There are different treatments for patients with esophageal cancer.
Patients with esophageal cancer have different treatment options available to them. Some treatments are standard (the treatments currently used) and others are in clinical trials. Clinical trials on treatments are studies designed to enhance current treatments or to get information about new therapies for people with cancer. When a clinical trial shows that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may consider participating in a clinical trial. Some clinical trials are only open to patients who have not yet undergone treatment.
Patients have special nutritional needs during treatment for esophageal cancer.
Because of problems with swallowing, many people with esophageal cancer find it difficult to eat. The esophagus may be narrowed because of the tumor or as a side effect of treatment. Some patients may receive nutrition directly through a vein. Some patients may need a feeding tube (a soft plastic tube that can be passed through the nose or mouth into the stomach) until they can eat on their own.
Six standard treatments are currently applied:
Surgery
The most common treatment for esophageal cancer is surgery. A portion of the esophagus may be removed during surgery, which is called an esophagectomy.
Esophagectomy. A portion of the esophagus is removed and the stomach is elevated and connected to the remaining esophagus.
The surgeon will connect the remaining healthy esophagus to the stomach so that the patient can swallow. A plastic tube or part of the intestine may be used as a connection. Lymph nodes near the esophagus may also be removed and examined under a microscope to see if the lymph nodes contain metastatic cancer cells. If the esophagus is partially blocked by a tumor, a self-expanding metal stent (tube) may be placed in the esophagus to keep the esophagus in a patent state.
Esophageal stent. A device (stent) is placed in the esophagus to keep it open so that food and fluid can pass through the esophagus into the stomach.
Early small tumors and highly heterogeneous growths can be removed endoscopically. An endoscope (a thin tube-like instrument with a light and lens for visualization) can be inserted through a small incision in the skin or an opening in the body (e.g., the mouth). An instrument 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 inhibit their growth. There are two types of radiation therapy:
The type of radiation therapy used depends on the type and stage of the cancer. Both in vitro and in vivo radiation therapy can be used to treat esophageal cancer.
During radiation therapy, a plastic catheter may be inserted into the esophagus to keep the esophagus in a patent state. This is called intraluminal cannulation and dilation.
Chemotherapy
Chemotherapy is a treatment that stops the growth of cancer cells by using drugs to kill the cancer cells or stop them from dividing. When chemotherapy is given from oral drugs, or through intravenous or intramuscular drugs, the drugs enter the bloodstream and can travel throughout the body (systemic chemotherapy) to reach the cancer cells. When chemotherapy drugs are placed directly in the cerebrospinal fluid, organs, or body cavities, such as the abdominal cavity, the drugs primarily affect cancer cells in these areas (regional chemotherapy). The way chemotherapy is administered depends on the type and stage of the cancer.
For more information, see approved drugs for esophageal cancer.
Radiotherapy
Radiotherapy is a treatment that combines chemotherapy and radiation therapy to increase the effectiveness of both treatments.
Laser therapy
Laser therapy is a treatment that uses a laser beam (a very narrow, intense beam of light) to kill cancer cells.
Electrocoagulation
Electrocoagulation is a therapy that uses an electric current to kill cancer cells.
A new type of therapy being tested in clinical trials.
This summary section describes the treatments being studied in clinical trials. Every new therapy being studied may not be mentioned here. Information about clinical trials can be found on the NCI website site.
Targeted therapy
Targeted therapy is a treatment that uses drugs or other substances to identify and attack specific cancer cells. Compared to chemotherapy and radiation therapy, targeted therapy usually causes less harm to normal cells. Monoclonal antibody therapy is one type of targeted therapy for esophageal cancer.
Monoclonal antibody therapy uses a class of antibodies obtained from a certain type of immune system cell in the laboratory to treat the cancer. These antibodies recognize substances on cancer cells or normal substances that can promote the growth of cancer cells. The antibodies attach to these substances and kill the cancer cells, inhibit the growth of the cancer cells, or inhibit the spread of the cancer cells. Monoclonal antibodies are given by injection. They can be used alone or they can deliver drugs, toxins or radioactive substances directly to cancer cells. Trastuzumab is a monoclonal antibody being studied for the treatment of esophageal cancer. It blocks the action of the growth factor protein HER2 – which delivers growth signals to esophageal cancer cells.
Treatment for esophageal cancer may have side effects.
For information about side effects of cancer treatment, see our side effects page.
Patients may want to participate in clinical trials.
For some patients, participating in a clinical trial may be the best treatment option. Clinical trials are part of the cancer research process. Clinical trials are conducted to see if new cancer therapies are safe and effective, or if they are better than standard therapies.
Many current standard therapies are based on earlier clinical trials. Patients who participate in clinical trials may be treated with standard therapies or they may be among the first to receive novel therapies.
Patients who participate in clinical trials can also help improve the way cancer is treated in the future. Even when clinical trials do not progress to effective new therapies, clinical trials often answer important questions and help research keep moving forward.
Patients can participate in clinical trials before, during, and after they start cancer treatment.
Some clinical trials study only patients who have not yet received treatment. Some clinical trials study patients whose disease has not yet improved. Still other clinical trials test new ways to prevent the cancer from coming back (reappearing) or to reduce the side effects of cancer treatment.
Clinical trials are being conducted in many parts of the country. Information about NCI-supported clinical trials can be found on the NCI’s Clinical Trials Search page. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed
Some tests to diagnose cancer or to determine cancer stage may be repeated. Some tests may be repeated to see how the therapy is working. The decision to continue, change, or stop treatment may be based on the results of these tests.
Sometimes, these tests continue after treatment ends. The results of these tests will show if your condition has changed or if the cancer has come back (reappeared). Sometimes, these tests are called follow-up tests.