What is esophageal carcinoma (adenocarcinoma) in early malignant stages?

Adenocarcinoma of the esophagus usually develops in the lower section near the junction with the stomach. It often develops from a condition known as Barrett’s esophagus, a change in the mucous membrane caused by long-term reflux (heartburn). In the early stages, the cancer is confined to the uppermost layer of the mucous membrane and can often be completely removed.
Symptoms are initially rare. Some patients notice a slight feeling of pressure when swallowing or vague upper abdominal discomfort. In Switzerland, the incidence of adenocarcinoma is slowly increasing, particularly in men over the age of 60.

Early-stage lesions (tissue changes) have an excellent chance of being cured. Endoscopic treatment—that is, removal of the tumor using a flexible instrument without major surgery—is often sufficient. In cases of deeper local growth or high-grade dysplasia (cell changes), endoscopic resection (removal of the tissue) or surgery is additionally recommended. For all stages, a discussion in the tumor board is crucial. Following successful treatment, regular follow-up with endoscopies is performed. As soon as the tumor penetrates into the deeper layers, combination therapy must be discussed (refer to locally advanced stage).