By Dr. Prashant Mehta, Oncology,
Esophageal cancer is a cancer of the tissue of the esophagus. Treatment options available for esophageal cancer will depend on the type and stage of the cancer, the patient’s overall health and the possible side-effects of treatment. For esophageal cancer that has not metastasised beyond the esophagus and the surrounding lymph nodes, doctors usually recommend a combination of several treatments such as surgery, chemotherapy and radiation therapy. The most common treatment options offered are:
Surgery is used as the primary treatment only for patients who are in the early stage of esophageal cancer, beyond which it is used in combination with other treatment methods. Surgery may involve removing the tumour when it is small and has not spread to other parts of the esophagus, or removing a portion of the esophagus, which is known as esophagectomy. Or if the cancer has spread to the stomach then a portion of the stomach is removed along with a part of the esophagus and surrounding lymph nodes, which is then known as esophagogastrectomy.
Chemotherapy is the method of using certain drugs to kill the cancerous cells or to stop their growth. Systematic chemotherapy is most commonly used in which the drugs are either injected into the bloodstream through an IV drip or ingested in the form of a tablet. Chemotherapy treatment is usually given in specific cycles which last a certain amount of time and has been known to have a number of side effects such as loss of appetite, nausea, risk of infection, hair loss, diarrhoea, etc. but it varies from person to person.
Radiation therapy involves using X-Rays or other high energy particles to destroy the cancer cells. The most common form of radiation therapy is called external-beam radiation therapy in which radiation is applied through a machine externally. Another, less common form is called brachytherapy. Treatment usually lasts from two to six weeks and can have side effects such as difficulty swallowing, sun-burn like symptoms, soreness and fatigue.
Targeted therapy is a newer form of treatment in which specific cancer cells or tissues are targeted directly by drugs or other chemicals to prevent their growth and spreading while minimising the damage to surrounding tissue. One type of targeted therapy used in the treatment of esophageal cancer is Monoclonal Antibody Therapy in which antibodies produced in the laboratory specifically to identify cancerous cells are used to attach to the cancer cells and kill them or block their growth.
What type of treatment will be best suited to the patient depends on a lot of individual factors and hence the appropriate course of action will be decided by the doctor or the specialist in charge of the patient’s care.