Esophageal Cancer
Cancer that begins in the esophagus (also called esophageal cancer) is divided into two major types, squamous cell carcinoma and adenocarcinoma, depending on the type of cells that are malignant. Squamous cell carcinomas arise in squamous cells that line the esophagus. These cancers usually occur in the upper and middle part of the esophagus. Adenocarcinomas usually develop in the glandular tissue in the lower part of the esophagus. The treatment is similar for both types of esophageal cancer. If the cancer spreads outside the esophagus, it often goes to the lymph nodes first. (Lymph nodes are small, bean-shaped structures that are part of the body's immune system.) Esophageal cancer can also spread to almost any other part of the body, including the liver, lungs, brain, and bones.

Diagnosis Of Esophageal Cancer

Barium Swallow or Upper Gastrointestinal (GI) X-rays

Barium in liquid form is used to coat the esophagus wall and then a digital x-ray is taken so that the condition of the esophagus can be clearly seen.

Upper Endoscopy for Esophageal Cancer

Endoscope is a flexible, very narrow tube with a video camera and light on the end. The patient is sedated to allow for this tube to pass through into the esophagus and stomach. The doctor can see on a compute monitor the abnormalities in the wall of the esophagus clearly.

Endoscopic Ultrasound for Esophageal Cancer

An endoscope with a small ultrasound probe attached to its sends very sensitive sound waves that penetrate deep into tissues. The sound waves bounce off the normal tissues images convey how deeply the tumor has invaded into the esophagus.

Bronchoscopy for Esophageal Cancer

The physician looks into the trachea (windpipe) and bronchi (tubes leading from the trachea to the lung).

Positron Emission Tomography (PET SCAN ) for Esophageal Cancer

In this test, the patient is administered radioactive isotope glucose and since the cancers use sugar much faster than normal tissues, the cancerous tissue takes up the radioactive material. A PET scanner can spot the radioactive deposits.

Treatment of Esophageal Cancer

The stage of cancer is determined first of all by analysing the size of the tumour and the number and location of enlarged lymph nodes. Accurate staging helps tailor treatment to the patient's specific needs. Staging can be done with CT scan, biopsy, esophageal ultrasound and PET scan.

Radiation Therapy

Radiation therapy is first deployed to shrink the tumor with carefully directed radiation at the tumor. This helps destroy or reduce the tumor, because cancer cells divide and grow faster than normal cells. Normal cells usually recover successfully from new age radiation like Linac, Gamma Knife, Novelis or Cyberknife. Radiation therapy is given as an outpatient for 5 minutes for 5 to 6 weeks.

Chemotherapy

Chemotherapy is used to help shrink the tumor and kill any cancer cells in the lymph nodes. There are several chemotherapy medications that work to kill lung cancer and often a combination of 2 of these medications is prescribed. The specific medication or combination of medications you receive will be selected based on your tumor type and your medical history. Chemotherapy will be given as an inpatient for 4-5 day sessions twice during your treatment. Other medications before and during chemotherapy are prescribed which are designed to minimize and relieve the side effects.

Re-staging

Approximately 4-6 weeks after your last treatments you will undergo several tests to determine the success of therapy. You may be required to undergo another set of tests like CT scan of the chest and upper abdomen and Upper endoscopy and esophageal ultrasound.

Surgical Resection

If you have had chemotherapy and radiation therapy, surgical resection of the esophagus will occur approximately 5-6 weeks after your last radiation treatment.


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