Virginia Commonwealth University

VCU Massey Cancer Center

Treatment for esophageal cancer

Specific treatment for esophageal cancer will be determined by your physician based on:

  • Your age, overall health and medical history.
  • Extent of the disease.
  • Your tolerance for specific medications, procedures or therapies.
  • Expectations for the course of this disease.
  • Your opinion or preference.

Different types of treatment may be used to control esophageal cancer and to reduce symptoms. Treatment may include:

  • Surgery – two types of surgery are commonly performed for esophageal cancer. In one type of surgery, part of the esophagus and nearby lymph nodes are removed and the remaining portion of the esophagus is reconnected to the stomach. In the other surgery, part of the esophagus, nearby lymph nodes and the top of the stomach are removed. The remaining portion of the esophagus is then reconnected to the stomach. Surgery may be performed after other treatment is completed.
  • Chemotherapy – the use of anti-cancer drugs to treat cancerous cells. In most cases, chemotherapy works by interfering with the cancer cell’s ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. The oncologist will recommend a treatment plan for each individual. Chemotherapy also may be used along with radiation therapy as the primary treatment. Chemotherapy also may be used to shrink the tumor prior to surgery.
  • Radiation therapy– the use of high-energy radiation to kill cancer cells and to shrink tumors. There are two ways to deliver radiation therapy, including the following:
    • External radiation (external beam therapy) – a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
    • Internal radiation (brachytherapy, implant radiation) – radiation is given inside the body as close to the cancer as possible. Substances that produce radiation, called radioisotopes, may be swallowed, injected or implanted directly into the tumor. Some of the radioactive implants are called “seeds” or “capsules.” Internal radiation involves giving a higher dose of radiation in a shorter time span than with external radiation. Some internal radiation treatments stay in the body temporarily. Other internal treatments stay in the body permanently, through the radioactive substance loses its radiation within a short period of time. In some cases, both internal and external radiation therapies are used.
  • Photodynamic therapy (PDT) – a type of laser treatment that involves injecting photosensitizing chemicals into the bloodstream. Cells throughout the body absorb the chemicals. The chemicals collect and stay longer in the cancer cells than in the healthy cells. At the right time, when the healthy cells surrounding the tumor may already be relatively free of the chemical, the light of a laser can be focused directly on the tumor. As the cells absorb the light, a chemical reaction destroys the cancer cells. The light is delivered through a endoscope, a small, flexible tube with a light on the end, that is inserted through the mouth or nose. PTD may be used to relieve or reduce symptoms of esophageal cancer, such as difficulty swallowing.

Sometimes, several of these treatments may be combined for treating esophageal cancer.