Esophageal Cancer Treatment
Treatment of esophageal cancer
depends on many factors: extent of the tumor, your age, general health, medical history, the stage of the
cancer, existence of metastases, etc. Knowing these details, your doctor can determine which treatment will be
most effective to fight the cancer in your esophagus. Any treatment considered, you will be invited to
participate in the final choice.
In general, treatment of
esophageal cancer includes surgery, chemotherapy, radiotherapy, and sometimes clinical trials.
If you have a small or
superficial cancer, your doctor may reduce the size of the cancer by electrocoagulation (also called radio
frequency diathermy or short wave electrolysis), photodynamic therapy, or brachytherapy. In this case, the
surgery will involve the removal of the entire tumor and attachment of the esophagus with a portion of your
cancers, surgery is performed to remove part of the esophagus, surrounding lymph nodes, and
the upper part of the
The remainder of your stomach is then
reattached to your esophagus. It is a
sophisticated surgical procedure reserved for patients with advanced esophageal caners.
Even when the
operation is performed by a competent surgeon, it can lead to serious complications: infection, bleeding and leakage from the area where the
remaining esophagus is reattached.
cannot be performed in all cancers of the esophagus; in fact, about 30% of esophageal cancers can be operated.
Alcohol-smoking related esophageal cancers often lead to heart and lung complications. In addition, secondary
lung or oral cancers are sometimes discovered at the diagnosis.
If the cancer
is too advanced, or if you are too old to undergo surgery, your doctor will consider chemotherapy together with
radiotherapy. Although rare, for some patients, this combination offers recovery and survival rate similar to
those of surgery.
be taken orally, in the treatment of esophageal cancer, chemotherapy drugs are often given by direct injection
into a vein to kill cancer cells. To treat your esophageal cancer, your physician can use chemotherapy alone or
in combination with surgery. However, it barely leads to a complete cure; chemotherapy helps reduce symptoms
associated with the disease such as painful and difficulty in swallowing (dysphagia).
Common chemotherapy drugs used to treat esophageal cancer is 5-FU associated with cisplatin. Vinorelbine, with
or without cisplatin, may be useful in the treatment of squamous cell carcinoma of the esophagus. Finally the
combination of 5-FU and irinotecan is sometimes
used if the above protocols do not work.
chemotherapy drugs always cause side effects, which may include:
- loss of
esophageal cancers or when the tumor is considered inoperable, a combination of radiotherapy and chemotherapy
(radio-chemotherapy) is often
used. It includes 5 weeks of radiotherapy (dose of 50 Gy) and chemotherapy. Your physician may also perform a
radio-chemotherapy in order to reduce the tumor and make it operable, neoadjuvant radiochemotherapy. Usually,
this procedure requires about 5 weeks of treatment, and indication of surgery is considered depending on the
response of your body to the therapy.
chemotherapy, radiation therapy is often accompanied by several side effects, which may include:
- loss of
taste or smell
of the mouth and gums
production of saliva
and dry skin at the treated site.
Clinical Trials - Clinical trials are new scientific studies aim at
evaluating new methods of prevention or/and treatment of a specific cancer. Some clinical trials are conducted
on medications aim to reduce side effects of chemotherapy drugs. Most often, physicians are aware of the
availability of those drugs. Ask your doctor if there is a trial available for your type of