Treatment for esophageal cancer depends on how much the cancer has spread. Doctors perform diagnostic tests to diagnose cancer in the esophagus and to determine how serious the cancer is. Diagnostic tests a doctor may use include an endoscopic examination, laparoscopy, barium swallow X-ray, CT scan, PET scan or MRI. Some treatments are aimed at killing the cancer cells and others are geared toward reducing any pain and ill side effects the patient is experiencing. As scientists continue to study esophageal cancer, new treatments are developed. Patients who have advanced forms of cancer may benefit from participating in a clinical trial where the newest treatments are being tested.
Surgery
Doctors commonly perform surgery to treat esophageal cancer. The surgery is called an esophagogastrectomy and is often the first line of treatment unless the growths are large. During an esophagogastrectomy, the surgeon removes the part of the esophagus that is cancerous. The remaining part of the esophagus is reconnected to the stomach. If a large piece of the esophagus is removed during surgery, the surgeon sometimes has to remove a piece of the colon and attach it to the esophagus to make it long enough to reach the stomach. Lymph nodes that are near the esophagus are often removed so that they can be tested in a laboratory for cancer cells. Cancer that has spread to the lymph nodes is a sign that the cancer may have spread to other areas of the body.
Radiation
When cancerous growths in the esophagus are large, radiation therapy is often prescribed. Radiation therapy is usually performed before surgery to shrink cancerous growths in the esophagus, which relieves pain and makes surgery less invasive. Radiation therapy is not used alone to treat esophageal cancer, but is rather used in combination with surgery, chemotherapy or both surgery and chemotherapy.
Chemotherapy
Like with radiation, chemotherapy is not usually used as a sole treatment to fight cancer of the esophagus. Chemotherapy is used in combination with radiation therapy, surgery or both radiation therapy and surgery. Chemotherapy is used to shrink tumor growth prior to surgery, to shrink cancerous growths that were not able to be removed during surgery and to relieve pain associated with large tumors.
Stenting
Sometimes a stent is inserted into a patient's esophagus to open up the esophagus to make swallowing easier. Stenting is not a cure for cancer of the esophagus, but is rather a treatment to enhance quality of life.
Photodynamic Therapy
Photodynamic Therapy (PDT) is used in advanced cases of esophageal cancer to relieve pain and reduce obstructions in the esophagus caused by large cancerous tumors. During PDT a light-sensitive medication is injected into the patient. The medication seeks out cancerous tissue and absorbs into it, leaving normal healthy tissue alone. After the medication is injected, a doctor inserts a laser through an endoscope and flashes the laser light at the cancerous growths. The laser light activates the light-sensitive medication so that it can kill cancer cells.
Laser Therapy
Laser therapy is another therapy that is used to enhance a patient's quality of life. The laser is used to shrink cancer growths and relive obstructions in the esophagus. Unlike with PDT, a medication is not injected into the patient before the laser therapy. To perform laser therapy, the doctor inserts the laser through an endoscope, finds the tumor and activates the laser on cancerous tissue.
