Treatment for esophageal cancer depends upon the size and location of the tumor and if it has spread as well as your overall health. Many different treatments may be used to treat your cancer and/or improve your quality of life by reducing symptoms.
Surgery is the most common treatment for early-stage esophageal cancer that has not spread to the lymph nodes or other parts of the body. There are four common surgical procedures. In all four, the surgeon will make two or more incisions and remove all or part of the esophagus, a portion of the stomach and nearby lymph nodes. The remaining stomach is pulled up into the chest or neck and connected to the remaining esophagus.
The four different surgical approaches to treating esophageal cancer have similar cure and complication rates. The type of surgery performed generally depends on the location and extent of your cancer. Your health care team will discuss in detail with you the type of surgery most appropriate for you.
Surgery may also be combined with radiation treatment and/or chemotherapy.
Radiation therapy uses X-rays or other high-energy rays to kill cancer cells and shrink tumors. The radiation affects only cancer cells in the treated area.
Radiation is usually combined with chemotherapy to treat esophageal cancer to prevent tumor growth and to reduce symptoms such as difficulty swallowing or bleeding.
Chemotherapy involves using drugs to kill cancer cells. These drugs enter the bloodstream to reach all areas of the body, making this treatment useful for cancer that has spread beyond the esophagus. Your doctor may use one or a combination of drugs to treat your cancer. Chemotherapy can be given several ways, such as intravenously (through a vein) or by mouth. Patients usually receive chemotherapy on an outpatient basis.
Since chemotherapy medicines may affect some healthy cells as well as cancer cells, side effects can occur. Your doctor can prescribe medicines to help relieve any side effects you experience. Your care team will give you detailed information about the chemotherapy medicines your doctor has prescribed.
Chemotherapy may be combined with radiation as a primary treatment (instead of surgery) or may be given before surgery to shrink a tumor.
Clinical trials are in progress to find the best esophageal cancer treatment methods. Researchers are studying new chemotherapy drugs and drug combinations to treat cancer that has spread and as a way to try to relieve symptoms. Your doctor will tell you if you are eligible to participate in a clinical trial.
There are other esophageal cancer treatment options. Your doctor will determine whether these treatments are appropriate for you.
Endoscopic Mucosal Resection (EMR): a highly effective treatment for small surface esophageal lesions. During the treatment, saline is injected in the esophageal wall to form a bubble under a lesion. The lesion is then suctioned into a small cap and removed, allowing the doctor to perform a resection without damaging the rest of the esophagus. More than one EMR may be needed to completely remove a lesion.
Laser therapy: uses high-intensity light to destroy cancer cells through an endoscope (a long and flexible tube). Also called laser ablation, this treatment approach may be used to relieve a blockage in the esophagus caused by the tumor. Relieving the blockage can help reduce symptoms such as difficulty swallowing.
Esophageal stents: small expandable metal or plastic tubes are placed over the tumor in the esophagus with the aid of an endoscope. Once placed, the stent can expand to open up the blocked part of the esophagus, allowing food and liquids to pass through easier.
How Important Is Nutrition?
During your treatment, it is important that you take in enough calories to prevent weight loss and maintain your energy and strength. Patients who have esophageal cancer often have a hard time eating because of pain or difficulty swallowing. In these cases, soft foods or liquid supplements may be easier to eat. MD Anderson at Cooper has dietitians on our team to help you manage your nutritional needs.
What Type of Follow-Up Care Is Needed?
Follow-up visits during and after esophageal cancer treatment are necessary to monitor any changes in your cancer. You should receive treatment as soon as possible if your cancer returns, spreads to new areas or progresses. Routine follow-up visits may include physical exams, X-rays, computed tomography (CT) scans and laboratory tests.
MD Anderson’s Approach to Esophageal Cancer Treatment
The key to an effective treatment is creating a customized plan that is tailored to each patient’s individual needs. Our doctors and specialists create each treatment plan by considering numerous factors such as where the cancer is located, the type of cancerous cells found, whether and how far the cancer has spread, and other health concerns you may have.
A range of advanced treatments are available at MD Anderson at Cooper, including advanced surgery, radiation therapy, and chemotherapy.
Make an Appointment with an Esophageal Cancer Specialist
The team at MD Anderson at Cooper can provide you with comprehensive, personalized care for esophageal cancer.