Esophageal Cancer Treatment

A cancer that arises from the esophagus – the food pipe that runs down from throat to stomach is called esophageal cancer. Esophagus is a hollow pipe that helps liquid and solid food travel to stomach. Esophageal cancer usually begins in the cells that line the inside of the esophagus. There are two major types of Esophageal Cancers –

• Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.
• Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.

SYMPTOMS
An early Esophageal Cancer does not produce noticeable symptoms, however the advance level cancer will show the following symptoms:-

• Difficulty swallowing (dysphagia)
• Weight loss without trying
• Chest pain, pressure or burning
• Worsening indigestion or heartburn
• Coughing or hoarseness

DIAGNOSIS

• Esophagram or Barrium Swallow
•  EGD or esophagus-gastric-duodenoscopy
• Endoscopic Ultrasound
• Bronchoscopy
• Biopsy
• Molecular Testing of Tumor
• Imaging Tests – CT Scan, MRI and PET Scan

TREATMENTS AVAILABLE IN INDIA

• Endoscopic Therapy – There are multiple methods involved in this which are explained below:
• Endoscopy and Dilation
• Endoscopy with Stent Placement
• Photodynamic Therapy
• Electrocoagulation
• Cryotherapy

• Surgery – The goal is to remove the esophageal cancer along with some healthy tissues at an advanced stage which has not spread to the surrounding areas.
• Esophagectomy – Surgery to remove some or most of the esophagus is called an esophagectomy. Often a small part of the stomach is removed as well. The upper part of the esophagus is then connected to the remaining part of the stomach. Part of the stomach is pulled up into the chest or neck to become the new esophagus. How much of the esophagus is removed depends upon the stage of the tumor and where it’s located.
• Minimally invasive esophagectomy – For some early cancers, the esophagus can be removed through several small incisions instead of large incisions. The surgeon puts a scope through one of the incisions to see everything during the operation. Then the surgical instruments go in through other small incisions. During esophagectomy, nearby lymph nodes are also removed.
• Radiation Therapy -Radiation therapy is the use of high-energy radiation to kill cancer cells. It is often combined with other types of treatment, such as chemotherapy and/or surgery, to treat esophageal cancer. Two common radiotherapy treatments are:
• External-beam radiation therapy: This type of treatment focuses radiation from outside the body on the cancer. This is the type of radiation therapy most often used when trying to cure esophageal cancer.
• Internal radiation therapy (brachytherapy): For this type of treatment, the doctor passes an endoscope down the throat to place radioactive material very close to the cancer. The radiation travels only a short distance, so it reaches the tumor but has little effect on nearby normal tissues. The radioactive source is then removed a short time later. Brachytherapy can be given 2 ways; for high-dose rate (HDR) brachytherapy, the doctor leaves the radioactive material near the tumor for a few minutes at a time, which may require several treatments. In low-dose rate (LDR) brachytherapy, a lower dose of radiation is put near the tumor for longer periods (1 or 2 days) at a time. The patient needs to stay in the hospital during this treatment, but it can usually be completed in only 1 or 2 sessions.
• Chemotherapy – In chemotherapy anti cancer drugs are used to stop the growth and division of Cancer cells.
• Target Therapy – It targets the Cancer’s specific genes, proteins or the tissues that aids in the cancer growth.

A cancer that arises from the esophagus – the food pipe that runs down from throat to stomach is called esophageal cancer. Esophagus is a hollow pipe that helps liquid and solid food travel to stomach. Esophageal cancer usually begins in the cells that line the inside of the esophagus. There are two major types of Esophageal Cancers –

• Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States, and it affects primarily white men.
• Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the upper and middle portions of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.

SYMPTOMS
An early Esophageal Cancer does not produce noticeable symptoms, however the advance level cancer will show the following symptoms:-

• Difficulty swallowing (dysphagia)
• Weight loss without trying
• Chest pain, pressure or burning
• Worsening indigestion or heartburn
• Coughing or hoarseness

DIAGNOSIS

• Esophagram or Barrium Swallow
•  EGD or esophagus-gastric-duodenoscopy
• Endoscopic Ultrasound
• Bronchoscopy
• Biopsy
• Molecular Testing of Tumor
• Imaging Tests – CT Scan, MRI and PET Scan

TREATMENTS AVAILABLE IN INDIA

• Endoscopic Therapy – There are multiple methods involved in this which are explained below:
• Endoscopy and Dilation
• Endoscopy with Stent Placement
• Photodynamic Therapy
• Electrocoagulation
• Cryotherapy

• Surgery – The goal is to remove the esophageal cancer along with some healthy tissues at an advanced stage which has not spread to the surrounding areas.
• Esophagectomy – Surgery to remove some or most of the esophagus is called an esophagectomy. Often a small part of the stomach is removed as well. The upper part of the esophagus is then connected to the remaining part of the stomach. Part of the stomach is pulled up into the chest or neck to become the new esophagus. How much of the esophagus is removed depends upon the stage of the tumor and where it’s located.
• Minimally invasive esophagectomy – For some early cancers, the esophagus can be removed through several small incisions instead of large incisions. The surgeon puts a scope through one of the incisions to see everything during the operation. Then the surgical instruments go in through other small incisions. During esophagectomy, nearby lymph nodes are also removed.
• Radiation Therapy -Radiation therapy is the use of high-energy radiation to kill cancer cells. It is often combined with other types of treatment, such as chemotherapy and/or surgery, to treat esophageal cancer. Two common radiotherapy treatments are:
• External-beam radiation therapy: This type of treatment focuses radiation from outside the body on the cancer. This is the type of radiation therapy most often used when trying to cure esophageal cancer.
• Internal radiation therapy (brachytherapy): For this type of treatment, the doctor passes an endoscope down the throat to place radioactive material very close to the cancer. The radiation travels only a short distance, so it reaches the tumor but has little effect on nearby normal tissues. The radioactive source is then removed a short time later. Brachytherapy can be given 2 ways; for high-dose rate (HDR) brachytherapy, the doctor leaves the radioactive material near the tumor for a few minutes at a time, which may require several treatments. In low-dose rate (LDR) brachytherapy, a lower dose of radiation is put near the tumor for longer periods (1 or 2 days) at a time. The patient needs to stay in the hospital during this treatment, but it can usually be completed in only 1 or 2 sessions.
• Chemotherapy – In chemotherapy anti cancer drugs are used to stop the growth and division of Cancer cells.
• Target Therapy – It targets the Cancer’s specific genes, proteins or the tissues that aids in the cancer growth.