Esophageal carcinoma treatment

Current standards for the diagnosis and treatment of esophageal cancer

The main examination method for making a diagnosis is a barium x-ray of the gullet and an esophagoscopy. Other studies are aimed at clarifying the size of the cancer, its aggressiveness and spread to other organs.

Esophagoscopy

This procedure involves inserting a thin tubular device through the mouth into the esophagus. At the very front of the machine is a small camera with light. This device is called an “endoscope” and it transmits an image of the esophagus to a screen.

Biopsy

During the esophagoscopy, the doctor takes tissue samples using special forceps. Samples are taken from all suspicious locations and checked in the laboratory.

Ultrasound

During the ultrasound examination, the doctor uses the upper abdomen. The contact gel ensures good transmission of sound waves. These waves are used to create an image of the esophagus. How detailed the doctor describes the image and draws conclusions from it depends on his experience. On the MedTour platform, you will find experienced doctors specializing in esophageal cancer.

Endosonography

A device with a small ultrasound probe is pulled through the mouth to the stomach. Sound waves are used to create images of esophageal tissue inside the body. Noticing suspicious lymph nodes, the doctor uses a fine needle and obtains samples for examination in the laboratory.

With the help of this technology you will know:

• the size and position of the tumor,
• the depth of ingrowth into the wall of the gullet,
• condition of the surrounding lymph nodes.

Bronchoscopy

Patients with advanced cancer should have their airways examined. In bronchoscopy, images are taken using a flexible tube that is passed through the bronchi. On the front of the device is a small camera with a light source. The purpose of this examination is to detect neoplasms in the airways.

PET-CT

With positron emission tomography, the patient receives a weakly radioactive substance (dextrose). With its help, the doctor sees on CT the metabolism of body cells – high metabolic activity indicates cancer cells.

Esophageal cancer treatment

Depending on the stage, carry out:

• local removal of the neoplasm: “from the inside” (endoscopic);
• surgical removal of the morbid growth;
• radiochemotherapy;
• palliative procedures (brachytherapy).

Endoscopic resection

Early detected tumors are removed endoscopically. To do this, instruments are inserted into esophagus through an endoscope and tumor is excised. Endoscopic resection removes only neoplasm and swallowing function remains – organ-preserving method. 9 out of 10 people get rid of all symptoms after this operation. Complications occur in only one in a thousand patients.

Surgical resection

During the operation, the esophagus is removed partially or completely. This treatment is applicable to patients with non-advanced tumors. The operation is performed under general anesthesia. Many clinics abroad use the Da Vinci robotic system. The amount of surgery depends on the characteristics of the neoplasm:

• location,
• size,
• distribution.

In certain situations, concomitant chemotherapy or radiation therapy may be used. They reduce the chance of relapse and increase the chances of recovery.

Radiotherapy

With this therapy, radiation is directed at the tumor tissue. During this procedure, the nuclei of the cells are so damaged that the cancer cells can no longer divide and die. Using modern irradiation technologies, the effect on healthy cells is minimal.

Chemotherapy

Therapy with chemical elements consists of several cycles. One cycle consists of administering the drug every day or every few days. Some active ingredients are taken in pill form. The duration depends on the combination of active ingredients used.

Breaks between cycles are done for:

• restoration of the body,
• dose reduction,
• monitoring the response of the tumor to treatment,
• assessment of patient tolerance to drugs.