Esophageal cancer, cancer arising in the tube that runs from the mouth to the stomach, killed about 15,000 people in the United States in 2009, according to the National Cancer Institute (NCI). During that time, more than 16,000 new cases were diagnosed.
Screening and aggressive early treatment are keys to reducing the deaths attributed to the disease. There is a wide variety of treatments available, with choices depending on factors like the type and stage of the cancer, the patient's state of health and personal preferences.
Surgery
According to the NCI, surgery is the most common type of treatment. Early and smaller masses can be removed by endoscopic surgery, says the Mayo Clinic. The usual surgery, called esophagectomy, involves the removal of the affected portion of the esophagus. Surrounding lymph nodes may also be removed at the same time. A tube or piece of intestine is used to maintain a connection to the stomach. Extensive masses involving the upper part of the stomach benefit from esophagogastrectomy, which involves the removal of the esophagus and the upper part of the stomach.
Radiation Therapy
This involves the use of x-rays and other forms of radiation to kill cancer cells. When employed after surgery, it is called adjuvant therapy. Raditaion can also be used to reduce the pain and discomfort of the illness, in which case it is called palliative therapy.
Radiation therapy can be external irradiation, which uses beams of radiation directed from outside the body to the cancer. It can also be internal radiation or brachytherapy, which involves the use of needles, wires or seeds placed directly into or near the cancer to deliver much localized radiation.
Chemotherapy
In chemotherapy, certain drugs are used to kill the cancer cells or stop them from growing. Chemotherapy can also be palliative or adjuvant therapy.
According to the American Cancer Society (ACS), chemotherapy is often used with radiation therapy. This combination, called chemoradiation, is useful in large tumors to shrink them to operable sizes. This treatment before surgery is called neoadjuvant therapy.
Drugs used in chemotherapy targeting cancer of the esophagus include 5-fluorouracill, capecitabine, cisplatin, carboplatin, oxaliplatin, doxorubicin and epirubicin. Other examples include methotrexate, bleomycin, mitomycin, paclitaxel, vinorelbine, topotecan and irinotecan.
Endoscopic Treatments
The endoscope, a lighted tube introduced into tubular structures to visualize the inner parts, can be used to deliver some forms of treatment in cancer of the esophagus. Apart from surgical resection of small masses, it can deliver laser ablation, photodynamic therapy, radiofrequency ablation, photocoagulation and Argon plasma coagulation, according to the ACS. These are either used in early cases or to reopen the blocked esophagus in advanced stages.
Other Treatments
Complementary treatments involving herbs and nutritional supplements are used in addition to prescribed treatments. Analgesics for pain and drugs to combat the side effects of the prescribed treatment are also used.
References
- National Cancer Institute: Esophageal Cancer Treatment: General Information
- National Cancer Institute: Esophageal Cancer Treatment: General Information about Esophageal Cancer
- Mayo Clinic: Esophageal Cancer
- American cancer society: Esophageal Cancer: Chemotherapy
- American cancer society: Esophageal Cancer: Endoscopic Treatments
