MedicineWorld.org Oncology - Cancer - esophageal cancer
How is esophageal cancer treated?
Treatment of esophageal cancer depends upon stage of the disease and the general physical condition of the patient. Treatment decision is often taken by a specialist team, which often includes an oncologist, surgeon and radiation oncologist. Treatment of early stage of esophageal cancer Early stages of esophageal cancer is often treated with surgery, however in many instances a combination of chemotherapy and radiotherapy is given prior to surgery to optimize the benefit of surgical therapy. In this situation the chemotherapy is usually given at the same time as radiation therapy. The most common chemotherapy used for this purpose is a combination of combination of cisplatin and flurouracil (5-FU). After about two months of chemotherapy and radiation patient is evaluated for surgery.
Surgery for esophageal cancer Surgery for esophageal cancer involves removal of the part of esophagus that is involved with cancer and joining the uninvolved part with stomach. The lymph nodes in the area are also removed. If the cancer is in the upper part of the esophagus the stomach may be pulled up to the chest to compensate for the loss of length in the esophagus. In a variation of this procedure the surgeon may remove a part of the small intestine and use this to compensate for the lost length of the esophagus, thus keeping the stomach in its normal position. If the cancer is in the lower part of the esophagus, surgeon can remove lower part of the esophagus and upper part of the stomach and join the two ends together. Surgery may cure some of the patients with esophageal cancer, however in many patients the cancer may come back after the surgery.
Treatment of esophageal cancer when the surgery is not an option Many times surgery may not be an option, because of the high position of the esophageal cancer or due to the poor general condition of the patient. Such patients are generally treated with a combination of chemotherapy and radiation. There are several chemotherapy drugs that are active in esophageal cancer. These include fluorouracil (5-FU), cisplatin, mitomycin, bleomycin, doxorubicin, methotrexate, paclitaxel, vinorelbine, topotecan, and irinotecan. The most commonly used drugs are cisplatin and flurouracil. If the cancer has not spread to distant organs as in stage IV, the combination of chemotherapy and radiation can some times cure the esophageal cancer, however the cure rates are much lower than achieved with surgery.
Treatment of esophageal cancer which has spread to other organs. Treatment of esophageal cancer, which has spread to other organs ( stage IV ), is mostly palliative since cure of the disease is not possible in these patients. Chemotherapy is often given to these patients in an attempt to decrease the size of the tumor and improve quality of life. Radiation therapy is not usually given to these patients.
Other palliative measure used in advanced esophageal cancer Photodynamic Therapy (PDT) is a treatment often used in advanced esophageal cancer. This treatment involves injection a drug, which would accumulate in the tumor. Few days after the injection of this drug, a laser light is directed on the tumor using an endoscope. The laser light will make some changes on the drug that has accumulated on the tumor and this will start attacking and killing the cancer cells. When difficulty in swallowing is a major problem in a patient with advanced esophageal cancer, the obstruction may be relieved by placement of a stent to bypass the obstruction. Pain control issues are very important in advanced esophageal cancer. Patients are often treated with morphine containing drug to relieve the pain.
Esophageal cancer: treatment
Esophageal cancer information. (MD Anderson Cancer Center)
How Is Esophagus Cancer Treated? (American Cancer Society)
Treatment of Esophagus Cancer by Stage (American Cancer Society)
Treatment of esophageal cancer (National Cancer Institute)
Treatment of Esophageal Cancer (Mayo Clinic)
Esophageal cancer: treatment (ASCO)
Surgery for esophageal cancer (American Cancer Society)
Chemotherapy for esophageal cancer (American Cancer Society)
Photodynamic Therapy (American Cancer Society)
Radiation Therapy for esophageal cancer (American Cancer Society)
Esophageal cancer: palliative therapy (American Cancer Society)
Clinical trials (American Cancer Society)
Clinical trials in esophageal cancer (Center Watch)
What is new in esophageal cancer (American Cancer Society)
Research on the Horizon (ASCO)
The Official Patient's Sourcebook on Esophageal Cancer
by Icon Health Publications
21st Century Complete Medical Guide to Esophageal Cancer
by PM Medical Health News
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