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How to Deal with Esophageal Cancer

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If you have esophageal cancer, your doctor will use different treatments to kill the cancer cells and ease your symptoms. These include surgery, chemotherapy, radiation therapy and immunotherapy.

Your doctor chooses based on the type of esophagus cancer you have, its stage, your overall health and your preferences. These treatment plans can help you live longer, ease your symptoms and maintain your quality of life.

Diagnosis

Doctors will use several tests if you have been diagnosed with esophageal cancer to help determine the type and stage of the illness. This information will help the doctor choose how to treat your esophageal cancer. 

The first test used is an upper endoscopy, which is a procedure that uses a thin, flexible tube with a camera on end (endoscope) to view your esophagus and stomach. A small amount of tissue may also be removed (biopsy) and viewed under a microscope by a pathologist to check for signs of cancer.

Computed tomography or magnetic resonance imaging are additional examinations. These scans show the esophagus and its surroundings in great detail. Before the scan, a unique contrast material may be injected into your blood to improve the contrast of soft tissues.

These tests can also tell the doctor how far cancer has spread to other body parts, called “staging.” This information is essential in planning treatment for your esophageal cancer. You can seek help from surgeons like Armen Parajian, who focuses on thoracic surgery with minimally invasive techniques.

Treatment

Your treatment options for esophageal cancer depend on the type of cancer and stage and your health and preferences. Your doctor will discuss all your options and help you choose the best one.

For early-stage tumors, your doctor may recommend endoscopic mucosal resection (EMR). This surgery uses a flexible tube with cameras and surgical tools at the tip to remove tumors in the mucosa layer of the esophagus.

During this procedure, your doctor removes only the tumor, not the surrounding tissue. It can help relieve symptoms and make swallowing easier for people with squamous cell carcinoma or adenocarcinoma.

You will need to modify your diet and drink plenty of water before and after surgery. Your doctor will also teach you special coughing and breathing exercises to clear your lungs.

Esophagectomy is the procedure used most frequently to treat esophageal cancer. This removes the esophagus section with cancer, a small amount of surrounding tissue, and nearby lymph nodes.

Symptoms

Usually, the first symptom of cancer in your esophagus is difficulty swallowing (dysphagia), which may feel as if food is stuck in your throat or you’re choking. It’s often mild to start but tends to worsen over time.

Your doctor will review your symptoms, medical history and exam to determine if you have cancer. They may order specific tests, including endoscopy and a biopsy or tissue sample.

A biopsy can help determine the stage of your cancer based on whether abnormal cells are found only in the esophagus or have spread (metastasized) to nearby tissues. This information helps your doctor plan the best treatment for you.

Risk factors for esophageal cancer include smoking, chewing tobacco and a family history of this type of cancer. Some disorders, such as gastroesophageal reflux disease (GERD) and Barrett’s esophagus, also increase your chances of developing this disease. It’s also possible to reduce your chances of getting esophageal cancer by eating a healthy diet and maintaining a healthy weight.

Follow-up

After you finish treatment for esophagus cancer, your doctor will talk with you about follow-up care. This can include getting regular blood tests and imaging (CT or MRI) to check for cancer cells in your body.

Your doctor might also recommend getting an endoscopy or a biopsy, which involves passing an extraordinary scope down your throat to look in your esophagus for cancer. These tests can help your doctor find the best treatment for you and see if cancer has spread.

If you have a recurrence, your doctor may recommend different treatments, such as surgery, radiation therapy, chemotherapy, targeted therapy or immunotherapy. These treatments are used to reduce the risk of cancer coming back and to treat symptoms and side effects.

You might be able to do things that can help your chances of cancer stay in check, such as eating a healthy diet or taking nutritional supplements. But at this time, not enough is known about how these lifestyle changes might affect your risk of cancer recurrence or spread.