Learn About Cancer »Types of Cancer »Gastrointestinal Cancer

What is cancer of the esophagus?

The esophagus is a muscular tube that connects the mouth to the stomach. It carries food and liquids to the stomach. The esophagus is about 10-13 inches long. Esophageal cancer is a disease in which cancerous cells form in the tissues of the esophagus.

Esophageal Cancer Staging

Therapy depends on accurate diagnosis endoscopic biopsy and staging which is often done with chest Computerized Tomography (CT), PET CT Endoscopic Ultrasound (EUS), when indicated endoscopic mucosal resection (or EMR), and the overall functional status of the patient. Thus, the initial clinical stage of the patient depends on integration of information obtained on biopsy, imaging and surgical staging to determine.

All biopsies and scans obtained at outside institutions are reviewed at Fox Chase.

Esophageal Cancer Treatment

Surgery is the best treatment option for early stages of the esophageal cancer. Fox Chase surgeons, Abraham "Avi" Lebenthal, MD and Walter J. Scott, MD, FACS offer an individualized tailored surgical approach that integrates the patient functional status and stage. Most patients with esophageal cancer present with locally advanced disease. At Fox Chase, these patients are usually offered a multidisciplinary multimodality treatment approach starting with confirmation of staging with laparoscopy. During this procedure the surgeon evaluates the location and extent of the esophageal cancer and excludes microscopic carcinomatosis. Additionally, a feeding tube is placed in the small bowel and a ‘port’ device is placed into a central vein to facilitate future chemotherapy. The patient then receives combined chemo and radiation therapy. Upon completion of chemoradiation, restaging scans are obtained and surgery is offered to the majority of the patients. We feel that nutritional support during neoadjuvant chemoradiation enables the patient to complete intended therapy and reach surgery stronger. We tailor our surgical procedure to the patient, however we are able to offer Minimally Invasive Esophagectomy to most even after prior chemoradiation.

Chemotherapy is the mainstay of treatment for metastatic esophageal cancer, clinical trials have shown that chemotherapy increases survival rates among patients.

Doctors at Fox Chase Cancer Center offer a variety of treatment options for patients with esophageal cancer, including:

• Surgery is the most common treatment for esophageal cancer. In the procedure, an esophagectomy, the surgeon removes part of the esophagus.
• Radiation therapy. Both internal and external radiation are used to treat the tumor.
• Chemotherapy. Anti-cancer drugs are directed into the spinal column, on organ or body cavity to treat the cancer cells that area.
• Endoscopic Mucosal Resection is the use of an endoscope in order to remove premalignant and non-invasive cancer

Fox Chase physicians were the first to develop a non-surgical approach — combining chemotherapy and radiation therapy for patients with esophageal cancer — in order to prolong life and, in some selective cases, avoid surgery to remove the esophagus.

Clinical Trials

Currently, patients with esophageal cancer have the opportunity to participate in a clinical trial that involves a combination of chemotherapy and radiation therapy with new drugs prior to surgery to improve cure rates. Clinical trials for esophageal cancer, including Phase I trials, are available at Fox Chase Cancer Center.

Special Needs

Patients with esophageal cancer have special nutritional needs. It is difficult to swallow, so many patients find it hard to eat. The esophagus may be narrowed by the tumor or as a side effect of treatment. Nutrition may be given intravenously or through a feeding tube.

For more information about gastrointestinal cancer treatment and prevention at Fox Chase Cancer Center or to make an appointment, call 1-888-FOX CHASE (1-888-369-2427).