How is esophageal cancer treated?

Surgery is the most common treatment, particularly if the cancer has not spread beyond the esophagus. Depending on the position of the tumor, the surgeon may need to enter the chest cavity, the abdomen or the neck and will remove the affected part of the esophagus with the surrounding lymph glands.

A tube is then made out of the stomach, which is drawn up into the chest or neck where it is joined to the remainder of the esophagus. Patients are usually cared for in an intensive-care ward after the operation. After leaving the hospital, patients can eat normal foods, but may feel full rather quickly. This usually improves over the next few months.

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Radiation therapy is also used as a potential cure in some patients. Sometimes it is used in conjunction with surgery, other times it may be the only treatment. Even if the tumor cannot safely be removed by surgery, then radiation therapy and chemotherapy can be used as a treatment. Radiation therapy can be given as an external beam or on the inside of the gullet via an endoscope (brachytherapy).

Major national and international trials are studying the effects of chemotherapy (or combined chemotherapy and radiation therapy) given either before or with surgery, compared to surgical treatment alone.

Additionally, a new, experimental treatment currently being investigated is to use photodynamic therapy (PDT). This involves giving the patient a special chemical that enters the cancer cells and is sensitive to certain light wavelengths. When light is passed into the esophagus using a probe, it activates the chemical, which then destroys the cancer.