Esophageal Cancer

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After completing a thorough lab analysis of your recent biopsy, a specialized doctor called a pathologist reported a diagnosis of esophageal cancer, or cancer that begins in the esophagus. Esophageal cancer affects men 3–4 times more often than women, and occurs most frequently in African-Americans.

About the Condition

The esophagus is a tube lined with muscles that contracts to transport food and liquids from the mouth to the stomach. The upper and lower ends of the esophagus are clamped together by specialized muscles, called sphincters. Normally the lower sphincter opens automatically to let food pass into the stomach and closes quickly to prevent stomach contents and acid from leaking back into the esophagus, or refluxing.

Cancer occurs when cells in the lining of the esophagus do not develop and die in their normal manner. Contributing factors may include excessive use of tobacco or alcohol and ongoing acid reflux conditions such as Barrett's esophagus. The extra cells that result form a growth, or tumor, which can be benign or malignant. Benign tumors are not cancer and do not spread throughout the body. Malignant tumors are cancer. Their cells may invade and damage surrounding areas or spread to other locations in the body (metastasize).

Adenocarcinoma, the most common form of esophageal cancer, affects the lower esophagus, while squamous cell carcinoma involves the middle and upper sections. Because the condition is often diagnosed at a later stage, your doctor may want to perform one or more tests to help determine if the cancer has spread, which could include the following:

•  MRI Scan
•  Ultrasound
•  Lymph Node Biopsy
•  X-ray
•  CT Scan
•  Bone Scan

Cancer that is confined within the esophageal wall is the most manageable and curable. If malignant cells extend through the esophagus into surrounding tissues, lymph nodes or other areas of the body, the treatment plan will be more complex and the cancer may not be curable. Many treatment options are available for patients with incurable esophageal cancer to help minimize pain and improve quality of life.

Treatment Options

Deciding on a treatment plan for your esophageal cancer can be complex and depend upon a variety of factors, such as your age, general health condition, stage of cancer and personal preferences. Sometimes more than one type of therapy may be used. The following treatment possibilities are available:

Surgery The main form of treatment for esophageal cancer is surgery. Typically the tumor and part of the esophagus are removed along with surrounding tissues and nearby lymph nodes. Occasionally an esophagectomy is necessary, which involves removal of the entire esophagus and repositioning of the stomach into the chest.

Radiation Therapy Another treatment method for esophageal cancer is radiation therapy, which can be delivered externally or internally. In external beam radiation, a high energy X-ray machine is used to direct radiation at the tumor. Internal radiation therapy destroys cancer cells with small implants that are placed directly into or near the tumor.

Chemotherapy The use of anti-cancer drugs, or chemotherapy, provides a way to slow tumor growth and reduce pain for patients whose cancer has spread outside of the esophagus.

Laser and Photodynamic Therapy Sometimes laser therapy or photodynamic therapy is used to treat esophageal cancer. Laser therapy uses high-intensity light to destroy malignant cells. In photodynamic therapy, abnormal cells are burned off by a specific type of laser after being illuminated by a photosensitizing drug. Both therapies can help relieve difficulty in swallowing.

You may also consider participating in clinical trials. These investigative studies help doctors learn about new treatments and better ways to use established treatments. Talk with your doctor about the possibility of taking part in a clinical trial in your area.

What You Can Do

You can choose to take an active role in your health and well-being. Learn as much as you can about your condition and have a list of questions ready each time you meet with your doctor. Join a cancer support group and talk with your family, friends, clergyperson or counselor as you feel comfortable. Other steps you can take to maximize your health include:

•  Having smaller and more frequent meals throughout the day
•  Eating soft, bland and pureed foods if you have trouble swallowing
•  Taking part in some form of exercise on a regular basis
•  Minimizing stress by getting enough sleep every night and using relaxation techniques
•  Visiting your doctor regularly and promptly reporting any new symptoms that develop

Additional Resources

American Cancer Society, 800.227.2345, http://www.cancer.org/
American College of Gastroenterology, 301.263.9000, http://www.acg.gi.org/
National Cancer Institute, 800.422.6237, http://www.cancer.gov/
Oncology Channel, http://www.oncologychannel.com/

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 9.07