Learn about the warning signs so you can get the care you need fast.

BySuma Magge, MD, Gastroenterology, Nuvance Health

You have probably experienced heartburn before — an all-to-familiar and unpleasant burning sensation in your chest, usually after eating or drinking spicy or acidic food. Having occasional heartburn is normal, but some symptoms of heartburn may indicate you have a more serious issue. If left untreated, frequent heartburn, or gastroesophageal reflux disease (GERD), can be a risk factor for esophageal cancer.

Here are a few heartburn symptoms to be on the lookout for and when you should speak to your doctor about finding relief.

Understanding heartburn and esophageal cancer

What is heartburn and how does it occur?

Acid reflux causes heartburn symptoms. Acid reflux happens when stomach acid and stomach contents splash back up into your lower esophagus and cause a burning sensation or pain.

What are the symptoms of heartburn?

The most common symptom of heartburn are:

Burning in your chest, throat or mouth
Backwash or regurgitation of food or acidic liquid
Upper abdominal or chest pain
Trouble swallowing
Sensation of a lump in your throat

Is heartburn a risk factor of esophageal cancer?

If you experience heartburn, it doesn’t mean you have esophageal cancer. Most of the time, heartburn is caused by an underlying condition called GERD, which happens when the lower esophageal sphincter doesn’t work properly. When stomach acid repeatedly splashes back up into your esophagus it weakens the seal between your stomach and the muscle that closes the esophagus. The negative interaction between stomach acid and your esophagus is what leads to the cause of heartburn or discomfort and pain.

Learn more about GERD.

When should you be concerned about heartburn?

Speak with your doctor if you experience frequent or severe heartburn, especially if you have difficulty swallowing, unintentional weight loss or blood in your stool. If you have persistent heartburn, especially at night, and regular heartburn medicine doesn't help, it could be a sign of esophageal cancer. These symptoms can be a sign of other serious conditions that require diagnosis and treatment from your doctor.

What is the link between heartburn and esophageal cancer?

The stomach produces strong acid and enzymes to help break down food. Sometimes, this acid can go back up from the stomach into the lower part of your esophagus. This is called gastroesophageal reflux disease (GERD) or reflux. Many people with GERD experience symptoms like heartburn or chest pain. However, some people with GERD don't have any symptoms.

Having GERD slightly increases the risk of getting esophageal adenocarcinoma, especially in those with frequent symptoms. However, most people with GERD do not develop esophageal cancer. GERD can also lead to Barrett’s esophagus, which further raises the risk of cancer.

Risk factors and warning signs of esophageal cancer

Esophageal cancer is a serious condition that can be life-threatening if not found and treated early. There are several risk factors and warning signs associated with esophageal cancer that can help you determine if you are affected. According to the American Cancer Society, esophageal cancer is more common among men than among women. The lifetime risk of esophageal cancer in the United States is about 1 in 127 in men and about 1 in 434 in women.

Learn more about esophageal cancer.

What are the risk factors for esophageal cancer?

The most common risk factors that increase the likelihood of developing esophageal cancer include:

Chronic gastroesophageal reflux disease (GERD) or frequent heartburn
Smoking and tobacco use
Heavy alcohol consumption
Poor diet lacking in fruits and vegetables
Obesity
Long-term exposure to certain chemicals and substances

Even if you have these risk factors, it does not mean you have esophageal cancer. But it’s important to know about them so you can lower your risk.

The most common warning signs associated with esophageal cancer are:

It’s hard to swallow (dysphagia)
Losing weight without a clear reason
Chest pain or discomfort that won’t go away
Coughing a lot or having a rough voice

Warning signs could mean that your heartburn symptoms are turning into something more serious, like esophageal cancer. If you have heartburn often or any of the risk factors, you should speak to your doctor. Finding a problem early and getting help can increase your chances of successful treatment and better results.

Find a gastroenterologist near you.

Detecting and screening for esophageal cancer

Early detection is key when it comes to treating esophageal cancer. Early detection leads to faster treatment which is crucial for better outcomes. The available treatment options for esophageal cancer depend on the stage of the disease and your overall health. Here are some of the treatment options for esophageal cancer.

How is esophageal cancer diagnosed?

Esophageal cancer is diagnosed through a variety of tests such as a physical examination and imaging. Your doctor may recommend several types of tests to properly screen you. Here are the types of tests your doctor can use to determine if you have esophageal cancer. Medical history and physical examination

Imagining of the esophagus to look for areas that may be cancerous
CT scan
Barium swallow test
MRI scan
Endoscopy
Lab tests of biopsy samples
Blood tests

When should I get screened for esophageal cancer?

You should get screened for esophageal cancer if you have persistent heartburn or acid reflux, especially if it doesn't go away with medication. You should get screened regularly if you are at a higher risk for esophageal cancer and have Barrett’s esophagus, a precancerous condition that can occur in people who regularly experience acid reflux.

Barrett's esophagus sometimes happens as a result of GERD when stomach acid damages the tissue in the esophagus. If you have Barrett’s esophagus, there’s a higher chance, although small, that you might get esophageal cancer later. Talk with your doctor to get screened. You should consider getting screened if you have multiple risk factors, warning signs or if you have family members with esophageal cancer.

Finding esophageal cancer early is important for successful treatment. If you have ongoing symptoms or risk factors, don't wait—talk to your doctor about getting screened.

What are the available treatment options for esophageal cancer?

When treating esophageal cancer, finding it early and getting treatment quickly is important for better results. Here are the variety of ways esophageal cancer can be treated.

Surgery: Sometimes, doctors need to operate to remove part or all of the esophagus, depending on how much the cancer has spread.

Radiation therapy: This treatment uses strong beams to kill cancer cells and make tumors smaller. It can happen before or after surgery.

Chemotherapy: This involves using medicines to kill cancer cells in the whole body. It might be used before or after surgery.

Targeted therapy: This treatment focuses on specific problems in cancer cells, stopping them from growing.

The chances of getting better depend on how early the cancer is found. Early-stage cancers can be treated more successfully. But if the cancer is advanced, it's harder to treat.

Treatment might cause some issues, like trouble swallowing, acid reflux, not getting enough nutrition, or infections. It's important you talk to your doctor about possible issues associated with treatment options.

Learn more about cancer care at the Nuvance Health Cancer Institute.

Speak to your doctor about all the resources available to you. Those diagnosed with esophageal cancer can get help from support groups, counseling, and educational materials. Additional resources can provide emotional support and information.

The bottom line: If you experience heartburn, it doesn't necessarily mean you have esophageal cancer. However, if you have frequent or severe heartburn, especially if you have difficulty swallowing, unintentional weight loss or blood in your stool, you should speak to your doctor.

There are many risk factors and warning signs associated with esophageal cancer such as having GERD, smoking or using tobacco products, drinking alcohol and being overweight. Esophageal cancer warning signs include chest pain and discomfort, unintentional weight loss, difficulty swallowing or coughing and having a rough voice. Esophageal cancer is diagnosed through a variety of tests such as a physical examination and imaging. Your doctor may recommend several types of tests to properly screen you.