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Esophageal cancer

Treatment options for esophageal cancer

Our esophageal cancer program offers radiation, surgery, chemotherapy and a number of other treatment options. Which would be appropriate for you depends on several factors, including the stage and extent of your disease. Your multidisciplinary team of esophageal cancer experts will answer your questions and recommend treatment options based on your unique diagnosis and needs. Common treatments for esophageal cancer include:

Immunotherapy

Immunotherapy drugs are designed to allow the immune system to better recognize and attack cancer cells.

Checkpoint inhibitors work by blocking specific protein receptors on the surface of cancer cells and/or immune cells. Blocking these receptors may prevent cancer cells from sending signals that allow them to hide from the immune system

Checkpoint inhibitors and other immunotherapy treatments may be used on esophageal tumors in combination with other treatments, such as surgery or chemotherapy. Immunotherapy are not recommended for all patients, and responses to the treatment may vary.

Targeted therapy

Targeted therapy drugs may be recommended for certain esophageal cancer patients to target specific proteins that help the cancer thrive. These treatments may be used as an alternative to surgery, or in some cases, to treat advanced esophageal cancers that haven’t responded to other treatments.

Gastroenterology

Common gastrointestinal procedures for esophageal cancer include:

Endoscopic ultrasound (EUS): An EUS allows us to view high-quality images of the esophagus and deliver treatment directly to a mass.

Endoscopic mucosal resection (EMR): This procedure is used to remove very early-stage cancer in the esophagus. In some cases, it may be used during the diagnosis process. During an EMR, a thin tube (endoscope) is inserted down the throat. The endoscope has instruments attached to the end that are designed to remove the tumor.

Cryotherapy: This procedure uses liquid nitrogen to freeze and kill cancer cells in an effort to shrink the tumor. This may also help improve swallowing.

Balloon dilation: This technique may be used to remove an obstruction in the esophagus.

Stent placements: Placing a stent in the esophagus may be recommended to improve swallowing. Stents are inserted through the mouth and do not require surgery.

Photodynamic therapy (PDT): Photodynamic therapy may be used to treat stage I esophageal cancer, or to alleviate symptoms associated with esophageal obstruction.

Radiation therapy

Radiation therapy may be an option in cases when esophageal cancer has advanced and is often performed in conjunction with chemotherapy. If radiation therapy helps shrink the tumor, surgery may be performed.

Side effects of radiation therapy, which may include difficulty swallowing, are also managed during cancer treatment. A stent may be placed in the esophagus before radiation therapy begins, and a temporary feeding tube may be used to help patients receive necessary nutrients during treatment.

Surgery

Surgery is the preferred procedure to treat early-stage adenocarcinoma. Your surgical oncologist will perform surgery to treat stage I and stage II esophageal cancer. For later-stage esophageal cancer, we typically combine other forms of treatment, such as radiation therapy and chemotherapy. These treatments may be used to shrink the tumor before surgery can be reconsidered. If cancer is found in the esophagus, nearby lymph nodes are also removed during surgery to test for the presence of cancer. 

Learn more about surgery for esophageal cancer

Interventional radiology

Treatment for esophageal cancer requires accuracy and precision. Interventional radiology is intended to allow doctors to visualize tumors in the esophagus and perform real-time image-guided interventional procedures.