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What is the Treatment for Esophageal Cancer?

Esophageal cancer, a serious condition, requires early treatment. Surgery, chemotherapy, and radiotherapy are common modalities, with neoadjuvant therapy showing promise.

  • 08 Feb 2024
  • 3 min read
  • 28 views

Food travels from the mouth and reaches the stomach via the esophagus or food pipe. Smoking and excessive alcohol consumption promote the growth of malignant cells in the esophagus. Esophageal cancer can develop either on the lower or upper surface. Adenocarcinoma starts in the mucus-producing glands at the bottom of the esophagus, which is closer to the stomach. Squamous cell carcinoma develops in the upper esophagus. Trouble swallowing food, chronic chest pain, and a persistent hoarse voice indicate serious complications. A mix of Esophageal cancer treatment modalities is required to deal with the tumours. 

 

Treatment of Esophageal Cancer

Esophageal cancer treatment depends on the stage, much like cancer in other organs. Esophageal cancer tends to spread along the entire oesophagus if not diagnosed in the early stages. 

  • In the primitive stages, endoscopy helps remove minute tumours in the esophagus.
  • Stage 1 cancer is treated primarily with surgery.
  • In stages 2 and 3, cancer infiltrates deeper layers of the esophagus and lymph nodes in the adjoining area. Chemotherapy, radiation, followed by surgery aid in the treatment. During esophagectomy, the affected portion of the esophagus is dissected, along with the upper part of the stomach and surrounding lymph nodes. The stomach is treated as the new tube to reconnect to the remaining part of the upper esophagus.
  • In the advanced or metastatic stage, cancer spreads away from its initial site. It can reach the lungs, liver, and even the bones. The primary mode of treatment for this stage is chemotherapy, while radiation provides symptomatic benefits. Potential side effects of chemotherapy include increased hair loss and an enhanced risk of infection. Targeted drug therapy and immunotherapy have proven to be beneficial at this stage.
  • Docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy is particularly useful in treating squamous cell carcinoma. However, the side effects of this regimen include febrile neutropenia, appetite loss, constipation, and fatigue.
  • Laparoscopy and robotic operations work effectively when open surgeries are not an option. These are non-invasive methods to treat esophageal cancer.
  • Radiotherapy is particularly beneficial for the treatment of the upper esophagus. In radiotherapy, a beam of high-intensity rays is directed towards the affected area to shrink tumours. It is a viable option for patients surgically unfit for operations in the lower and middle esophagus. Side effects include damage to the nearby organs and difficulty swallowing.
  • Surgery, chemotherapy, and radiotherapy, when performed in isolation, result in poor survival rates. Neoadjuvant therapy usually combines radiotherapy and chemotherapy to kill cancerous cells. It improves the survival rate by 3–5 years.
  • Palliative surgeries to relieve the symptoms include esophageal stenting and jejunostomies. Esophageal obstruction is relieved via the insertion of a stent. In jejunostomy, a tube is inserted in the lumen of the jejunum to provide the required nutrition.

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Conclusion

Esophageal cancer is the sixth leading cause of cancer mortality in the world. The poor prognosis of the disease makes it crucial to seek early esophageal cancer treatment. Prevention is better than cure. Maintain a healthy diet, exercise regularly and abstain from alcohol consumption for a better life. Ensure that you have health insurance to tide over the waves of grief.

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