Esophageal Cancer (Cancer of the Esophagus)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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What are the treatment for esophageal cancer?

The approach to treatment is individualized to each patient's situation. Recommended treatments depend on the stage and health of the patient.

Esophageal cancer is often found in older patients who have other underlying illnesses which complicates treatment. Esophageal cancer is often diagnosed late in the course of the disease because symptoms often occur only after a tumor has grown and potentially spread. Most often, if the patient can tolerate it, treatment consists of a combination of chemotherapy, radiation therapy, and surgery.

Surgery

The surgical procedure for esophageal cancer is removal of the esophagus (Esophagectomy = esophagus + ectomy = removal). This is often recommended for patients with stage II or III cancer. Those with stage IV cancer may not be surgical candidates because of poor prognosis. Certain patients may not be appropriate candidates for surgery because the cancer has spread to adjacent structures like the heart or lung. Some patients may not be candidates for surgery because of underlying medical illnesses, such as advanced heart or lung disease or diabetes that would increase the risk of death during or shortly after surgery.

Chemotherapy and radiation

Chemotherapy and radiation therapy may be administered prior to surgery to help shrink the tumor. There are a variety of chemotherapy protocols that may be considered but at present they are being used off label and are not FDA approved. Surgery is often delayed for 4 to 6 weeks to allow the chemotherapy and radiation to be administered.

Targeted therapy

There are specific genes that are associated with esophageal cancer. In certain circumstances, the tumor can be tested to see whether genes like HER2 are present. Targeted medications can attach or bind to different protein sites on the tumor cells and inhibit tumor growth. This is not chemotherapy which tries to kill tumor cells (and normal ones as a side effect), but rather a potential adjunct.

Endoscopic treatments

If the esophageal cancer is confined the walls of the esophagus with no spread to the lymph nodes or distant organs (stage I), surgical removal of the tumor may be accomplished via endoscopic procedure.

What kinds of doctors treat esophageal cancer?

Esophageal cancer is a condition that requires surgical. In addition to the general surgeon, there are many other types of physicians who may contribute to care.

  • Gastroenterologists may be involved in diagnosing, treating, and monitoring the disease.
  • Oncologists make treatment plans that include chemotherapy and radiation therapy.
  • Radiation is administered by a radiation oncologist.

Should the cancer become untreatable or symptom control be needed, palliative care specialists may be involved to help improve quality of life.

Medically Reviewed by a Doctor on 11/6/2015
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  • Esophageal Cancer - Symptoms and Signs

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  • Esophageal Cancer - Prognosis and Stage

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  • Esophageal Cancer - Types

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  • Esophageal Cancer - Risk Factors

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  • Esophageal Cancer - Diagnosis

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  • Esophageal Cancer - Doctors & Second Opinion

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