Cancer of the esophagus is a cancer that originates in the lining of the esophagus and spreads from the inside out through the walls of the organ. Once esophageal cancer is diagnosed, staging occurs. Staging is a standardized way of describing the spread of disease and helps guide treatment and prognosis. For this kind of cancer, stages include Stage 0, which is carcinoma in situ, or noninvasive cancer, through Stage IV, which is metastatic, widespread disease.
Significance
The American Cancer Society estimates that in 2009, there were 16,470 new diagnoses of esophageal cancer made in the United States, and that same year, about 14,530 individuals died from the disease. This cancer is three to four times more common in men than women, and it is more common in African-American individuals than other ethnicities.
Diagnosis and Staging
If a patient comes in with symptoms that possibly suggest esophageal cancer, like trouble swallowing, a barium swallow will typically be ordered. In this test, a barium liquid is ingested, covering the walls of the esophagus, and on an X-ray, any abnormal areas on the esophagus can be seen. Another diagnostic procedure is an endoscopy, in which a tube is fed through the mouth and down the throat, into the esophagus and stomach. A camera is attached to see any cancerous areas, and biopsies are usually taken of the abnormal area. These biopsies can help provide a definitive diagnosis of esophageal cancer. These tests help diagnose esophageal cancer, but other tests need to be done to determine the stage, or extent, of the cancer. A CT scan and/or PET scan can show how far the cancer has spread, aiding in staging the disease.
Features
According to the National Cancer Institute, Stage III esophageal cancer is diagnosed when the cancer has spread to the outer wall of the esophagus and may or may not be in tissues surrounding the esophagus or nearby lymph nodes. The American Cancer Society further defines Stage III with three substages, depending on how many lymph nodes are cancerous and the extent to which the cancer has spread.
Treatment
The National Cancer Institute lists several treatments for Stage III esophageal cancer, including surgery, chemoradiation and clinical trials. Surgery may include removal of part of the esophagus and nearby lymph nodes. Chemoradiation involves the use of chemotherapy and radiation together. Clinical trials may be available to some patients, depending on the eligibility criteria, and talking with health-care providers can determine whether a clinical trial might be appropriate.
Prognosis
According to the American Cancer Society, the five-year survival rate, or the percentage of individuals alive five years after diagnosis of regional esophageal cancer, is 18 percent. Regional cancer describes cancer that has spread to nearby tissues or lymph nodes.
References
- National Cancer Institute: Esophageal Cancer Treatment
- American Cancer Society: What Are the Key Statistics for Cancer of the Esophagus?
- American Cancer Society: How is Cancer of the Esophagus Diagnosed?
- National Cancer Institute: Treatment Options by Stage
- American Cancer Society: How is Cancer of the Esophagus Staged?
