9 Facts You Probably Didn’t Know About GEJ Cancers

by Sheila M. Eldred Health Writer

If you’d never heard of the gastroesophageal junction, or GEJ, before your cancer diagnosis, you're not alone. It refers to the point where the esophagus meets the stomach (just beneath your diaphragm). If you or someone close to you has cancer in this part of the body, here are some more key points about cancers of the GEJ that you may not have known.

Doctors disagreeing.

Scientists don’t agree on how to classify GEJ cancers

Stomach or esophagus? It’s a question up for debate in the scientific community. Previously classified as gastric cancers, the 7th edition of Union for International Cancer Control (UICC) staging system moved GEJ cancers to the esophageal group. Not everyone agrees with the move, however.

Order for endoscopy

How cancers of the GEJ is diagnosed

Currently, cancers that begin near or grow into the GEJ are treated the same as esophageal cancers. So diagnosis could be made through an upper endoscopy, in which a doctor looks at the inside of the esophagus with a lighted tube, or an endoscopic ultrasound, which uses sound waves to determine where it has spread, or barium swallow, which allows for X-rays of the esophagus, or a CT, PET, or MRI scan.

Cigarette in ashtray hands holding a whiskey.

Risk factors for GEJ cancers

While some conditions such as gastroesophageal reflux disease and Barrett’s esophagus increase the risk of GEJ cancers, there are some lifestyle choices you can control to decrease your risk. Yep, you guessed it: cut out all smoking and tobacco use, and limit alcohol.

Woman surprised by weight loss.

Signs and symptoms of cancers located in the GEJ

Symptoms associated with GEJ cancers include difficulty or painful swallowing and unintentional weight loss. Other symptoms include coughing, nausea, vomiting, and black stools. Unfortunately, GEJ cancers are similar to esophageal cancers in that they don’t usually produce noticeable symptoms until they are advanced.

Growth in esophagus.

More diagnoses...

Whether they’re classified as gastric or esophageal, GEJ tumors are increasingly common. About half of gastric carcinomas occur at the GEJ; when they’re considered in the esophageal world, they’re the predominant form.

Older man consulting with doctor.

… especially in men

Cancers of the esophagus are four times more common in men than women. And your risk goes up as you get older.

Gold number 5 balloon.

Prognosis of GEJ cancers

If the GEJ cancer is confined to the esophagus, the five-year survival rate is 43 percent. Cancers that have spread to the lymph nodes have a 23 percent 5-year survival rate, and cancer that has spread to distant sites have a 5 percent five-year survival rate.

Highlighted United States of america.

Unique to the U.S.

In most of the world, squamous cell carcinoma is the most common form of esophageal cancer. But in the U.S., where tobacco use has dropped while GERD has risen, adenocarcinoma is more common. Adenocarcinoma means the cancer started in the glands of one of your organs.

Advocacy spelled out

Be your own advocate

All in all, the more you know about your specific condition, the better you can advocate for yourself. If you have an inkling that you have a GEJ cancer, share that suspicion with your doctor. Here’s how one woman did it.

Sheila M. Eldred
Meet Our Writer
Sheila M. Eldred

Sheila Mulrooney Eldred is a graduate of Columbia’s School of Journalism and a former newspaper reporter. As a freelance health journalist, she writes about everything from life-threatening diseases to elite athletes. Her stories have appeared in The New York Times, Nature, FiveThirtyEight, Pacific Standard, STAT News, and other publications. In her spare time, she and her family love running, cross-country skiing, and mountain biking in Minneapolis.