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Esophageal Cancer - Treatments  

How is Esophageal Cancer Treated?

If you are diagnosed with esophageal cancer, you have options. Your physician will work with you and your family to discuss your unique situation and all possible treatments. Factors that will be taken into consideration in determining your best treatment plan are the size and location of the tumor, the involvement of surrounding tissue, whether it has spread to other body parts, and your overall health.

Treatments include:

Esophagectomy (Surgery)

If your health is relatively good and your tumor has not spread outside of the esophagus, an esophagectomy will be performed to  remove the esophagus. This is the treatment method of choice. This usually involves removing a portion of the esophagus and then using the stomach to replace the esophagus so that you will be able to continue to eat and swallow after your operation.

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Using chemotherapeutic drugs to kill cancer cells may be used before or after surgery, alone, or in combination with other treatments such as radiation treatment. These medications are usually given intravenously but may occasionally be given in pill form.

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This is a type of therapy that can be performed at the time of the endoscopy. Incisions are not required. Like photodynamic therapy, cryotherapy can be used to treat very small cancers or precancerous changes in the esophagus. Cryotherapy can also be used to relieve symptoms such as bleeding or difficulty swallowing.

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Endoscopic Mucosal Resection (EMR)

Also a newer treatment option, EMR involves using special tools to lift and cut abnormal lesions or tumors from the esophageal lining. EMR can only be used to treat very small areas of the esophagus. EMR provides information that will help your physicians plan your overall treatment for your cancer. EMR is also performed at the time of endoscopy.

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Esophageal Stents

If you are having trouble swallowing, you may have a stent placed in your esophagus to relieve discomfort and keep the esophagus open. The design of esophageal stents may vary, but these are usually placed at the same time as an endoscopy. Surgical incisions are not required.

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Photodynamic Therapy

Photodynamic therapy (PDT) can be used for some very small cancers or precancerous changes in the esophagus to try to eliminate disease. If your cancer is larger and causing symptoms such as difficulty swallowing or bleeding, PDT can be used to help these symptoms. You will receive an injection of a light-sensitive drug that remains in cancer cells longer than in healthy cells. You will then have an endoscopy, during which your physician will place a laser light in your esophagus that reacts with the drug in the cancer cells to destroy these cells.

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Radiation may be given prior to or after surgery alone or in combination with chemotherapy. High-energy waves are applied to the neck, chest or abdominal areas (depending on the location of your cancer) to kill these cancer cells.

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