What Are the Treatments for Oesophagus Cancer?

The oesophagus, or the esophagus as it is commonly called, is part of the digestive track. It connects the stomach with the mouth through a muscular tube that extends through the neck. Oesophagus cancer normally begins in the lining of the esophagus. The normal (squamous) cells in the lining start to degenerate, and eventually a malignant tumor forms. This is called squamous cell cancer. Cancers that develop lower in the esophagus, next to the stomach, are called adenocarcinoma. The type of cancer and the degree to which it has spread within the oesophagus will determine what treatment method will be used.

Diagnosis

• Prior to treatment, oesophagus must be diagnosed properly. Generally, oesophagus cancer is diagnosed using a test called an endoscopy. This involves the doctor looking at the lining of the oesophagus with a telescope. If the doctor observes an abnormal area while looking at the oesophagus, a small piece of the abnormal tissue is removed and biopsied. X-rays may also be used to diagnose oesophagus cancer, after a patient drinks a special liquid that allows the abnormal cell groups to show up on an X-ray.

Treatment

• Generally, there are several important factors that go into determining the type of treatment. Most of these factors -- including the size and location of the tumor -- are used to determine the "stage" of the cancer. Stage I oesophagus cancer is treated differently than Stage IV. Stage I oesphogus cancer refers to cancer that is only in the lining of the esophogus. Stage II cancer refers to oesophogus cancer that has spread beyond the lining. Stage III refers to cancer that may have advanced locally into lymph nodes or nearby tissue. Stage IV refers to metastatic cancer, which means the cancer has spread elsewhere in the body distinct from the oesophogus. The majority of oesophagus cancers are asymptomatic until they are quite advanced, so oesophagus cancer is often not diagnosed until it is quite advanced.

Non-Metastatic Oesophagus Cancer

• Stages I through III of oesophagus cancer are non-metastatic meaning the cancer cells are only in the oesophagus and have not spread to any distant parts of the body. The purpose of treatment (Stages I, II and III) is to cure the cancer by ridding the body of cancer cells. Normally, a combination of chemotherapy, surgery and radiation is used to eliminate these malignant cells. The chemotherapy may be adjuvant or neo-adjuvant. Adjuvant chemotherapy is used prior to surgery, to help shrink the amount of cancer cells so they can all be removed. Neo-adjuvant chemotherapy is used after the surgery to ensure that there are no remaining cancer cells.

Surgery

• The surgery performed on the oesophagus to remove cancer cells is called an esophagogastrectomy. The doctor performing the surgery reforms the portion of the oesophagus that contains cancer cells, as well as the nearby lymph nodes and the top of the stomach. The oesophagus and remaining stomach area are then reattached, using, in some cases, a piece of the colon. This allows food to continue to pass from the throat to the stomach using the oesophagus.

Metastatic Oesophagus Cancer

• Stage IV, or metastatic, oesophagus cancer can't be cured. Doctors use radiation and chemotherapy to attempt to slow the growth of cancer cells or kill cancer cells, both in the oesophagus and in the areas where the metastases occurred. Treatment also includes management of symptoms. This may involve the use of a tube being inserted into the oesophagus to allow food to pass more easily, or the use of laser treatments to burn away parts of the tumor so patients can swallow more easily.