Scientists are constantly learning more about cancer – what causes it, how it impacts our body and how to treat or cure it. One study has looked at a possible link between frequent drinking of hot beverages and an increased risk of esophageal cancer.

So should coffee drinkers worry? Not drastically, but you should always be mindful of what you put in your body, says Edie Krueger, MD, [pronounced EE-dee // KREE-ger] a radiation oncologist at OSF HealthCare.

“The science behind it is that there’s thermal injury to the lining of the esophagus, or the tube that connects the mouth to the stomach. The thermal injury causes the cells to become aberrant [not normal, in other words] and grow on their own without any checkpoints. That’s basically what cancer is,” Dr. Krueger says.

So what should people do? Dr. Krueger says if you’re a morning coffee or tea person, that’s fine. But if you drink scalding hot beverages multiple times a day, consider changing habits. Let the drink cool off before taking a swig. The study mentions 65 degrees Celsius (149 degrees Fahrenheit) as a danger zone. That’s about the temperature when you get coffee right out of the pot, Dr. Krueger says. Also, swap the afternoon hot coffee or tea with another drink.

“Things in moderation are fine,” Dr. Krueger says.

Why it’s important

Esophageal cancer is not the most common in America (around 20,000 cases per year, Dr. Krueger says). But she says it’s a “tough cancer to treat,” underscoring the need to know about it and get treatment sooner rather than later.

She says there are two types of esophageal cancer. The most prevalent in America is adenocarcinoma. The other type, squamous cell carcinoma, is the one with a possible link to hot drinks.

“The symptoms, in general, are things like reflux or trouble swallowing - especially trouble swallowing things like bread or tough foods like steak or chicken. Just really hard to get food down,” Dr. Krueger explains.

“Usually, esophageal cancer is treated with what we call trimodality therapy. That’s surgery, chemotherapy and radiation,” she adds.

Avoiding alcohol, smoking and obesity are ways to help prevent esophageal cancer.

Learn more

Read more about cancer care on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

Interview clips

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Leading-edge robotics transform cancer surgery

A safer, more precise procedure

Traditionally, esophagectomies have been high-risk surgeries, requiring large incisions in the chest and abdomen. Recovery could take up to a month in the hospital, followed by months of recovery at home. Robotic-assisted techniques are changing that reality.

Instead of one large incision, surgeons make small incisions in the chest and abdomen. Using the da Vinci 5 robotic surgery system, doctors can operate with more accuracy and control. This allows them to get touch-like (haptic) feedback that helps them feel what’s happening during the surgery.

According to a recent report in the Annals of Thoracic Surgery, robotic esophagectomy “proves to be a safe and effective option for patients with midesophageal to distal esophageal cancers.”

"The advantages of the robotic platform are lesser length of stay in the hospital, earlier return to work or activity because of shortening incisions and better lymph node yield," says Burhan Hassan, MD, staff thoracic surgeon with OSF HealthCare.

Benefits of robotic esophagectomy

Patients undergoing the robotic approach can experience:

• Faster and easier recovery
• Less blood loss
• Reduced pain during recovery
• Minimal scarring
• Lower risk of infection
• Shorter hospital stays
• Greater accuracy in delicate procedures

“Our length of stay since we started performing robotic esophagectomy has come down to seven days on average, which is five days under the national standard,” Dr. Hassan says.

Who is affected by esophageal cancer?

Esophageal cancer generally falls into two types:

• Squamous cell carcinoma – often linked to smoking and alcohol use
• Adenocarcinoma – usually affecting the lower esophagus, with cases on the rise

“While squamous cancer cases have remained steady or even declined, adenocarcinoma cases are increasing, and poor diet is a contributing factor,” Dr. Hassan explains. "Reflux is one of the reasons why a patient would have lower esophagus cancer. Reflux is related to diet. Most gastric cancer is traditionally related to diet, that's why it's mostly seen in the Japanese population, because of the diet there. But in the U.S. subset, the biggest cause is reflux."

More frequent use of scans and EGDs (esophagogastroduodenoscopy) has also led to earlier detection of esophageal cancers, giving patients a better chance of successful treatment.

What patients can expect

A robotic esophagectomy typically lasts five to six hours. Patients usually spend one day in the intensive care unit (ICU) and another five to six days in a general hospital room.

Dr. Hassan and his team aim to completely remove the tumor while preserving surrounding healthy tissue. Recent clinical guidelines also recommend shifting away from radiation as a treatment option, instead favoring chemotherapy followed by surgery for better outcomes.

Transforming cancer care

Once considered one of the most invasive cancer surgeries, esophagectomy is being redefined with robotics. For patients at OSF HealthCare, this means faster recoveries, shorter hospital stays and improved quality of life.

To learn more about robot-assisted surgeries at OSF, visit the OSF HealthCare website.

Video Interview Clips

Da Vinci 5 B-Roll

In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby

Roughly 20,000 Americans are diagnosed with esophageal cancer each year. It’s a form of cancer more commonly seen in men, with around 1 in every 100 men or 1 in every 400 women being diagnosed over their lifetime.

While other forms of cancer have specific screenings to find the disease, esophageal cancer treatment relies greatly on the presence of symptoms.

“The most common symptoms are patients who have trouble swallowing,” says Kyle Stang, MD, a radiation oncologist with OSF HealthCare. “We call it dysphagia. Whether it’s trouble getting food down when you’re swallowing or pain when you swallow, that’s the most concerning symptom. You can also have reflux or heartburn that don’t get better with medications. Other times, folks can present with weight loss, coughing, shortness of breath or even chest pain.”

The esophagus is the tube that connects your mouth and stomach. It helps deliver food between the two. According to Dr. Stang, esophageal cancer is a more aggressive form of cancer. He emphasizes the importance of seeing your doctor as soon as possible when symptoms are present.

“The way we treat esophageal cancer really depends on the stage and scenario. For some types of very early stage esophageal cancer, we can treat that with surgery alone,” Dr. Stang says. “For most patients, we’re talking about chemotherapy and radiation therapy for about five and a half weeks. Following that, we’ll typically re-evaluate someone to see if they’re a good candidate for surgery to take out the tumor in the esophagus or the upper part of the stomach.”

Dr. Stang says some common risk factors for esophageal cancer include alcohol, smoking, obesity, and a pre-existing history of gastroesophageal reflux disease (GERD), as well as Barrett’s Esophagus, which is a condition related to chronic inflammation of the esophagus where some of the cells begin to turn dysplastic (showing abnormal development. 

"We consider that to be a pre-invasive condition,” Dr. Stang adds.

While there’s a lot of work to do in the medical community regarding the treatment of esophageal cancer, Dr. Stang says one new treatment is showing promise.

“The ongoing clinical trials have been looking at a new form of treatment called immunotherapy,” Dr. Stang says. “Newer trials are looking at this therapy to see if we can bring in that new agent after chemotherapy and radiation therapy to see if we can improve outcomes.”

While the immunotherapy trials may not provide results for years, Dr. Stang reminds patients to see their health care provider if you experience any symptoms.

Video Interview Clips