The esophagus is the muscular passage that food and liquids use to reach the stomach. The two main types of esophageal cancer are squamous cell carcinoma (which starts in the cells of the lining) and adenocarcinoma (which starts in the tissue that helps you swallow).
Screening is not generally recommended for these types of cancers. However, individuals with a history of Barrett’s esophagus may have endoscopic exams with biopsies for screening.
Treatment Options for Esophageal Cancer
Esophageal cancer can be treated either by surgery or by combining radiation with chemotherapy. The approach to treatment depends on the stage and grade of the cancer. Sometimes, radiation and/or chemotherapy is given before surgery for esophageal cancer. Radiation may also be used, with or without chemotherapy, to relieve pain in more advanced disease.
Surgery for Esophageal Cancer
Surgery is the most common treatment for esophageal cancer. An esophagectomy is surgery to remove some or most of the esophagus, and sometimes tissue around it. If the esophagus is removed, the doctor may reposition the stomach higher in the chest, or use a piece of intestine to bridge the gap between the stomach and the remaining esophagus to preserve function. Lymph nodes may also be removed and biopsied for cancer. Esophageal cancer surgery often requires extended hospitalizations. Some surgeons are now doing the procedures using minimally invasive techniques. Complications include heartburn, stomach emptying problems, narrowing of the esophagus where the surgery was performed.
Chemotherapy for Esophageal Cancer
Chemotherapy drugs can be given (either orally or intravenously) to shrink the tumor before surgery. It can also be used in conjunction with radiation. In advanced cases, chemotherapy can be administered in a palliative manner to control symptoms.
Radiation Therapy for Esophageal Cancer
In cases of esophageal cancer, radiation therapy is mainly used as part of a larger treatment regimen to relieve difficulty swallowing. Radiation can be used alone, before surgery to shrink tumors, or after surgery to kill any cancer cells that may remain. During radiation treatments for esophageal cancer, a stent (small tube) is sometimes inserted into the esophagus to keep it open.