Childhood Esophageal Cancer (PDQ®)–Patient Version
What is childhood esophageal cancer?
Childhood esophageal cancer is a rare type of cancer that forms in the esophagus.
The esophagus is the hollow, muscular tube that moves food and drink from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue.
There are two common forms of esophageal cancer.
- Squamous cell carcinoma of the esophagus is the most common esophageal tumor in children. This cancer begins in the thin, flat cells called squamous cells that line the inside of the esophagus.
- Adenocarcinoma of the esophagus is a less common type of esophageal tumor in children. It begins in the glands that secrete mucus in the esophagus.
Causes and risk factors for childhood esophageal cancer
Esophageal cancer in children is caused by certain changes in the way cells in the esophagus function, especially how they grow and divide into new cells. Often, the exact cause of these cell changes is unknown. Learn more about how cancer develops at What Is Cancer?
A risk factor is anything that increases the chance of getting a disease. Not every child with one or more of these risk factors will develop esophageal cancer. And it will develop in some children who don't have a known risk factor.
Known risk factors for childhood esophageal cancer include:
- having gastroesophageal reflux
- having Barrett esophagus
- swallowing chemicals, which may burn the esophagus and cause cell changes that may lead to cancer
Talk with your child's doctor if you think your child may be at risk.
Symptoms of childhood esophageal cancer
Children with esophageal cancer may not have symptoms until the tumor has grown large or spread. It's important to check with your child's doctor if your child:
- has trouble swallowing
- loses weight
- feels tired and weak
- has indigestion and heartburn
- has reflux
- has nausea or vomiting
These symptoms may be caused by problems other than cancer. The only way to know is to see your child's doctor.
Tests to diagnose childhood esophageal cancer
If your child has symptoms that suggest esophageal cancer, the doctor will need to find out if these are due to cancer or another problem. The doctor will ask when the symptoms started and how often your child has been having them. They will also ask about your child's personal and family medical history and do a physical exam. Depending on these results, they may recommend other tests. If your child is diagnosed with esophageal cancer, the results of these tests will help you and your child's doctor plan treatment.
The tests used to diagnose esophageal cancer may include:
Chest x-ray
An x-ray is a type of radiation that can go through the body and make pictures. A chest x-ray is one that makes pictures of the organs and bones inside the chest.
CT scan (CAT scan)
A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, such as the chest and abdomen. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.
PET scan (positron emission tomography scan)
A PET scan uses a small amount of radioactive sugar (radioactive glucose) that is injected into a vein. The PET scanner rotates around the body to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer cells often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body.
Magnetic resonance imaging (MRI)
MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of the esophagus. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Ultrasound exam
A test that uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
Barium swallow
Barium swallow is a series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series.
Esophagoscopy
An esophagoscopy is a procedure to look inside the esophagus to check for abnormal areas. An esophagoscope is inserted through the mouth or nose and down the throat into the esophagus. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. A biopsy is usually done during an esophagoscopy. Sometimes a biopsy shows changes in the esophagus that are not cancer but may lead to cancer.
Bronchoscopy
A bronchoscopy is a procedure to look inside the trachea and large airways in the lungs for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Thoracoscopy
A thoracoscopy is a surgical procedure to look at the organs inside the chest to check for abnormal areas. A cut (incision) is made between two ribs and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. Sometimes this procedure is used to remove part of the esophagus or lung.
Immunohistochemistry
Immunohistochemistry is a laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s cells. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to the antigen in the sample of the patient’s cells, the enzyme or dye is activated, and the antigen can then be seen under a microscope.
Getting a second opinion
You may want to get a second opinion to confirm your child's cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. This doctor may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child's cancer.
To learn more about choosing a doctor and getting a second opinion, see Finding Cancer Care. You can contact NCI's Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your child's appointments, see Questions to Ask Your Doctor about Cancer.
Who treats children with esophageal cancer?
A pediatric oncologist, a doctor who specializes in treating children with cancer, oversees treatment for esophageal cancer. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:
Treatment of childhood esophageal cancer
There are different types of treatment for children and adolescents with esophageal cancer. To decide on a treatment plan for your child, you and their care team will think about many factors, such as your child's overall health and whether the cancer is newly diagnosed or has come back.
Your child's treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child's care team about what to expect before treatment begins. For help every step of the way, see our booklet, Children with Cancer: A Guide for Parents.
Treatment of esophageal cancer in children might include:
- Radiation therapy, which uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Internal radiation therapy is used to treat esophageal cancer. For this treatment, a plastic or metal tube is passed through your child's mouth into the esophagus. A machine that is outside the body has a special tool that is placed in the tube to send radiation toward the cancer. To learn more, visit Radiation Therapy to Treat Cancer.
- Chemotherapy (also called chemo), which uses drugs to stop the growth of cancer cells. Chemotherapy either kills the cancer cells or stops them from dividing. Chemotherapy may be given in different ways. To learn more about how chemotherapy works, how it is given, common side effects, and more, visit Chemotherapy to Treat Cancer.
- Surgery to remove as much of the tumor as possible.
If your child's cancer comes back after treatment, their doctor will talk with you about what to expect and possible next steps. There might be treatment options that may shrink the cancer or control its growth. If there are no treatments, your child can receive care to control symptoms from cancer so they can be as comfortable as possible.
Clinical trials
For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.
You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child's age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Learn more about clinical trials, including how to find and join one, at Clinical Trials Information for Patients and Caregivers.
Prognostic factors for childhood esophageal cancer
If your child has been diagnosed with esophageal cancer, you likely have questions about how serious the cancer is and your child's chances of survival. The likely outcome or course of a disease is called prognosis.
Your child's prognosis depends on:
- the type of esophageal cancer (squamous cell or adenocarcinoma)
- whether the cancer was completely removed by surgery
- whether the cancer has spread to other areas of the body
- whether the cancer is newly diagnosed or has recurred (come back)
The prognosis is better if the cancer can be completely removed during surgery and if it has not spread to other areas of the body.
No two people are alike, and responses to treatment can vary greatly. Your child's cancer care team is in the best position to talk with you about your child's prognosis.
Side effects and late effects of cancer treatment
Cancer treatments can cause side effects. Which side effects your child might have depends on the type of treatment they receive, the dose, and how their body reacts. Talk with your child's treatment team about which side effects to look for and ways to manage them.
Learn more about Side Effects of Cancer Treatment.
Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include:
- physical problems, such as narrowing of the esophagus
- changes in mood, feelings, thinking, learning, or memory
- second cancers (new types of cancer) or other problems
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. Learn more about Late Effects of Treatment for Childhood Cancer.
Follow-up care
As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition changes or if the cancer comes back.
Coping with your child's cancer
When your child has cancer, every member of the family needs support. Taking care of yourself during this difficult time is important. Reach out to your child’s treatment team and to people in your family and community for support. To learn more, see Support for Families: Childhood Cancer.
Related resources
For more childhood cancer information and other general cancer resources, visit:
About This PDQ Summary
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
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Purpose of This Summary
This PDQ cancer information summary has current information about the treatment of childhood esophageal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
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Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Esophageal Cancer. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/esophageal/patient/child-esophageal-treatment-pdq. Accessed <MM/DD/YYYY>.
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