Many kinds of treatment can be used for esophageal cancer. You may get a combination of different treatments. The treatments used depend on a number of factors, such as:
- The type of esophageal cancer.
- Where the cancer is in the esophagus.
- The stage (extent) of the cancer (how big it is and if it has spread).
- Your age.
- Your overall health.
- Your concerns and preferences.
Some of the most common treatments used are listed below.
Surgery
This is the most common treatment for early stage esophageal cancer, especially if it's in the lower part of the esophagus. Surgery may cure the cancer at this stage because the cancer is small and only in the esophagus.
Even when the cancer can't be cured, surgery might be used to help ease symptoms caused by the tumor, like pain or bleeding. It can also be done to put in a feeding tube if you're not able to swallow.
Radiation therapy
This treatment is most often used along with chemotherapy, either before or after surgery. Radiation and chemotherapy before surgery can help shrink a tumor. This can make it easier to take out. After surgery, radiation and chemotherapy can kill cancer cells that might be left. It may also be used as part of the main treatment in people who can't have surgery. It may be used to help relieve symptoms in people with advanced cancer, too.
Chemotherapy and targeted therapy
For esophageal cancer, chemotherapy is often used with radiation. It may be used before or after surgery. Or it may be part of the treatment for people who can't have surgery.
Targeted therapy medicines work differently from standard chemotherapy medicines. Targeted therapy may be useful for some people. These medicines target certain gene changes in the cancer cells. (Your cancer cells will be tested to see if they have these changes.)
Both of these treatments can be used to treat cancers that have spread beyond the esophagus.
Endoscopic treatments
These treatments are done using an endoscope. This is a thin, flexible, lighted tube that's put in your mouth and slid into your esophagus. Endoscopic treatments can be used to help relieve symptoms caused by the cancer. These include using photodynamic therapy, freezing (cryotherapy), a laser, or an electric current (electrocoagulation) to kill cancer cells in your esophagus. An endoscope can also be used to put in a stent. This is a small metal tube that's put in to keep your esophagus open.
Palliative treatment
Your doctor may suggest treatments that help ease your symptoms but don't treat the cancer. This is called palliative care. It's often used with other treatments. For instance, pain medicine can be a palliative treatment.
Or your doctor may suggest that you get only palliative care if they believe that treatments are likely to cause you more harm than good.
Immunotherapy
Immunotherapy medicines help your body's natural immune system find and kill cancer cells. Medicines called immune checkpoint inhibitors may be used to treat advanced esophageal cancer. These medicines are given through intravenous infusion. These medicines may be given alone or with chemotherapy or targeted therapy.