Esophageal Cancer Treatment

The Thoracic Center

(732) 235-7802 • (732) 235-8150 (fax)

Esophageal Cancer

Esophageal Cancer Overview

Esophageal cancer is an increasingly common malignancy in the United States. Last year, almost 30,000 people in this country developed this serious disease. Although squamous cell carcinoma is the most common subtype globally, in North America the incidence of adenocarcinoma is rapidly rising. Treatment can involve medical therapies, such as radiation and chemotherapy, or operations on the esophagus itself.

Esophageal Cancer Causes

Alcohol consumption and smoking are major risk factors in the development of squamous cell esophageal cancer, but their role in adenocarcinoma is less clear. Barrett’s esophagus with high grade dysplasia is associated with a high incidence of invasive adenocarcinoma. Barrett’s esophagus develops after the lining of the esophagus is exposed to gastric acid due to gastroesophageal reflux disease. People with Barrett’s are at a 30 – 40 fold increased risk of developing esophageal cancer as compared to the general population.

Esophageal Cancer Symptoms

Most esophageal cancers do not cause symptoms until the cancer has reached an advanced stage. The most common symptom is difficulty swallowing, or dysphagia. Individuals often have a sensation that food is getting stuck in the throat or chest. Without realizing it, people often change their diet and eating habits and avoid foods that are difficult to swallow. Even liquids are not able to pass when the cancer is advanced. People produce additional saliva to assist the food and liquids to pass through the esophagus.In rare cases, people can have chest pain or discomfort, chest pressure, or chest burning. Pain with swallowing is a late sign of a large cancer blocking the esophagus. Unintended weight loss is associated with the inability to swallow and a decreased appetite. Other symptoms include hoarseness and hiccups.

Esophageal Cancer Diagnosis

Esophageal cancer is diagnosed and cancer spread is determined with any combination of the following exams, tests, and procedures:

Esophageal Cancer Treatment/Surgery

Esophageal cancer remains one of the most difficult solid tumors to treat. A variety of treatment modalities are available, dictated by the stage of the disease. Here at Robert Wood Johnson University Hospital and The Cancer Institute of New Jersey, we take a team approach to the management of this disease. Medical oncologists, radiation oncologists, surgical oncologists, thoracic surgeons, and gastroenterologists work together to map out the best treatment plan for each individual patient.

The goals of treatment are cure and restoring the ability to swallow. Surgery offers the best chance to achieve these goals in the appropriate patient. Surgical approaches include transhiatal esophagectomy (resecting the esophagus without opening the chest cavity) and esophagectomy with thoracotomy (with opening the chest ). The choice is dictated by the location and stage of the tumor. Our gastrointestinal oncology team works in concert to determine the best approach for each particular patient.

Multimodality therapy may include any combination of surgical, radiation therapy, chemotherapy, and endoscopic approaches. Depending upon the circumstances, chemotherapy and radiation therapy may be offered before (neoadjuvant) or after (adjuvant) surgery. Treatments are carried out within the Departments of Surgery and Medicine at Rutgers Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, and Robert Wood Johnson University Hospital.

Esophagectomy is performed at Robert Wood Johnson University Hospital. Please call (732) 235-7802 to schedule an appointment with one of The University Thoracic Surgeons.

Esophageal Cancer Prevention

Our team also diagnoses and manages precancerous conditions of the esophagus, including Barrett’s esophagus. We perform endoscopic screening procedures and, when necessary, surgery to detect precancerous conditions of the esophagus and to prevent the development of an actual cancer.

Esophageal Cancer Research

Through the auspices of the Divisions of Thoracic Surgery and Gastroenterology at Rutgers Robert Wood Johnson Medical School and the Rutgers Cancer Institute of New Jersey, we are also able to offer participation in clinical trials for the prevention and treatment of esophageal cancer. Clinical trials afford patients access to the latest and most promising developments in the field.

(732) 235-7802 • (732) 235-8150 (fax)

 

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