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Esophageal Cancer Treatment Options

Once we have determined the stage of esophageal cancer, we can begin to plan esophageal cancer treatment. For simplicity, we are going to talk about different treatment categories of esophageal cancer, and how they are generally treated. You and your cancer care team will find the right treatment that’s best for you. In general, we can talk about four different categories of esophageal cancer: Superficial cancers are T1a and some T1b cancers that have no spread to the lymph nodes (N0). These can frequently be removed from inside the esophagus with an endoscope and never need surgery. Early stage cancers are T1b and some T2 cancers that have no spread to the lymph nodes (N0). These are usually treated with surgery and don’t need chemotherapy and radiation. Locally advanced cancers are T3 or node-positive tumors, meaning N1 or N2 or N3. These cancers are treated with chemotherapy and radiation first, which is then followed by surgery. Metastatic cancers are M1, in which cancer has spread to other organs. These cancers are treated with chemotherapy. Esophageal Cancer Care Team The care of esophageal cancer takes a whole team working together to give you the best care. Gastroenterologist works with an endoscope, which is a flexible tube which inserted through the mouth into the esophagus. The gastroenterologist may perform one of several procedures in your care: • Upper endoscopy to examine the inside of the esophagus and biopsy any concerning areas • Endoscopic ultrasound to examine the depth of invasion of a tumor in the esophagus • Endoscopic mucosal resection to treat superficial cancers of the esophagus Diagnostic radiologist • Interpret CT or PET scans • Perform biopsies under the guidance of CT or ultrasound Medical Oncologist • Treat cancer with chemotherapy or immunotherapy, using drugs given intravenously. Radiation Therapist • Treats cancer with high-energy x-rays that target the esophagus and nearby lymph nodes Surgeon • Perform surgery to remove the cancer in the esophagus and surrounding lymph nodes and reconstruct the gastrointestinal tract. This usually means creating a new esophagus from a portion of the stomach. • Place a feeding tube if necessary for nutrition • Place a central venous port for chemotherapy. In future videos, we will talk about each of these treatment options in detail.