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Types and Goals of Treatment for Esophageal Cancer

Treatment for cancer is either local or systemic.

Local treatments remove, kill, or control the cancer cells in one spot. Surgery, radiation, photodynamic therapy, and electrocoagulation are local treatments.

Systemic treatments kill or control cancer cells through the whole body. Chemotherapy is an example. 

How you and your doctor choose to treat esophageal cancer depends on the goal of treatment. When the cancer is found at an early stage before it has spread far from your esophagus, the goal may be a cure. When the cancer is found in later stages, when it has spread far from your esophagus, the cancer may not be cured. In that case, the goal may be to slow the cancer, ease symptoms, and improve your quality of life. This noncurative treatment is called palliative therapy.

Whether the goal is to cure the cancer or to ease symptoms, there are several treatment choices:

  • Surgery. This is the most common treatment for early stage esophageal cancer, especially cancer in the lower part of the esophagus. It may cure the cancer if it is caught in an early stage. Even when cancer can’t be cured, your doctor may use surgery to ease symptoms.

  • Radiation therapy. This treatment is often used with chemotherapy, either before or after surgery. Radiation and chemotherapy before surgery can help shrink a tumor and make it easier to take out. After surgery, radiation, and chemotherapy can be used to try to kill any cancer cells that are left. It may also be used as part of the main treatment in people who can't have surgery. 

  • Chemotherapy. For esophageal cancer, chemotherapy is usually used along with radiation therapy. It may be used before or after surgery, or it may be part of the treatment for people who can't have surgery.

  • Photodynamic therapy (PDT). This treatment uses a special drug and laser to kill cancer cells. PDT can be used to treat some very early stage cancers, but it is most often used to help relieve symptoms, such as trouble swallowing, in people with advanced cancer. 

A newer treatment to help relieve symptoms is electrocoagulation. This is the use of electricity to kill cancer cells.  

Doctors are studying new ways to treat esophageal cancer. These new methods are tested in clinical trials. Before starting treatment, ask your doctor if there are any clinical trials that you should check on.

Choosing the most appropriate cancer treatment is a decision that ideally involves you, your family, and your health care team. Learn all you can about the cancer and treatment choices so that you can help make decisions about your care. One of the best ways to get the information you need is to ask your doctor and the rest of your health care team. Make sure you ask how the treatment will change your daily life. Find out how your diet might have to change and how you will look and feel. Ask how successful the treatment usually is and find out about the risks and possible side effects.

What are the treatment statistics for people with esophageal cancer?

These are the survival statistics for esophageal cancer, according to the National Cancer Institute:

  • The overall five-year survival rate for people with esophageal cancer is about 18 percent for white men, 17 percent for white women, 11 percent for black men, and 13 percent for black women.

  • The earlier esophageal cancer is diagnosed, the better the chance of surviving. If the cancer is still confined to the esophagus, the five-year survival rate is 37 percent. If it has spread to nearby tissues or lymph nodes when first found, the five-year survival rate is 18 percent. If it has spread to distant parts of the body, the five-year survival rate is 3 percent. These statistics are adjusted for the fact that some people with esophageal cancer may die of other causes. 



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