Esophageal Cancer (cont.)
Treatment
Treatment for esophageal cancer depends on a number of factors, including
the size, location, and extent of the tumor, and the general health of the
patient. Patients are often treated by a team of specialists, which may
include a gastroenterologist (a doctor who specializes in diagnosing and
treating disorders of the digestive system), surgeon (a doctor who
specializes in removing or repairing parts of the body), medical oncologist
(a doctor who specializes in treating cancer), and radiation oncologist (a
doctor who specializes in using radiation to treat cancer). Because cancer
treatment may make the mouth sensitive and at risk for infection, doctors
often advise patients with esophageal cancer to see a dentist for a dental
exam and treatment before cancer treatment begins.
Many different treatments and combinations of treatments may be used to
control the cancer and/or to improve the patient's quality of life by reducing
symptoms.
- Surgery is the most common treatment for esophageal cancer. Usually,
the surgeon removes the tumor along with all or a portion of the esophagus,
nearby lymph nodes, and other tissue in the area. (An operation to remove the
esophagus is called an esophagectomy.) The surgeon connects the remaining
healthy part of the esophagus to the stomach so the patient is still able to
swallow. Sometimes, a plastic tube or part of the intestine is used to make the
connection. The surgeon may also widen the opening between the stomach and the
small intestine to allow stomach contents to pass more easily into the small
intestine. Sometimes surgery is done after other treatment is finished.
- Radiation therapy, also called radiotherapy, involves the use of
high-energy rays to kill cancer cells. Radiation therapy affects cancer cells in
the treated area only. The radiation may come from a machine outside the body
(external radiation) or from radioactive materials placed in or near the tumor
(internal radiation). A plastic tube may be inserted into the esophagus to keep
it open during radiation therapy. This procedure is called intraluminal
intubation and dilation. Radiation therapy may be used alone or combined with
chemotherapy as primary treatment instead of surgery, especially if the size or
location of the tumor would make an operation difficult. Doctors may also
combine radiation therapy with chemotherapy to shrink the tumor before surgery.
Even if the tumor cannot be removed by surgery or destroyed entirely by
radiation therapy, radiation therapy can often help relieve pain and make
swallowing easier.
- Chemotherapy is the use of anticancer drugs to kill cancer cells. The
anticancer drugs used to treat esophageal cancer travel throughout the body.
Anticancer drugs used to treat esophageal cancer are usually given by injection
into a vein (IV). Chemotherapy may be combined with radiation therapy as primary
treatment (instead of surgery) or to shrink the tumor before surgery.
- Laser therapy is the use of high-intensity light to destroy tumor
cells. Laser therapy affects the cells only in the treated area. The doctor may
use laser therapy to destroy cancerous tissue and relieve a blockage in the
esophagus when the cancer cannot be removed by surgery. The relief of a blockage
can help to reduce symptoms, especially swallowing problems.
- Photodynamic therapy (PDT), a type of laser therapy, involves the use
of drugs that are absorbed by cancer cells; when exposed to a special light, the
drugs become active and destroy the cancer cells. The doctor may use PDT to
relieve symptoms of esophageal cancer such as difficulty swallowing.
Clinical trials (research studies) to evaluate new ways to treat cancer are
an important option for many patients with esophageal cancer. In some studies,
all patients receive the new treatment. In others, doctors compare different
therapies by giving the new treatment to one group of patients and the usual
(standard) therapy to another group. Through research, doctors learn new, more
effective ways to treat cancer. More information about research studies can be
found in the NCI publication Taking Part in Clinical Trials: What Cancer
Patients Need to Know. NCI's Web site has a section on clinical trials at
http://cancer.gov/clinicaltrials. This section provides general information
about clinical trials and detailed information about specific ongoing studies.
This information is also available from the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237). For deaf and hard of hearing callers with TTY
equipment, the number is 1-800-332-8615.
Next: What are the side effects of treatment for cancer of the
esophagus? »
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