“How long can I live if I have esophageal cancer?” This question, I believe, is the most important one that every patient wants to know.
The first thing you should know is that esophageal cancer is not an incurable disease. The survival rate of early-stage patients can reach more than 90% in 5 years with reasonable treatment; even advanced patients can significantly extend their survival time with standard treatment.
Early-stage esophageal cancer can be cured by about 90% after surgery or minimally invasive treatment
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The 5-year survival rate after surgical resection of early-stage esophageal squamous carcinoma is reported to be 85% to 90%; the 5-year survival rate after minimally invasive treatment can be 85% to 95%. This shows that early detection and early treatment are very important for the cure of esophageal cancer.
But unfortunately, clinically, most patients with esophageal cancer are already in the middle and late stages when they are detected, and their prognosis is worse. Data show that the median survival for patients with advanced esophageal cancer (i.e., only 50% of patients live beyond this time) is about 18 months (Figure below).
And, as the stage of the disease increases, the survival time gets shorter and the prognosis gets worse.
So, again, we want to emphasize that regular screening, early detection of cancer, and aggressive treatment in high-risk groups are the most effective means of fighting cancer.
Gastroscopy is the most effective way to screen for esophageal cancer. However, gastroscopy is an invasive test, so it is recommended that people at high risk start considering screening at age 40.
What are the factors that affect survival in esophageal cancer?
The stage of the tumor, the type of pathology, the treatment, and your physical and mental state are all factors that are related to the survival of esophageal cancer.
Staging
As mentioned earlier, there are clinical and pathological stages of tumor staging. In general, the earlier the staging, the better the prognosis; the later the staging, the lower the survival rate.
As the graph above shows in relation to clinical stage and survival, whether it is squamous or adenocarcinoma, as the clinical stage goes up, the survival rate gets lower (i.e., the curve goes progressively downward).
Specifically, the 5-year postoperative survival rate for esophageal cancer ranges from 25% to 40%, with the 5-year survival rates for stages I, II, III, and IV being about 90%, 50%, 35%, and 15%, respectively.
Pathologic staging generally provides a more detailed analysis of the tumor, including many indicators, such as the depth of tumor infiltration and lymph node metastasis. The deeper the tumor infiltration, the lower the survival rate and the worse the prognosis, as demonstrated in several clinical trials. Lymph node metastasis includes, the number of lymph node metastasis, and whether there is distant metastasis, which is a stronger prognostic influence factor. As soon as distant metastases to the lymph nodes are present, the staging is stage IV, suggesting distant dissemination, and survival is generally short.
Pathology type
The overall prognosis of esophageal cancer is closely related to the type of pathology.
The 5-year survival rate for squamous carcinoma is approximately 24%. The prognosis is somewhat worse than for adenocarcinoma (5-year survival rate of 27%) under the same treatment conditions. This difference can also be seen in the graph above. The curve for squamous carcinoma tends to be more downward overall, representing a lower survival rate.
It is worth noting that the prevalence of adenocarcinoma is very low in this country, and that squamous carcinoma is the predominantly susceptible type, accounting for about 90% of all esophageal cancer cases.
For decades, Chinese oncologists have accumulated a lot of experience in the treatment of esophageal squamous carcinoma during their research work on the prevention and treatment of esophageal cancer in areas with a high incidence of esophageal cancer, such as Lin County, Henan Province and Mag County, Hebei Province. Therefore, even if you find out squamous cancer, there is no need to worry too much. The company’s main goal is to provide the best possible service to its customers.
Treatment
Choosing the right treatment can help patients achieve a better prognosis.
The basic treatment principles for esophageal cancer include:
For patients with operable stages I-IVA, there are 3 treatment modality options:
- surgery + adjuvant radiotherapy;
- simultaneous preoperative radiotherapy, followed by surgery, observation, and palliative care including chemotherapy, depending on your situation;
- radical radiotherapy + surgery or observation.
Stage IVB patients have the primary choice of chemotherapy, with supportive therapy if chemotherapy and radiation are not tolerated, and palliative surgery or radiation therapy, etc., if needed.
Studies have shown that the 5-year survival rate for esophageal cancer in China is about 38% after surgery and 25.8% after radiotherapy; the overall survival rate of neoadjuvant chemotherapy combined with surgery is significantly higher than that of surgery alone.
I hope you understand that your physician will analyze and make decisions about which treatment option to choose based on your medical condition, tumor stage, and presence of metastases. I hope you trust your primary care physician and work with him in the fight against esophageal cancer.
Other factors
Your physical and mental state, sensitivity to medications, etc., can also affect outcomes and survival. In particular, your ability to follow your doctor’s advice and to actively participate and cooperate with your treatment can have a significant impact on outcomes.
In other words, “fate” is sometimes in your hands.
We often see patients in our clinic who, not long after their doctor has determined their treatment plan and started treatment, believe in some “miracle drug” or so-called “ancestral treasure” based on hearsay or “acquaintance experience. “As a result, he delayed the treatment and even aggravated his disease. The most important thing is that the patient has a chance to live longer and better after standardized scientific treatment.
To summarize: the key to curing esophageal cancer is, early diagnosis and early treatment. Gastroscopic screening can improve the diagnosis of early esophageal cancer, which can be cured by surgical resection.
If you are already in the middle or advanced stage when you are seen, then you can also receive a combination of surgery-based treatment with chemotherapy and radiation therapy. After surgery, depending on the pathology, your doctor will develop a reasonable adjuvant radiotherapy regimen that can significantly improve your prognosis and quality of life.