Oesophageal cancer treatment
Once oesophageal cancer is found, your doctor will want to do more tests to find out if the cancer cells have spread to other parts of the body. Doctors call this ‘staging’. Oesophageal cancer is best treated if found in its earliest stages, before it has spread to other parts of the body. This is why people with Barrett’s oesophagus, which puts them at higher risk of oesophageal cancer than other people, are screened regularly so that the cancer is caught early and there is a good chance of surgery to cure it.
However, oesophageal cancer has very few symptoms at the onset and often the cancer is well advanced before there are any recognisable symptoms. Treatment of oesophageal cancer will depend on the size of the cancer, whether it has spread and the patient’s age and general state of health.
Treatment options for oesophageal cancer
Options for treatment of oesophageal cancer or for relief of symptoms include the following.
- Surgery to cut out the cancer. The surgeon may remove the cancerous section or even all of the oesophagus: this is called an oesophagectomy. Sometimes the upper part of the stomach is also removed. Nearby lymph nodes and other tissue in the area will also be removed to prevent the spread of other cancer cells. If a section is cut out, the surgeon will probably connect the healthy part of the oesophagus to the stomach, so that the person can still swallow. Sometimes the surgeon will make a tube out of the stomach and join it to the remaining bit of the oesophagus.
- In cases where the cancer blocks the oesophagus the surgeon may insert an expandable tube (called a stent) to hold open the sides of the oesophagus, or the oesophagus will be dilated and widened. A laser may also be used to destroy any cancer blocking the oesophagus.
- Radiotherapy (high energy X-rays). This can be used alone or in combination with surgery or chemotherapy. Radiotherapy can be given as an external beam or from radioactive rods placed directly into the oesophagus, using an endoscope. Doctors call this brachytherapy.
- Chemotherapy. This uses medications to kill or slow the growth of the cancer cells. The medications may be taken as a pill, or by injection into the body. Chemotherapy may be used with radiotherapy (chemoradiotherapy) or without radiotherapy. Chemoradiotherapy (chemotherapy and radiation therapy) is sometimes used before surgery.
- A treatment called photodynamic therapy may be used to treat cancer that's in the early stages, or to relieve pain and obstruction associated with more advanced cancers. This involves taking a special medication that makes the cancer cells sensitive to light of certain wavelengths. Then a probe is put into the oesophagus and light of these wavelengths is passed into the oesophagus. The light activates the medication which then destroys the cancer cells.
Surgery for oesophageal cancer is a major operation that will need considerable post-surgery treatment and recovery time.
Treatment with radiotherapy and chemotherapy can’t differentiate between cancer cells and healthy cells. While radiotherapy is directed so that the cancerous area receives the highest dose, the surrounding tissue is still affected and this is a cause of side effects. Likewise, chemotherapy affects healthy cells as well as cancer cells, especially those that are fast growing, such as those lining the digestive tract and bone marrow, causing side effects such as mouth ulcers, anaemia and susceptibility to infection.
Unfortunately, oesophageal cancer is a serious condition and the long-term survival rate is not good, even with treatment. This type of cancer has also been known to recur even after surgery, chemotherapy and/or radiotherapy.
Prevention of oesophageal cancer
You can help to prevent or minimise the risk of oesophageal cancer by eliminating risk factors from your lifestyle. Smoking is a major risk factor, so if you smoke, you need to stop. Heavy alcohol intake is also a major risk, so cutting down or eliminating your intake of alcohol is also recommended. Also, it is always wise to eat a well-balanced diet.
Longstanding gastro-oesophageal reflux disease can cause Barrett’s oesophagus, which is a major risk factor for oesophageal cancer. If you have been diagnosed with Barrett’s oesophagus your doctor will need to monitor this condition to detect any changes that may indicate that cancer is developing. This will probably involve having regular endoscopies. Cancers detected like this in the early stages usually have a good outcome.
Last Reviewed: 25 March 2009
- 1. MayoClinic.com. Esophageal cancer [updated 2007, May 11; accessed 2009, May 7]. Available at: http://www.mayoclinic.com/health/esophageal-cancer/DS00500
