According to the American Society of Clinical Oncology, the treatment that a patient receives for esophageal cancer depends on factors such as how extensive the tumor is and if the tumor is in the upper or lower esophagus. Other factors to consider are the general health of the patient, and whether or not the cancer has spread to other parts of the body. A team of doctors working with the patient decides between standard treatments or a treatment that is part of a clinical trial to develop a new method of dealing with esophageal cancer.
Types
The five types of standard treatment for esophageal cancer include surgery, radiation therapy, chemotherapy, laser therapy and electrocoagulation, says the National Cancer Institute.
Surgery is the most frequently used treatment for cancer of the esophagus. In a procedure called esophagectomy, the surgeon removes part of the esophagus and then connects the remaining healthy part to the stomach either directly or via a plastic tube or a portion of the intestine.
In radiation therapy, doctors use high-energy X-rays or other kinds of radiation to destroy cancer cells. The radiation can come from a machine external to the body or from a radioactive substance sealed in needles or seeds that are surgically implanted into or near the tumor.
Chemotherapy is a treatment that kills cancer cells or prevents their growth through the use of drugs. In systemic chemotherapy, patients take the drugs orally or intravenously and they travel through the bloodstream to get to cancer cells anywhere in the body. In regional chemotherapy the drugs would be administered directly into the esophagus, and they would act to kill cancer cells almost exclusively in that area.
In laser therapy, doctors use a narrow and intense beam of light to kill esophageal cancer cells.
Electrocoagulation therapy uses an electric current to destroy esophageal cancer cells.
Considerations
According to the National Cancer Institute, patients who are thinking about entering a clinical trial for their esophageal cancer treatment should be aware that some clinical trials are open only to those who have not yet undergone any treatment. In addition, patients should keep in mind that a clinical trial affords an opportunity to use innovative cancer therapies but there is no guarantee of success.
Warning
Patients need to know that surgery to excise esophageal cancer has a risk of serious complications associated with it, says the Mayo Clinic. These include infection, bleeding and leakage at the point at which the remaining healthy esophagus is attached to the stomach.
Advanced Radiation Therapy Techniques
The Memorial Sloan-Kettering Cancer Center reports on two advancements in radiation therapy techniques designed to reduce damage to surrounding healthy tissue during radiation treatment for esophageal cancer.
One technique is called intensity-modulated radiation therapy, and it uses three-dimensional images from computed tomography or CT scans to enable the radiation oncologist to more precisely target the cancerous tissue.
The other technique is respiratory gating, which can take into account the motion of the esophageal tumor during the patient's breathing cycle. Damage to healthy tissue is minimized because radiation is delivered only at certain points during the breathing cycle.
Prevention/Solution
The Robert Wood Johnson University Hospital diagnoses and treats precancerous conditions of the esophagus such as Barrett's esophagus in which there is damage from stomach acid. Endoscopic and surgical procedures are used to prevent the condition from developing into esophageal cancer.
References
- American Society of Clinical Oncology: Esophageal Cancer
- National Cancer Institute: Esophageal Cancer Treatment
- MayoClinic.com: Esophageal Cancer: Treatment and Drugs
- Memorial Sloan-Kettering Cancer Center: Esophageal Cancer: Treatment
- Robert Wood Johnson University Hospital: The Thoracic Center: Esophageal Cancer
