Esophageal Cancer
General Information About Esophageal Cancer(Symptoms)
Stages
Treatment Option Overview
Esophageal cancer is a disease in which malignant (cancer)
cells form in the tissues of the esophagus. The esophagus is a muscular
tube that moves food and liquids from the throat to the stomach.
The most common types of esophageal cancer are squamous cell
carcinoma and adenocarcinoma. Squamous cell carcinoma begins in flat
cells lining the esophagus. Adenocarcinoma begins in cells that make
and release mucus and other fluids.
Smoking and heavy alcohol use increase the risk of esophageal
squamous cell carcinoma. Gastroesophageal reflux disease and Barrett
esophagus may increase the risk of esophageal adenocarcinoma.
Esophageal cancer is often diagnosed at an advanced stage
because there are no early signs or symptoms.
General Information About Esophageal Cancer
Key Points
- Esophageal cancer is a disease in which malignant (cancer)
cells form in the tissues of the esophagus.
- Smoking, heavy alcohol use, and Barrett esophagus can
increase the risk of esophageal cancer.
- Signs and symptoms of esophageal cancer are weight loss and
painful or difficult swallowing.
- Tests that examine the esophagus are used to detect (find)
and diagnose esophageal cancer.
- Certain factors affect prognosis (chance of recovery) and
treatment options.
Esophageal
cancer is a disease in which malignant (cancer) cells form in the
tissues of the esophagus.
The esophagus
is the hollow, muscular tube that moves food and liquid from the throat
to the stomach.
The wall of the esophagus is made up of several layers of tissue,
including mucous
membrane, muscle, and connective
tissue. Esophageal
cancer starts on the inside lining of the esophagus and
spreads outward through the other layers as it grows.
The esophagus and stomach
are part of the upper gastrointestinal (digestive) system.
The two most common
forms of esophageal cancer are named for the type of cells
that become malignant
(cancerous):
- Squamous
cell carcinoma: Cancer
that forms in squamous
cells, the thin, flat cells lining the esophagus. This
cancer
is most often found in the upper and middle part of the esophagus, but
can occur anywhere along the esophagus. This is also called epidermoid
carcinoma.
- Adenocarcinoma:
Cancer that begins in glandular
(secretory) cells. Glandular cells in the lining of the esophagus
produce and release fluids
such as mucus.
Adenocarcinomas usually form in the lower part of the esophagus, near
the stomach.
Smoking,
heavy alcohol use, and Barrett esophagus can increase the risk of
esophageal cancer.
Anything that increases
your risk of getting a disease is called a risk
factor. Having a risk factor does not mean that you will
get
cancer; not having risk factors doesn't mean that you will not get
cancer. Talk with your doctor if you think you may be at risk. Risk
factors include the following:
- Tobacco
use.
- Heavy alcohol
use.
- Barrett
esophagus: A condition
in which the cells lining the lower part of the esophagus have changed
or been replaced with abnormal
cells that could lead to cancer of the esophagus. Gastric
reflux (the backing up of stomach contents into the lower
section of the esophagus) may irritate the esophagus and, over time,
cause Barrett esophagus.
- Older age.
See the PDQ
summary on Esophageal
Cancer Prevention for more information.
Signs
and symptoms of esophageal cancer are weight loss and painful or
difficult swallowing.
These and other signs
and symptoms
may be caused by esophageal cancer or by other conditions. Check with
your doctor if you have any of the following:
- Painful or difficult swallowing.
- Weight loss.
- Pain behind the breastbone.
- Hoarseness and cough.
- Indigestion and heartburn.
Tests
that examine the esophagus are used to detect (find) and diagnose
esophageal cancer.
The following tests and
procedures may be used:
- Physical
exam and history
: An exam of the body to check general signs of
health, including checking for signs of disease, such as lumps or
anything else that seems unusual. A history of the patient's health
habits and past illnesses and treatments will also be taken.
- Chest
x-ray : An x-ray
of the organs
and bones inside the chest. An x-ray is a type of energy beam that can
go through the body and onto film, making a picture of areas inside the
body.
- Barium
swallow : A series of x-rays of the
esophagus
and stomach. The patient drinks a liquid that contains barium
(a silver-white metallic
compound).
The liquid coats the esophagus and stomach, and x-rays are taken. This
procedure is also called an upper
GI series.
Barium swallow. The
patient swallows barium liquid and it flows through the esophagus and
into the stomach. X-rays are taken to look for abnormal areas.
- Esophagoscopy
: A procedure to look inside the esophagus to check
for abnormal areas. An esophagoscope is inserted through the mouth or
nose and down the throat into the esophagus. An esophagoscope is a
thin, tube-like instrument with a light and a lens
for viewing. It may also have a tool to remove tissue samples, which
are checked under a microscope
for signs of cancer. When the esophagus and stomach are looked at, it
is called an upper
endoscopy.
Esophagoscopy. A thin,
lighted tube is inserted through the mouth and into the esophagus to
look for abnormal areas.
- Biopsy
: The removal of cells or tissues so they can be
viewed under a microscope by a pathologist
to check for signs of cancer. The biopsy is usually done during an
esophagoscopy. Sometimes a biopsy shows changes in the esophagus that
are not cancer but may lead to cancer.
Certain
factors affect prognosis (chance of recovery) and treatment options.
The prognosis
(chance of recovery)
and treatment options depend on the following:
- The stage
of the cancer (whether it affects part of the esophagus, involves the
whole esophagus, or has spread to other places in the body).
- Whether the tumor can be completely removed by surgery.
- The patient's general health.
When esophageal cancer is found very early, there is a better chance of
recovery. Esophageal cancer is often in an advanced stage when it is
diagnosed.
At later stages, esophageal cancer can be treated but rarely can be
cured.
Taking part in one of the
clinical
trials
Stages of Esophageal Cancer
Key Points
- After esophageal cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the esophagus or to
other parts of the body.
- There are three ways that cancer spreads in the body.
- Cancer may spread from where it began to other parts of the
body.
- The grade of the tumor is also used to describe the cancer
and plan treatment.
- The following stages are used for squamous cell carcinoma
of the esophagus:
- Stage 0 (High-grade Dysplasia)
- Stage I squamous cell carcinoma of the esophagus
- Stage II squamous cell carcinoma of the esophagus
- Stage III squamous cell carcinoma of the esophagus
- Stage IV squamous cell carcinoma of the esophagus
- The following stages are used for adenocarcinoma of the
esophagus:
- Stage 0 (High-grade Dysplasia)
- Stage I adenocarcinoma of the esophagus
- Stage II adenocarcinoma of the esophagus
- Stage III adenocarcinoma of the esophagus
- Stage IV adenocarcinoma of the esophagus
After
esophageal cancer has been diagnosed, tests are done to find out if
cancer cells have spread within the esophagus or to other parts of the
body.
The process used to find
out if cancer
cells
have spread within the esophagus
or to other parts of the body is called staging.
The information gathered from the staging process determines the stage
of the disease. It is important to know the stage in order to plan
treatment. The following tests and procedures may be used in the
staging process:
- Endoscopic
ultrasound (EUS): A procedure in which an endoscope
is inserted into the body, usually through the mouth or rectum.
For esophageal
cancer, the endoscope is inserted through the mouth. An
endoscope is a thin, tube-like instrument with a light and a lens
for viewing. A probe at the end of the endoscope is used to bounce
high-energy sound waves (ultrasound)
off internal tissues
or organs
and make echoes. The echoes form a picture of body tissues called a sonogram.
This procedure is also called endosonography.
- CT
scan (CAT scan): A procedure that makes a
series of detailed pictures of areas inside the body, such as the
chest, abdomen,
and pelvis,
taken from different angles. The pictures are made by a computer linked
to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This
procedure is also called computed tomography, computerized tomography,
or computerized axial tomography.
- PET
scan (positron emission tomography scan): A
procedure to find malignant
tumor
cells in the body. A small amount of radioactive
glucose
(sugar) is injected into a vein. The PET scanner
rotates around the body and makes a picture of where glucose is being
used in the body. Malignant tumor cells show up brighter in the picture
because they are more active and take up more glucose than normal cells
do. A PET scan and CT scan may be done at the same time. This is called
a PET-CT.
- MRI
(magnetic resonance imaging): A procedure that uses a
magnet, radio
waves, and a computer to make a series of detailed
pictures
of areas inside the body. This procedure is also called nuclear
magnetic resonance imaging (NMRI).
- Thoracoscopy
: A surgical
procedure to look at the organs inside the chest to check for abnormal
areas. An incision
(cut) is made between two ribs and a thoracoscope
is inserted into the chest. A thoracoscope is a thin, tube-like
instrument with a light and a lens for viewing. It may also have a tool
to remove tissue or lymph
node samples, which are checked under a microscope for
signs
of cancer. In some cases, this procedure may be used to remove part of
the esophagus or lung.
- Laparoscopy
: A surgical procedure to look at the organs inside
the abdomen
to check for signs of disease. Small incisions (cuts) are made in the
wall of the abdomen and a laparoscope
(a thin, lighted tube) is inserted into one of the incisions. Other
instruments may be inserted through the same or other incisions to
perform procedures such as removing organs or taking tissue samples to
be checked under a microscope for signs of disease.
There
are three ways that cancer spreads in the body.
Cancer can spread
through tissue,
the lymph
system, and the blood:
- Tissue. The cancer spreads from where it began by growing
into nearby areas.
- Lymph system. The cancer spreads from where it began by
getting into the lymph system. The cancer travels through the lymph
vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting
into the blood. The cancer travels through the blood
vessels to other parts of the body.
Cancer
may spread from where it began to other parts of the body.
When cancer spreads
to another part of the body, it is called metastasis.
Cancer cells
break away from where they began (the primary
tumor) and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system,
travels through the lymph vessels, and forms a tumor
(metastatic
tumor) in another part of the body.
- Blood. The cancer gets into the blood, travels through the
blood vessels, and forms a tumor (metastatic tumor) in another part of
the body.
The metastatic
tumor is the same type of cancer as the primary
tumor. For example, if esophageal
cancer spreads to the lung, the cancer cells in the lung
are
actually esophageal cancer cells. The disease is metastatic esophageal
cancer, not lung
cancer.
The
grade of the tumor is also used to describe the cancer and plan
treatment.
The grade
of the tumor describes how abnormal the cancer cells look under a
microscope and how quickly the tumor is likely to grow and spread.
Grades 1 to 3 are used to describe esophageal cancer:
- In grade 1, the cancer cells look more like normal cells
under a microscope and grow and spread more slowly than grade 2 and 3
cancer cells.
- In grade 2, the cancer cells look more abnormal under a
microscope and grow and spread more quickly than grade 1 cancer cells.
- In grade 3, the cancer cells look more abnormal under a
microscope and grow and spread more quickly than grade 1 and 2 cancer
cells.
The
following stages are used for squamous cell carcinoma of the esophagus:
Stage
0 (High-grade Dysplasia)
In stage
0, abnormal
cells
are found in the mucosa
or submucosa
layer of the esophagus
wall. These abnormal cells may become cancer
and spread into nearby normal tissue.
Stage 0 is also called high-grade
dysplasia.
Stage
I squamous cell carcinoma of the esophagus
Stage
I is divided into Stage IA and Stage IB, depending on
where
the cancer
is found.
- Stage
IA: Cancer has formed in the mucosa
or submucosa
layer of the esophagus
wall. The cancer cells
are grade
1. Grade 1 cancer cells look more like normal cells under a microscope
and grow and spread more slowly than grade 2 and 3 cancer cells.
Stage IA squamous cell
cancer of the esophagus. Cancer has formed in the mucosa or submucosa
layer of the esophagus wall. The cancer cells are grade 1 or the grade
is unknown. Grade 1 cancer cells look more like normal cells under a
microscope and grow and spread more slowly than grade 2-3 cancer cells.
- Stage
IB: Cancer has formed:
- in the mucosa
or submucosa
layer of the esophagus
wall. The cancer cells
are grade
2 and 3; or
- in the mucosa or submucosa layer and spread into the
muscle layer or the connective
tissue layer of the esophagus wall. The cancer cells are
grade 1. The tumor
is in the lower esophagus or it is not known where the tumor is.
Grade 1 cancer
cells look more like normal cells under a microscope
and grow and spread more slowly than grade 2 and 3 cancer cells.
Stage IB squamous cell
cancer of the esophagus. Cancer has formed in the mucosa or submucosa
layer of the esophagus wall, and the cancer cells are grade 2-3; OR
cancer has formed in the mucosa or submucosa layer and spread into the
muscle layer or the connective tissue layer of the esophagus wall, and
the cancer cells are grade 1. Grade 1 cancer cells look more like
normal cells under a microscope and grow and spread more slowly than
grade 2-3 cancer cells. The tumor is in the lower esophagus or it is
not known where the tumor is.
Stage
II squamous cell carcinoma of the esophagus
Stage
II is divided into Stage IIA and Stage IIB, depending on
where the cancer
has spread.
- Stage
IIB: Cancer:
- has spread into the muscle layer or the connective
tissue layer of the esophagus
wall. The cancer cells
are grade
2 and 3. Grade 2 and 3 cancer cells look more abnormal
under a microscope
and grow and spread more quickly than grade 1 cancer cells. The tumor
is in either the upper or middle esophagus; or
- is in the mucosa
or submucosa
layer and may have spread into the muscle layer of the esophagus wall.
Cancer is found in 1 or 2 lymph
nodes near the tumor.
Stage IIB squamous cell
cancer of the esophagus. The tumor is in either the upper or middle
esophagus. Cancer has spread into the muscle layer or the connective
tissue layer of the esophagus wall, and the cancer cells are grade 2-3;
OR cancer is in the mucosa or submucosa layer and may have spread into
the muscle layer of the esophagus wall, and cancer is found in 1 or 2
lymph nodes near the tumor. Grade 2-3 cancer cells look more abnormal
under a microscope and grow and spread more quickly than grade 1 cancer
cells.
Stage
III squamous cell carcinoma of the esophagus
Stage
III is divided into Stage IIIA, Stage IIIB, and Stage
IIIC,
depending on where the cancer
has spread.
- Stage
IIIA: Cancer:
- is in the mucosa
or submucosa
layer and may have spread into the muscle layer of the esophagus
wall. Cancer is found in 3 to 6 lymph
nodes near the tumor;
or
- has spread into the connective
tissue layer of the esophagus wall. Cancer is found in 1
or 2
lymph nodes near the tumor; or
Stage IIIA squamous
cell cancer of the esophagus (1). Cancer is in the mucosa or submucosa
layer and may have spread into the muscle layer of the esophagus wall,
and cancer is found in 3 to 6 lymph nodes near the tumor; OR cancer has
spread into the connective tissue layer of the esophagus wall, and
cancer is found in 1 or 2 lymph nodes near the tumor.
- has spread into the diaphragm,
pleura
(tissue
that covers the lungs
and lines the inner wall of the chest cavity),
or sac around the heart. The cancer can be removed by surgery.
Stage IIIA squamous
cell cancer of the esophagus (2). Cancer has spread into the (a)
diaphragm, (b) pleura (tissue that covers the lungs and lines the inner
wall of the chest cavity), or (c) membrane (sac) around the heart. The
cancer can be removed by surgery.
- Stage
IIIC: Cancer has spread:
- into the diaphragm,
pleura
(tissue
that covers the lungs
and lines the inner wall of the chest cavity),
or sac around the heart. The cancer can be removed by surgery.
Cancer is found in 1 to 6 lymph
nodes near the tumor;
or
Stage IIIC squamous
cell cancer of the esophagus (1). Cancer has spread into the (a)
diaphragm, (b) pleura (tissue that covers the lungs and lines the inner
wall of the chest cavity), or (c) membrane (sac) around the heart. The
cancer can be removed by surgery. Cancer is found in 1 to 6 lymph nodes
near the tumor.
- into other nearby organs
such as the aorta,
trachea,
or spine,
and the cancer cannot be removed by surgery; or
- to 7 or more lymph nodes near the tumor.
Stage IIIC squamous
cell cancer of the esophagus (2). Cancer has spread into nearby organs,
such as the aorta, trachea, or spine, and the cancer cannot be removed
by surgery; OR cancer has spread to 7 or more lymph nodes near the
tumor.
Stage
IV squamous cell carcinoma of the esophagus
In Stage
IV, cancer
has spread to other parts of the body.
Stage IV squamous cell
cancer of the esophagus. The cancer has spread to other parts of the
body, such as the lung, liver, adrenal gland, kidney, or bone.
The
following stages are used for adenocarcinoma of the esophagus:
Stage
0 (High-grade Dysplasia)
In stage
0, abnormal
cells
are found in the mucosa
or submucosa
layer of the esophagus
wall. These abnormal cells may become cancer
and spread into nearby normal tissue.
Stage 0 is also called high-grade
dysplasia.
Stage
I adenocarcinoma of the esophagus
Stage
I is divided into Stage IA and Stage IB, depending on
where
the cancer
is found.
- Stage
IA: Cancer has formed in the mucosa
or submucosa
layer of the esophagus
wall. The cancer cells
are grade
1 or 2. Grade 1 and 2 cancer cells look more like normal cells under a microscope
and grow and spread more slowly than grade 3 cancer cells.
Stage IA adenocarcinoma
of the esophagus. Cancer has formed in the mucosa or submucosa layer of
the esophagus wall. The cancer cells are grade 1 or 2. Grade 1 and 2
cancer cells look more like normal cells under a microscope and grow
and spread more slowly than grade 3 cancer cells.
- Stage
IB: Cancer has formed:
- in the mucosa
or submucosa
layer of the esophagus
wall. The cancer cells
are grade
3; or
- in the mucosa or submucosa layer and spread into the
muscle layer of the esophagus wall. The cancer cells are grade 1 or 2.
Grade 1 and 2 cancer
cells look more like normal cells under a microscope
and grow and spread more slowly than grade 3 cancer cells.
Stage IB adenocarcinoma
of the esophagus. Cancer has formed in the mucosa or submucosa layer of
the esophagus wall, and the cancer cells are grade 3. Grade 3 cancer
cells look more abnormal under a microscope and grow and spread more
quickly than grade 1 or 2 cancer cells; OR cancer has formed in the
mucosa or submucosa layer and spread into the muscle layer of the
esophagus wall, and the cancer cells are grade 1 or 2. Grade 1 and 2
cancer cells look more like normal cells under a microscope and grow
and spread more slowly than grade 3 cancer cells.
Stage
II adenocarcinoma of the esophagus
Stage
II is divided into Stage IIA and Stage IIB, depending on
where the cancer
has spread.
- Stage
IIA: Cancer has spread into the muscle layer of the esophagus
wall. The cancer cells
are grade
3. Grade 3 cancer cells look more abnormal
under a microscope
and grow and spread more quickly than grade 1 and 2 cancer cells.
Stage IIA
adenocarcinoma of the esophagus. Cancer has spread into the muscle
layer of the esophagus wall. The cancer cells are grade 3. Grade 3
cancer cells look more abnormal under a microscope and grow and spread
more quickly than grade 1 or 2 cancer cells.
- Stage
IIB: Cancer:
- has spread into the connective
tissue layer of the esophagus
wall; or
- is in the mucosa
or submucosa
layer and may have spread into the muscle layer of the esophagus wall.
Cancer is found in 1 or 2 lymph
nodes near the tumor.
Stage IIB
adenocarcinoma of the esophagus. Cancer has spread into the connective
tissue layer of the esophagus wall; OR cancer is in the mucosa or
submucosa layer and may have spread into the muscle layer of the
esophagus wall, and cancer is found in 1 or 2 lymph nodes near the
tumor.
Stage
III adenocarcinoma of the esophagus
Stage
III is divided into Stage IIIA, Stage IIIB, and Stage
IIIC,
depending on where the cancer
has spread.
Stage
IV adenocarcinoma of the esophagus
In Stage
IV, cancer
has spread to other parts of the body.
Recurrent Esophageal Cancer
Recurrent
esophageal
cancer is cancer
that has recurred
(come back) after it has been treated. The cancer may come back in the esophagus
or in other parts of the body.
Treatment Option Overview
Key Points
- There are different types of treatment for patients with
esophageal cancer.
- Patients have special nutritional needs during treatment
for esophageal cancer.
- Six types of standard treatment are used:
- Surgery
- Radiation therapy
- Chemotherapy
- Chemoradiation therapy
- Laser therapy
- Electrocoagulation
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical
trial.
- Patients can enter clinical trials before, during, or after
starting their cancer treatment.
- Follow-up tests may be needed.
There
are different types of treatment for patients with esophageal cancer.
Different types of
treatment are available for patients with esophageal
cancer. Some treatments are standard
(the currently used treatment), and some are being tested in clinical
trials. A treatment clinical trial is a research
study meant to help improve current treatments or obtain
information on new treatments for patients with cancer.
When clinical trials show that a new treatment is better than the
standard treatment, the new treatment may become the standard
treatment. Patients may want to think about taking part in a clinical
trial. Some clinical trials are open only to patients who have not
started treatment.
Patients
have special nutritional needs during treatment for esophageal cancer.
Many people with
esophageal cancer find it hard to eat because they have trouble
swallowing. The esophagus
may be narrowed by the tumor
or as a side
effect of treatment. Some patients may receive nutrients
directly into a vein.
Others may need a feeding tube (a flexible plastic tube that is passed
through the nose or mouth into the stomach)
until they are able to eat on their own.
Six
types of standard treatment are used:
Surgery
Surgery
is the most common treatment for cancer of the esophagus. Part of the
esophagus may be removed in an operation called an esophagectomy.
Esophagectomy. A portion of
the esophagus is removed and the stomach is pulled up and joined to the
remaining esophagus.
The doctor will connect the remaining healthy part of the esophagus to
the stomach so the patient can still swallow. A plastic tube or part of
the
intestine
may be used to make the connection.
Lymph
nodes near the esophagus may also be removed and viewed
under
a
microscope
to see if they contain cancer. If the esophagus is partly blocked by
the tumor, an expandable metal
stent
(tube) may be placed inside the esophagus to help keep it open.
Esophageal stent. A device
(stent) is placed in the esophagus to keep it open to allow food and
liquids to pass through into the stomach.
Small, early-stage
cancer and high-grade
dysplasia
of the esophagus may be removed by endoscopic
resection.
An endoscope
(a thin, tube-like instrument with a light and a lens
for viewing) is inserted through a small incision
(cut) in the skin or through an opening in the body, such as the mouth.
A tool attached to the endoscope is used to remove tissue.
Radiation
therapy
Radiation
therapy is a cancer treatment that uses high-energy x-rays
or other types of radiation
to kill cancer cells
or keep them from growing. There are two types of radiation therapy:
- External
radiation therapy uses a machine outside the body to send
radiation toward the cancer.
- Internal
radiation therapy uses a radioactive
substance sealed in needles, seeds,
wires, or catheters
that are placed directly into or near the cancer.
The way the radiation
therapy is given depends on the type and stage
of the cancer being treated. External and internal radiation therapy
are used to treat esophageal cancer.
A plastic tube may be
inserted into the esophagus to keep it open during radiation therapy.
This is called intraluminal
intubation and dilation.
Chemotherapy
Chemotherapy
is a cancer treatment that uses drugs
to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. When chemotherapy is taken by mouth or injected
into a vein or muscle, the drugs enter the bloodstream and can reach
cancer cells throughout the body (systemic
chemotherapy). When chemotherapy is placed directly into
the cerebrospinal
fluid, an organ,
or a body cavity
such as the abdomen,
the drugs mainly affect cancer cells in those areas (regional
chemotherapy). The way the chemotherapy is given depends
on
the type and stage of the cancer being treated.
See Drugs
Approved for Esophageal Cancer for more information.
Chemoradiation
therapy
Chemoradiation
therapy combines chemotherapy and radiation therapy to
increase the effects of both.
Laser
therapy
Laser
therapy is a cancer treatment that uses a laser
beam (a narrow beam of intense light) to kill cancer cells.
Electrocoagulation
Electrocoagulation
is the use of an electric current to kill cancer cells.
New
types of treatment are being tested in clinical trials.
This summary section
describes treatments that are being studied in clinical trials. It may
not mention every new treatment being studied. Information about
clinical trials is available from the NCI
website.
Targeted
therapy
Targeted
therapy is a type of treatment that uses drugs or other
substances to identify and attack specific cancer cells. Targeted
therapies usually cause less harm to normal cells than chemotherapy or
radiation therapy do. Monoclonal
antibody therapy
is a type of targeted therapy used in the treatment of esophageal
cancer.
Monoclonal antibody
therapy uses antibodies
made in the laboratory from a single type of immune
system cell. These antibodies can identify substances on
cancer cells or normal substances that may help cancer cells grow. The
antibodies attach to the substances and kill the cancer cells, block
their growth, or keep them from spreading. Monoclonal antibodies are
given by infusion.
They may be used alone or to carry drugs, toxins,
or radioactive material directly to cancer cells. Trastuzumab
is a monoclonal antibody being studied in esophageal cancer. It may be
given to block the effect of the growth
factor protein
HER2,
which sends growth signals to esophageal cancer cells.
Patients
may want to think about taking part in a clinical trial.
For some patients,
taking part in a clinical
trial may be the best treatment choice. Clinical trials
are
part of the cancer research process. Clinical trials are done to find
out if new cancer treatments are safe and effective or better than the standard
treatment.
Many of today's
standard treatments for cancer are based on earlier clinical trials.
Patients who take part in a clinical trial may receive the standard
treatment or be among the first to receive a new treatment.
Patients who take
part in clinical trials also help improve the way cancer will be
treated in the future. Even when clinical trials do not lead to
effective new treatments, they often answer important questions and
help move research forward.
Patients
can enter clinical trials before, during, or after starting their
cancer treatment.
Some clinical trials
only include patients who have not yet received treatment. Other trials
test treatments for patients whose cancer has not gotten better. There
are also clinical trials that test new ways to stop cancer from recurring
(coming back) or reduce the side
effects of cancer treatment.
Clinical trials are
taking place in many parts of the country. See the Treatment Options
section that follows for links to current treatment clinical trials.
These have been retrieved from NCI's
listing of clinical trials.
Follow-up
tests may be needed.
Some of the tests
that were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to
continue, change, or stop treatment may be based on the results of
these tests.
Some of the tests
will continue to be done from time to time after treatment has ended.
The results of these tests can show if your condition
has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up
tests or check-ups.
Treatment Options By Stage
Stage 0 (High-grade Dysplasia)
Treatment of stage 0 may include the
following:
- Surgery.
- Endoscopic
resection.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage 0 esophageal cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage I Esophageal Cancer
Treatment of stage I esophageal squamous cell carcinoma
or adenocarcinoma
may include the following:
- Chemoradiation
therapy followed by surgery.
- Surgery alone.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage I esophageal cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage II Esophageal Cancer
Treatment of stage II esophageal squamous cell
carcinoma or adenocarcinoma
may include the following:
- Chemoradiation
therapy followed by surgery.
- Surgery alone.
- Chemotherapy
followed by surgery.
- Chemoradiation therapy alone.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage II esophageal cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage III Esophageal Cancer
Treatment of stage III esophageal squamous cell
carcinoma or adenocarcinoma
may include the following:
- Chemoradiation
therapy followed by surgery.
- Chemotherapy
followed by surgery.
- Chemoradiation therapy alone.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage III esophageal cancer. For more specific results,
refine the search by using other search features, such as the location
of the trial, the type of treatment, or the name of the drug. Talk with
your doctor about clinical trials that may be right for you. General
information about clinical trials is available from the NCI website.
Stage IV Esophageal Cancer
Treatment of stage IV esophageal squamous cell
carcinoma or adenocarcinoma
may include the following:
- Chemoradiation
therapy followed by surgery.
- Chemotherapy.
- Laser surgery
or electrocoagulation
as palliative therapy
to relieve symptoms
and improve quality of life.
- An esophageal stent
as palliative therapy to relieve symptoms and improve quality of life.
- External
or internal radiation therapy
as palliative therapy to relieve symptoms and improve quality of life.
- Clinical trials
of chemotherapy.
- A clinical trial of targeted
therapy combined with chemotherapy.
Treatment Options for Recurrent Esophageal Cancer
Treatment of recurrent esophageal cancer may
include the following:
- Use of any standard
treatments as palliative
therapy to relieve symptoms
and improve quality of life.
- Clinical trials.
-NIH
