Esophageal Cancer

Symptoms of esophageal cancer get more severe as the cancer progresses. Many of these can also be caused by other health problems, so talk to your doctor if you experience any these symptoms:

• Trouble swallowing – especially dry solid foods
• Pressure or burning in your chest after swallowing
• A feeling that food is stuck in your throat
• Weight loss
• Heartburn
• Indigestion
• Frequent choking
• Trouble swallowing liquids & saliva
• Hoarseness
• Coughing
• Vomiting

If your doctor thinks you might have esophageal cancer, exams and tests will be required to reach an accurate diagnosis. This begins with your physician asking questions about your health history, symptoms, risk factors and family history of disease, and may continue with more in-depth tests:

• Sedated Traditional Endoscopy: You will be sedated while your doctor uses an endoscope to look inside your body for signs of esophageal cancer.
• Volumetric Laser Endomicroscopy: A highly advanced new endoscopic imaging technology allowing for real-time diagnosis of surface and subsurface abnormalities.
• Biopsy Collection: An examination of tissue removed from your body to discover the presence, cause, or extent of a disease, like cancer.
• Endoscopic Mucosal Resection (EMR): A technique used to remove cancerous or other abnormal lesions found in the digestive tract. EMD has been advocated for early esophageal cancers and has been shown to be less invasive, safe, and effective nonsurgical therapy for early squamous-cell carcinoma.
• PET (Positron Emission Tomography) and CT (Computed Tomography) Scans: A PET is a powerful, non-invasive, imaging technique that accurately images the biological function of the human body. Computed tomography (CT or CAT scan) is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
• Molecular Staging of Tumors: Low grade or Grade I tumors look more like normal tissue. High grade or Grade III tumors look disorganized under the microscope and may behave more aggressively than Grade I tumors. Those tumors that look neither well-differentiated nor poorly differentiated are designated Grade II. The histologic grade can suggest how slow growing (Grade I) or aggressive (Grade III) a tumor is.
• Staging Laparoscopy: May be used to determine a stage of cancer for the abdominal organ.

Your treatment program will be unique to you and your needs. Upon diagnosis, a plan is mapped out, taking into consideration your age, overall health and health history, how much the cancer has advanced, predicted course of the disease, tolerance for available procedures and medications, as well as your preferences and opinions. For some esophageal cancers, the goal of treatment is to cure the cancer. If a cure isn't possible, you may receive treatment to shrink the cancer, keep it under control for as long as possible and/or improve your quality of life.

• Surgery: This is the most common treatment for early stage esophageal cancer, especially cancer in the lower part of the esophagus. It may cure the cancer if it’s caught in an early stage. Even when cancer can’t be cured, your health care provider may suggest surgery to ease your symptoms.
• Radiation Therapy: This treatment is often used with chemotherapy, either before or after surgery. Radiation and chemotherapy before surgery can help shrink a tumor, making it easier to remove. It may also be used to kill cancer cells after surgery, as part of the main treatment in people who can't have surgery. to help relieve symptoms in people with advanced cancer.
• Chemotherapy and Targeted Therapy: For esophageal cancer, chemotherapy is often used with radiation before or after surgery. It may also be part of the treatment for people who can't have surgery. Targeted therapy medicines work differently from standard chemotherapy medicines and may be useful for some people.
• Photodynamic Therapy (PDT) and Other Endoscopic Treatments: PDT uses a special light-activated medicine and laser to kill cancer cells in some very early stage cancers. It’s most often used to help relieve symptoms in people with advanced cancer. Other endoscopic treatments can also be used to help relieve symptoms in advanced cancer. These include using a laser or electric current to destroy cancer cells in your esophagus.
• Supportive Care: Your healthcare provider may suggest treatments that help ease your symptoms, but don’t treat the cancer. These can sometimes be used with other treatments. Or your doctor may suggest them if treatments are more likely to cause more harm than good.
• Clinical Trials: Researchers are always looking for new ways to treat esophageal cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.
• The Multidisciplinary Cancer Clinic: The INTEGRIS Cancer Institute’s Multidisciplinary Gastrointestinal clinic brings together medical oncologists, gastroenterologists, radiation oncologists and radiologists as a team to provide specific services to the patient with the aim of ensuring that the patient receives optimum care and support.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for esophageal cancer include:

• Mind, body therapies including acupuncture, massage, and yoga
• Research and clinical trials
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Resource Room
• Clinical social work services
• Counseling
• Patient navigation and survivor care planning
• Multi-disciplinary clinic coordination
• Cancer screenings
• Patient and family support groups
• Integrative Medicine Clinic