Getting treated for esophageal cancers — and precancerous conditions such as Barrett's esophagus — at City of Hope gives you access to unparalleled treatment options and exceptional care. It means you are the focus of a multidisciplinary team of world class scientific leaders that know the newest and best treatments for your disease.
More than 16,000 Americans will be diagnosed with esophageal cancer in 2016, according to the American Cancer Society — and timely diagnosis and intervention can make a dramatic difference in improving your chances of survival and quality of life.
If you have been diagnosed with esophageal cancer or are looking for a second opinion consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
As one of only a few dozen institutes to be designated a comprehensive cancer center by the National Cancer Institute, City of Hope is an acknowledged leader in esophageal cancer research and treatment. Our decades of experience, specialized therapy protocols and extensive clinical trials program mean newly diagnosed or relapsed patients can find a treatment regimen that is tailored to their individual needs and gives them the best chance for survival.
U.S. News & World Report has rated City of Hope one of the top cancer hospitals in the country for over a decade — reflecting how our multidisciplinary team takes an integrated, comprehensive approach to diagnosing and treating esophageal cancers, as well as precancerous conditions such as Barrett’s esophagus.
City of Hope patients have access to our comprehensive team of supportive care experts, who can help manage and treat quality-of-life issues that may come up such as trouble eating, drinking or speaking following treatment.
February 18, 2016
December 30, 2014
December 20, 2014
December 30, 2012
Esophageal cancer is a disease in which cells in the tissues of the esophagus — a hollow muscular tube that moves food and liquid from the throat to the stomach — become abnormal and grow and divide uncontrollably into tumors.
Other cancers, such as lymphomas, sarcomas and melanomas, may start in the esophageal tract, but they are exceedingly rare. Each type of esophageal cancer grows and is treated in different ways. A multidisciplinary team will work together and carefully study your individual case to determine the best treatment plan.
There is no standard screening test for esophageal cancer. It is usually found as a result of symptoms caused by the cancer.
Symptoms can include:
Many of these symptoms may be caused by other conditions, so it is important to rule those out before pursuing screening for esophageal cancer. If you or a loved one is experiencing any of the above symptoms, please contact a doctor for further evaluation.
Sources: American Cancer Society, National Cancer Institute
Timely and accurate detection of esophageal cancer is essential to planning the best course of treatment. After a thorough physical examination, City of Hope doctors may also use the following tests to diagnose esophageal cancer and precancerous conditions such as Barrett’s esophagus:
To properly plan for treatment, esophageal cancer patients are staged according to how advanced the disorder is. This is done while taking into consideration a number of factors, including:
Patients are staged according to their risk level, with higher risk patients typically requiring more intensive treatments.
More information on esophageal cancer staging criteria is available on the National Cancer Institute’s website.
Esophageal cancer is often diagnosed at an advanced stage, so treatment should be rapid and aggressive, requiring the expertise of specialists in the disease.
Because esophageal cancer rarely shows symptoms in early stages, it is often advisable to treat precancerous conditions — such as Barrett’s esophagus.
At City of Hope, a multidisciplinary team of medical experts across different fields — including thoracic surgery, radiation oncology, medical oncology and supportive care medicine — work together to plan and implement a treatment plan that is individually tailored to you so that you get the best results.
Therapies we use to treat cancer and precancer of the esophagus may include:
Surgery is often the primary treatment for esophageal cancer, as well as precancerous esophageal conditions such as Barrett’s esophagus. Surgery may also be used to alleviate esophageal cancer symptoms, including difficulty swallowing and speaking.
Chronic heartburn (gastroesophageal reflux disease) can lead to irritation of the lining of the esophagus. Over time, this irritation can cause the cells to become precancerous, a condition known as Barrett’s esophagus. Through an endoscope (small, flexible camera that enters through the mouth), experts at City of Hope can destroy (ablate) this precancerous tissue, allowing the body to lay down a new layer of more normal cells.
We can also remove very early stage cancers with the endoscope, in a technique known as endoscopic mucosal resection. These endoscopic treatments are outpatient procedures and, in most cases, do not require an overnight stay. Patients recover quickly and usually resume normal activities by the next day.
For Barrett’s esophagus and early stage esophageal tumors, these endoscopic treatments are highly effective and have cure rates equivalent to traditional surgery.
Minimally Invasive Surgery and Its Benefits
Unfortunately, most esophageal cancers are found at a more advanced stage than can be treated with endoscopic therapies. For these aggressive tumors, we recommend a radical esophagectomy, which involves removal of most of the esophagus, as well as some of the stomach.
Many patients receive a combination of treatments with chemotherapy and radiation before surgery. In most cases, City of Hope surgeons perform radical esophagectomy using minimally invasive, robotic techniques.
Compared to traditional esophagectomy which requires a large abdominal incision, a large chest incision with rib spreading, and sometimes a neck incision, minimally invasive esophagectomy has been shown to cause less pain, less blood loss, a faster recovery and fewer complications. There is no difference in the risk of cancer recurrence.
Radiation is often combined with other therapies to treat esophageal cancer. For cancers of the esophagus, radiation may be applied externally, using one or more beams focused on the tumor or internally, using radioactive seeds that are implanted into or near the tumor site (brachytherapy).
City of Hope also offers helical TomoTherapy, a technology combining radiation delivery with advanced imaging that results in more focused beams of radiation focused on the tumor, while minimizing exposure to adjacent tissues and organs, including the heart, lungs and spine.
Chemotherapy — the use of anti-cancer medicines — includes a wide range of drugs to treat primary and metastatic esophageal cancer. City of Hope provides both standard chemotherapies and access to newly developed drugs (or drug combinations) through an extensive program of clinical trials.
Chemotherapy can also enhance the effectiveness of surgery or radiation therapy, by shrinking the tumor before the procedure and making it easier to remove (neoadjuvant chemotherapy), or given after the procedure to minimize the chance of recurrence (adjuvant chemotherapy.)
As part of the treatment team, a medical oncologist will evaluate the patient’s cancer, health and other factors, so that the chemotherapy, if appropriate, can be tailored to the patient throughout the continuum of care.
City of Hope’s renowned physicians and researchers use the latest in technology and innovation to treat cancer, and couple that expertise with an enduring belief in providing compassionate care. If you have been diagnosed with esophageal cancer or are looking for a second opinion consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
Our clinicians and researchers frequently collaborate to develop and evaluate new therapies designed to improve survival and quality of life. City of Hope patients have access to a wide variety of clinical trials ranging from new chemotherapy and targeted therapies, novel surgical techniques and new radiation approaches — all focused on enhancing treatment, detection and prevention of esophageal cancer.
Some of our current research projects include:
When you come to City of Hope, you automatically gain access to an unparalleled array of support services to help you and your family take each step in your cancer journey. We can help with all of these concerns, and more: