How is esophageal cancer treated?

People with early to locally advanced stages of esophageal cancer can be treated with chemotherapy, radiation and surgery.

Donna Hill Howes, RN
Family Practitioner

Esophageal cancer can be treated with surgery, radiation therapy, chemotherapy or a combination of these treatments. For example, radiation therapy and chemotherapy may be given before or after surgery.

The treatment that's right for you depends mainly on the following:

  • Where the cancer is located within the esophagus
  • Whether the cancer has invaded nearby structures
  • Whether the cancer has spread to lymph nodes or other organs
  • Your symptoms
  • Your general health

Esophageal cancer is hard to control with current treatments. For that reason, many doctors encourage people with this disease to consider taking part in a clinical trial, a research study of new treatment methods. Clinical trials are an important option for people with all stages of esophageal cancer.

Your health care team can describe your treatment choices, the expected results of each and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.

This answer from the National Cancer Institute has been reviewed and/or edited by Dr. William D. Knopf.

Dr. Ajay K. Sahajpal, MD
Transplant Surgeon

Standard treatments include a multidisciplinary approach with chemotherapy, radiation and surgery. After presentation at a tumor board, either a neoadjuvant approach of chemo/radiation is undertaken with surgery or surgery first followed by adjuvant therapy.

Patients with early stage esophageal tumors can be treated by a combination of minimally invasive techniques that can include endoscopic mucosal resection (EMR) or radiofrequency ablation. If the tumor has penetrated beyond the initial layer of the esophagus, these techniques are not viable and surgery is necessary. We now perform minimally invasive sophagectomy (MIE) in most cases patients with more advanced tumors are encouraged to undergo multimodality therapy with chemotherapy and radiation therapy followed by surgery. Preoperative therapy increases the likelihood of complete removal of the tumor, and increases cure rate.

Surgery, radiation, medications (chemotherapy) or any combination of the three might be used to treat esophageal cancer. Different surgeries are available depending on how advanced the esophageal cancer is. These surgeries remove the mass of cancer cells (the tumor), the tumor and surrounding parts of the esophagus, or the tumor, surrounding parts of the esophagus, and stomach. A stent in the esophagus may be used to keep it open properly if a tumor is blocking it.

Esophageal cancers also might be shrunk using radiation therapy, which guides beams of energy to the cancer. Chemotherapy is yet another treatment option for esophageal cancer in which drugs are used to kill the cancer cells. Laser therapy is a surgery using lasers to kill cancer cells, as electrocoagulation uses electricity. An endoscope may be used to remove or shrink tumors of the esophagus, possibly along with medications that halt or prevent tumor growth. Other treatments may include targeted therapy, the use of drugs designed to specifically prevent the growth of cancer cells or stop the growth of vessels that supply tumors with blood. Each case of esophageal cancer is unique, and the best treatment options must be decided between the affected person and their doctor.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.