Could Obesity Put You At Higher Risk For Esophageal Cancer?

Obesity is one of the most debilitating diseases that you can suffer from. Many of our patients report that before surgery, almost everything in their life was harder due to obesity: from bending down to tie their shoes to boarding an airplane to playing with their kids. Obesity can also put you at increased risk of conditions such as sleep apnea, type 2 diabetes, high cholesterol, heart attacks, and even cancer. In this article, we’re going to explore the link between obesity and one of the most common cancers in the United States, esophageal cancer.

What Is Esophageal Cancer?

As the name suggests, esophageal cancer is cancer in the esophagus. The esophagus is the tube that runs from your throat to your stomach, which helps you move food from the back of your throat to your stomach after it has been swallowed. This cancer usually begins in cells on the surface of the esophagus or in the cells of mucus-secreting glands in the esophagus.

Esophageal cancer is extremely dangerous. According to the National Cancer Institute, the five-year survival rate for this cancer is roughly 20 percent. This type of cancer represents the 6th most common cause of cancer deaths in the world. 

Signs and symptoms of this cancer include:

  • trouble swallowing (called dysphagia)
  • weight loss (often unintentional or without trying)
  • chest pain
  • hoarseness
  • chronic cough
  • esophageal bleeding
  • blackened stool (due to esophageal bleeding)
  • tiredness (due to blood loss leading to anemia)
  • vomiting

What Causes Esophageal Cancer?

It’s unclear what exactly causes esophageal cancer. However, anything that chronically irritates your esophagus may contribute to a higher risk of esophageal cancer. 

Risk factors for this type of cancer include:

  • Gastroesophageal reflux disease (GERD)
  • smoking
  • drinking alcohol
  • achalasia (difficulty swallowing due to a sphincter that won’t relax)
  • Barrett’s esophagus (an esophageal condition caused by chronic acid reflux)
  • drinking lots of very hot liquids
  • unhealthy dietary habits (not consuming enough fruits and vegetables)
  • obesity

Obesity and Esophageal Cancer: A Causal Connection

How does excess weight increase the likelihood of developing esophageal cancer? Doctors aren’t sure exactly why suffering from obesity puts patients at a higher risk of cancer, but the link between obesity and esophageal cancer is well-established. One reason might be that visceral fat–fat that surrounds the vital organs–causes inflammation. Inflammation can cause tissue damage and also make the body less responsive to insulin, which in turn leads the body to produce more insulin to try to make up for the resistance. This leads to more cell division, which in the setting of inflammation could lead to cancer.

A second possible reason is that fat cells produce estrogen, which means that people (both men and women) who suffer from obesity often have higher than-normal levels of estrogen in their systems. Many tumor cells are stimulated by estrogen, which can lead to the growth of some types of cancers.

According to Dr. Basen-Engquist, Ph.D. and Director of the Center for Energy Balance in Cancer Prevention and Survivorship at The University of Texas MD Anderson Cancer Center, “Basically, higher estrogen levels lead to increased cell production, which could result in tumor growth.”

The bottom line is that weight management and cancer prevention go hand in hand because there’s a strong connection between obesity and esophageal cancer.

Other Esophageal Issues Caused By Obesity

In addition to cancer, obesity can cause other issues with the esophagus. Studies have shown that visceral obesity is a risk factor for Gastroesophageal reflux disease (GERD). GERD occurs when a person’s stomach acid flows from their stomach back up into their esophagus, which can irritate the lining of the esophagus. 

Obesity can also contribute to Barrett’s esophagus, a condition in which the lining of the patient’s esophagus tries to protect itself against acid exposure by transforming the cell types to be more like stomach tissue. This transformation carries a cancer risk. Both conditions can lead to heartburn and regurgitation, as well as chest pain (more common for GERD) and trouble swallowing food.

Can Bariatric Surgery Reduce Your Risk of Esophageal Cancer?

The good news is that bariatric surgery can dramatically reduce your risk of cancer. According to the CDC, maintaining a healthy weight is one of the “most important steps you can take to lower your risk of getting cancer.” The link between obesity and esophageal cancer is clear, which means that weight management and cancer prevention are, in this case, the same thing. By leveling the playing field in your battle against obesity, and helping you to lose weight and keep it off, bariatric surgery can substantially reduce your risk of multiple cancers including esophageal cancer. 

However, if you suffer from esophageal issues such as GERD or Barrett’s esophagus then it is extremely important to choose the right bariatric surgery for you. Gastric bypass surgery has been found to reduce the risk of esophageal cancer. One reason is that gastric bypass surgery is the “ultimate antireflux procedure” and can help resolve problems such as acid reflux before they develop into more serious conditions.

By contrast, it is important to avoid the gastric sleeve. The gastric sleeve is a powerful weight-loss tool that has helped many patients, but it does run the risk of increasing acid reflux symptoms. For this reason, we do not recommend gastric sleeve surgery for patients suffering from heartburn or acid reflux.

Taking the Next Step On Your Weight Loss Journey

Obesity is a very painful disease to deal with, and it can put you at a higher risk of many other diseases. If you are suffering from obesity, then the best gift that you can give yourself is to seek a meaningful and powerful surgical intervention.  If you’re ready to take the next step on your weight loss journey, we encourage you to schedule a bariatric assessment with us.

Our patients routinely say that surgery was the best decision they ever made.

“I feel like I have won the lottery and have been given a second chance in life! March 25, 2014, was the first day of the rest of my new life and I can’t even start to express in words how grateful I am.”—Rochelle Goforth, patient.

If you’re suffering, don’t wait. Call our Denver office today.

Dr. Joshua Long headshot

This page was medically reviewed by Dr. Joshua Long, MD, MBA, FACS, FASMBS. Dr. Long is a double-board-certified bariatric surgeon and bariatric medical director for Parker Adventist Hospital.
Full Bio: Dr. Joshua Long, MD, MBA, FACS, FASMBS
Page Updated: May 25th, 2023

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