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 is the prognosis with esophageal cancer? What is the survival rate for esophageal cancer?

Most often, esophageal cancer is a treatable disease but not a curable one.

Patients who have severe Barrett's esophagus (some consider this stage T0 or precancerous) and those with few cancer cells tend to have relatively successful outcomes.

The overall five-year survival rate averages between 5%-30%. This is especially low because patients tend to present late in their disease when the cancer has already spread.

Lymph node and other organ involvement markedly lowers survival rate.

There is a better survival rate in patients whose tumors disappeared with radiation and chemotherapy before surgery (three-year survival rate of 48%), as compared to those who had some residual tumor at time of surgery (27%).

The prognoses for squamous cell carcinoma and adenocarcinoma are about the same.

Is it possible to prevent esophageal cancer?

Since squamous cell carcinoma is associated with smoking (and smokeless tobacco products), stopping smoking will significantly decrease the risk of this type of esophageal cancer.

Alcohol abuse is also related to squamous cell carcinoma, especially when combined with tobacco product use. Alcohol products should be used in moderation.

Esophageal adenocarcinoma is associated with GERD and the development of Barrett's esophagus. It is important to limit the risk factors for developing esophageal reflux. These include:

  • losing weight,
  • moderating alcohol use,
  • avoiding excess anti-inflammatory medication use (aspirin, ibuprofen, naproxen), and
  • avoiding smoking.

If symptoms of GERD develop, they should be assessed and treated by your health care professional. Should symptoms persist or worsen, the recommendation may be to undergo endoscopy to determine whether Barrett's esophagus is present.

Barrett's esophagus needs to be managed and monitored to assess whether there is progression of cell damage. This may include endoscopic ablation, or killing of abnormal tissue using different techniques including radiofrequency ablation, photodynamic therapy, or cryotherapy.

REFERENCES:

"Cancer Facts and Figures 2015." American Cancer Society.

Rice, T.W., V.W. Rusch, H. Ishwaran, and E.H. Blackstone. "Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Cancer Staging Manuals." Cancer 116.16 Aug. 15, 2010: 3763-73.

Steevens, J., et al. "Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: a prospective cohort study." Gut. 59:1 (2010): 39-48.

United States. National Cancer Institute. "Photodynamic Therapy for Cancer." Sept. 6, 2011. <https://www.cancer.gov/about-cancer/treatment/types/surgery/photodynamic-fact-sheet>.

Varghese, T. K., et al. "The society of thoracic surgeons guidelines on the diagnosis and staging of patients with esophageal cancer." Annals of Thoracic Surgery. 96:1 (2013): 346-356.

Medically Reviewed by a Doctor on 11/30/2016

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