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Overview

Esophageal Cancer: Treatment, Procedure, Cost and Side Effects

What is the treatment?

N/A

How is the treatment done?

Esophageal cancer is among the top cancer killing disease in the world. Esophagus is the tube linking the throat to the stomach, thus providing the passage for travelling of food from the mouth to the stomach. The tissues and cells lining the esophagus starts mutating rapidly leading to abnormal growth in cell which in turn leads to the formation of a tumor. Symptoms can range from difficulty in swallowing to rapid weight loss.

The treatment for esophageal cancer depends on the type of cells that are involved. As such esophageal cancer is of two types-

Adenocarcinoma (EAC) - This type of esophageal cancer generally involves the glandular cells lining the lower part of the esophagus. Some of the causes of EAC are smoking, obesity and acid reflux often termed as GERD and heartburn.

Squamous-cell carnimona (ESCC) - This type of esophageal cancer generally involve the epithelial cells present in the upper and middle portions of the esophagus. Some of the causes for ESCC are tobacco, alcohol, poor diet, coughing or hoarseness and chewing betel nut.

Early stages of esophageal cancer do not show any symptoms for which treatment usually begins at a much later stage. Moreover, people having Barrett’s Syndrome, a precancerous condition that increases the risk of developing esophageal cancer should immediately consult a doctor. The diagnosis of esophageal cancer is done by endoscopy and biopsy through which the presence of cancer cells is confirmed by a pathologist. However, treatments of the cancer depend upon the patients’ health, cancer stage and location of the cancerous cells.

Who is eligible for the treatment? (When is the treatment done?)

Treatments for esophageal cancer depends on the type of cancer, health conditions and the stage of cancer. After the diagnosis that includes an endoscopy where the esophagus is examined with the help of a tube having video lens down your throat and biopsy where an endoscope is used to collect a sample of tissue for examination. The pathologist may include additional tests like-Endoscopic Ultrasound (EUS), Computerized Tomography (CT) and Positron Emission Tomography (PET).

If you are between stage I to III or the malignant tumor has not spread to other parts, then a surgery may be advised by your doctor. Surgery is the surgical removal of the tumor. A surgical oncologist is a doctor who specializes in cancer surgery. In a surgery, the tumor may be removed or a part of the esophagus may be removed or removing the esophagus along with the lymph nodes and stomach where the stomach is pulled up and reattached to the esophagus. This type of surgery is termed as esophagactomy. Along with this a combination of chemotherapy and radiation therapy might be used. In chemotherapy, drugs are used to destroy cancer cells and in radiation therapy, high-energy rays are used to kill the cancer cells. Both of them might be used individually or in combination for patients having a surgery or not having a surgery.

Moreover, there are certain treatments for the side effects occurring in a patient after or before a surgery or radiation and chemotherapy that includes- Endoscopy and dilation, endoscopy with stent placement, photodynamic therapy, electrocoagulation and cyrotherapy.

Who is not eligible for the treatment?

People who are eligible for the treatment of esophageal cancer shows various symptoms and signs including- difficulty in swallowing (also known as dysphagia), rapid weight loss, chest pain assisted with sensations of burning and coughing or hoarseness. People diagnosed with Barrett’s syndrome which is a precancerous condition are also eligible for the treatment.

Are there any side effects?

Individuals who do not show any symptoms of esophageal cancer,either the squamous cell carcinoma or adenocarcinoma, should not undergo chemootherapy or radiation therapy.

What are the post-treatment guidelines?

There are various side effects of esophageal cancer and its associated treatment including pain, infections such as pneumonia, dysphagia( difficulty in swallowing), nausea, vomiting ,rapid weight loss and malnutrition. Moreover, patients may suffer from depression and become emotionally unstable to continue treatment and the post-surgery medications.

How long does it take to recover?

Cancer and its various treatments often have various side effects that need monitoring and relieving the person of the side effects. This type of support is termed as palliative care where patient’s emotional, social and physical needs are taken care of. It includes betterment of life and providing support to patients and their families. It may be started as early as the cancerous cells are detected or after the surgical removal of the tumor. The palliative care includes medication, nutritional changes, relaxation methods and other therapies. Therefore, palliative care is a very important part of the overall recovery of a cancer patient.

What is the price of the treatment in India?

Recovery time depends upon various factors including- type of esophageal cancer, a person's health conditions, the stage at which cancer is at and the type of treatment the paerson is undergoing. The treatment may last upto four to six weeks but the palliative care may extend for many years.

Are the results of the treatment permanent?

Cancer is a costly affair. People suffering from esophageal cancer can incur costs between Rs. 305,922 to Rs.5 or 6,00,000. The treatment cost can go on increasing depending upon the hospital you are admitted to and the type of treatment you are going for.

What are the alternatives to the treatment?

The treatment of cancer does not have a permanent solution. If the cancer is detected early,then there are chances of it not returning. However, the cancer might recur even after the surgery and the associated chemotherapy and radiation therapy.

Safety: Disease Effectiveness: Low Timeliness: Medium Relative Risk: Very High Side Effects: High Time For Recovery: High Price Range:

Rs.305,922-Rs 5,00,000

Popular Health Tips

Achalasia - Symptoms + Treatment

MBBS, MS - General Surgery, M.Ch - Surgical Gastroenterology/G.I. Surgery, Fellowship in Hepatobiliary Surgery & Liver Transplantation, International Visiting Scholar
Surgical Gastroenterologist, Hyderabad
Achalasia - Symptoms + Treatment

Achalasia is a serious disorder of the esophagus in which your nerves and muscles fail to work properly. This disorder causes problems in your body such as chest pain, difficulty to swallow food and excessive coughing.

You will also face problems in breathing in case the food enters in to the lungs. There is a valve in your lower esophageal splinter, which closes the esophagus from your stomach. If you have problems like achalasia then perhaps your lower esophageal splinter fails to open while swallowing food it can lead to accumulation of food in esophagus. In this condition the nerves in your body gets damaged and hence cause health complications.

You are at risk of achalasia when you are middle aged, but it can also occur during childhood. Auto immune disorder often places you at risk for achalasia.

Symptoms of achalasia:
The major symptom of achalasia is dysphagia in which you face problems while swallowing food. You may feel that the food is struck in your esophagus which causes choking and problems when you breathe. There may be other symptoms of achalasia which includes:
1. Loss of weight
2. Heart burn
3. Discomfort or pain while you eat food
4. Chest pain
5. Risk of esophagus cancer

Treatment for achalasia:
Esophageal manometry is a technique your doctor may use, if he suspects achalasia when the symptoms include difficulty while you eat and swallow foods. A tube measures the muscular activity in your stomach and reports about the functioning of your esophagus. Another way to diagnose is through X- ray of the esophagus or endoscopy.

The treatment for achalasia generally starts with oral medications. Sphincter nitrates and calcium blockers often help to relax the muscles. Botox can also help to relax your sphincter and help you swallow food.
Esophagomyotomy also helps to treat achalasia in which your doctor can use an incision to access the sphincter and also alter it to enable better flow into the stomach. It’s a generally successful procedure, but sometimes can cause Gastroesophageal reflux disease (GERD) which causes heart burn and would require intensive care. Sometimes surgery can also help to give relief but it can also cause acid reflux, respiratory problems, tearing of esophagus along with other serious complications.

Laparoscopic surgery is a simple and effective way of treating this problem .The tight lower esophageal sphincter is released to make way for easy passage of food.The patient recovers in one day and is discharged home following this operation. If you wish to discuss any specific problem, you can consult a gastroenterologist.

2978 people found this helpful

Esophagectomy - Know Why It Is Required!

MBBS, MS - General Surgery
General Surgeon, Ludhiana
Esophagectomy - Know Why It Is Required!

The surgical procedure to remove the oesophagus (the tube between your stomach and mouth), partially or completely, and reconstruct it by using a section of the large intestine or stomach is called esophagectomy.

Esophagectomy is commonly used to treat oesophageal cancer.

Uses:

Early-stage oesophageal cancer is frequently treated with an esophagectomy. Other than that, esophagectomy is also performed to treat oesophageal dysplasia (a condition in which cells in the oesophageal lining are precancerous or likely to develop cancer if not promptly treated).

Esophagectomy is commonly performed when cancer has spread to the stomach, lymph nodes or associated organs.

Some other conditions which require esophagectomy include:

  1. Oesophageal trauma.

  2. Swallowing of cell-damaging, or caustic agents such as lye.

  3. Problematic stomach disorders that make the passage of food to the stomach difficult.

  4. A previously performed esophagectomy was unsuccessful.

Procedures:

There are three ways a surgeon may perform an esophagectomy, which include:

  • Transthoracic Esophagectomy (TTE)

In this type of procedure, the incision is made on the chest. A TTE is mostly used to treat the following conditions:

    • Cancer present only in two-thirds of the oesophagus

    • Barrett’s oesophagus (Abnormal cell transformation in the lower oesophagus)

    • Damage to the oesophagus by swallowing a caustic agent

    • Reflux esophagitis (stomach acids return to the oesophagus) complications

  • Transhiatal Esophagectomy (THE)

In THE, the incision is made from the end of the breastbone to the bellybutton. THE is performed for the following conditions:

    • To remove the cancerous oesophagus

    • To tighten or narrow the oesophagus in order to make swallowing easier

    • To fix issues in the nervous system

    • To repair frequent gastroesophageal reflux

    • Correct a hole in the oesophagus caused by any caustic agent

  • En Bloc Esophagectomy

In this procedure, the oesophagus, part of the stomach and all the lymph nodes in the abdomen and chest are removed. The incisions are made in the abdomen, chest and neck; the stomach will be reshaped and brought up to the chest to put back the oesophagus.

Potentially curable tumours are treated by en bloc esophagectomy.

Outlook:

Recovery time of esophagectomy is three weeks approximately. You are allowed to go back to your regular diet after a month. You might find that you are eating smaller portions as you stomach size is reduced.

Why Should You Go for Esophagectomy?

MBBS, MS - General Surgery, Fellowship in Minimal Access Surgery
General Surgeon, Agra
Why Should You Go for Esophagectomy?

Esophagectomy is a procedure of removing a part of the esophagus and reconstructing the same using another organ of the body. The oesophagus is the tube that connects the stomach and the mouth. This procedure is often performed in an advanced stage of esophageal cancer and Barrett’s esophagus. This procedure removes the cancer cells from the esophagus and gives relief from the symptoms. The organs from where the reconstructing tissues are taken are generally large intestine and stomach.

Many esophagectomy surgeries are performed with minimally invasive techniques. The latter is commonly known as laparoscopic surgery. This is a procedure where numerous small incisions are made in order to perform the surgery. This procedure results in faster recovery and reduced pain as compared to the conventional surgery.

Newer methods such as Robotic surgery are being adopted by many doctors these days. Procedures like these can access the oesophagus through places such as the throat, collarbone and abdomen. They make a minute incision to get to the exact location of the cancer and treat them with an improved precision, unlike the conventional surgical methods.

An important aspect of treating this condition is to determine the procedure that is going to be implemented. To determine this, doctors uses imaging techniques such as PET scan, CT scan and an MRI scan. A doctor might also prescribe other tests such as FNAC and endoscopic ultrasound. Heart evaluations are also conducted before the surgery to ensure that there are no complications involved while performing the surgery.

Before Esophagectomy

Unless the cancer is detected at a very early stage, most doctors recommend radiation or chemotherapy or both. These treatments help to shrink the size of the cancer and make for an effective oesophagectomy. Both chemotherapy and radiation have their set of side effects, which include loss of appetite, fatigue, hair loss, vomiting and skin discolouration.

After Esophagectomy

Post the procedure, a patient cannot directly consume food. He is required to consume food through a pipe for a duration of four-six weeks. Adequate nutrition is required during this phase to recover quickly. Once the patient is able to resume a normal diet, it should be ensured that he takes food in reduced quantities to make up for the reduced stomach size.

Follow-up

Almost 90% of patients who have gone through this procedure report an improved life quality. While lifestyle related adjustments have to be made, there could be regular follow-ups to ensure the below mentioned complications do not arise:

1. Breathing-related problems

2. Swallowing problem

3. Effectively managing heartburn and ensuring the pain is under control

4. A thorough review of the nutritional diet to be consumed by the patient to counter sudden weight loss.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2061 people found this helpful

Know The Procedure Of Esophagectomy!

FICS, FCCP (USA), DNB (General Surgery), MS - General Surgery, MBBS
General Surgeon, Delhi
Know The Procedure Of Esophagectomy!

The surgical procedure to remove the oesophagus (the tube between your stomach and mouth), partially or completely, and reconstruct it by using a section of the large intestine or stomach is called esophagectomy.

Esophagectomy is commonly used to treat oesophageal cancer.

Uses:

Early-stage oesophageal cancer is frequently treated with an esophagectomy. Other than that, esophagectomy is also performed to treat oesophageal dysplasia (a condition in which cells in the oesophageal lining are precancerous or likely to develop cancer if not promptly treated).

Esophagectomy is commonly performed when cancer has spread to the stomach, lymph nodes or associated organs.

Some other conditions which require esophagectomy include:

  1. Oesophageal trauma.

  2. Swallowing of cell-damaging, or caustic agents such as lye.

  3. Problematic stomach disorders that make the passage of food to the stomach difficult.

  4. A previously performed esophagectomy was unsuccessful.

Procedures:

There are three ways a surgeon may perform an esophagectomy, which include:

  • Transthoracic Esophagectomy (TTE)

In this type of procedure, the incision is made on the chest. A TTE is mostly used to treat the following conditions:   

    • Cancer present only in two-thirds of the oesophagus

    • Barrett’s oesophagus (Abnormal cell transformation in the lower oesophagus)

    • Damage to the oesophagus by swallowing a caustic agent

    • Reflux esophagitis (stomach acids return to the oesophagus) complications

  • Transhiatal Esophagectomy (THE)

In THE, the incision is made from the end of the breastbone to the bellybutton. THE is performed for the following conditions:

    • To remove the cancerous oesophagus

    • To tighten or narrow the oesophagus in order to make swallowing easier

    • To fix issues in the nervous system

    • To repair frequent gastroesophageal reflux

    • Correct a hole in the oesophagus caused by any caustic agent

  • En Bloc Esophagectomy

In this procedure, the oesophagus, part of the stomach and all the lymph nodes in the abdomen and chest are removed. The incisions are made in the abdomen, chest and neck; the stomach will be reshaped and brought up to the chest to put back the oesophagus.

Potentially curable tumours are treated by en bloc esophagectomy.

Outlook:

Recovery time of esophagectomy is three weeks approximately. You are allowed to go back to your regular diet after a month. You might find that you are eating smaller portions as you stomach size is reduced. In case you have a concern or query you can always consult an expert & get answers to your questions!

3282 people found this helpful

Esophageal Cancer - How It Can Be Detected?

DNB, Surgical Gastroenterology, MS(Surgery)
Gastroenterologist, Chennai
Esophageal Cancer - How It Can Be Detected?

Heatburn or acid reflex is a burning sensation that is felt in the throat or chest region after the intake of certain foods. While many of us must have felt heatburn once in our lifetime, too many occurrences such as this could be a fair indication of esophageal cancer.

How an acidburn is related to esophagus?
Esophagus is the tube which carries food from the throat to the stomach. In the case of an acid reflux, the acid from the stomach jumps to the esophagus leading to a condition known as the Barrett’s esophagus. This is a condition which replaces the tissue present in the esophagus with a similar kind of tissue found in the lining of the intestine. This being said, Barrett’s esophagus doesn’t necessarily lead to esophageal cancer.

Key symptoms of Esophageal Cancer
Difficulty swallowing is a key symptom of esophageal cancer. This condition is known as dysphasia. As the tumor grows bigger, it becomes more difficult to swallow food. Esophageal pain is also a common symptom reported by many patients. Loss in appetite and an unexplained weight loss are some of the other symptoms of this type of cancer. Although esophageal cancer does not show any visible signs in the early stage, some of the key indicators are chronic couch, indigestion and hoarseness of voice.

Key risk factors:
Some of the key risk factors for this type of cancer are as follows:

  1. Men tend to run a higher risk of getting this cancer than women.
  2. Esophageal cancer are often detected in people above the age of 55 or more
  3. Chronic tobacco users have higher chances of getting esophageal cancer
  4. Consumption of alcohol increases the risk of esophageal cancer
  5. Obesity increases the risk of acid flux thereby leading to esophageal cancer
  6. Radiation treatment in the abdomen or chest area might also lead to esophageal cancer

How an esophageal cancer is detected?
Primarily there are 3 ways by which this cancer is detected. The first step for an oncologist to detect this cancer is to perform an endoscopy. If this fails, doctors often try a barium swallow on suspected patients and take an x-ray to understand the esophagus lining. If all this fails, doctors rely on a CT scan to detect this cancer.

How is esophageal cancer treated?
If a patient is lucky and the cancer gets detected in a very early stage, the tumor along with the infected cell can be surgically removed. Apart from surgery, some other alternatives are radiation and chemotherapy. A combination of radiation and chemotherapy or a surgery followed by radiation can also be suggested by the doctor. The treatment plan depends on the stage of detection.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3954 people found this helpful

Popular Questions & Answers

My mother is a case of esophageal cancer and I am diagnosed with h.pylori. Infection only on the basis of rapid blood test. No biopsy could be done due to swelling in my oesophagus, and after having medicines i. E lansoprazole, clarithromycin and tinidazole, no improvement is noticed. Need I go for biopsy of easophaegas. Please help.

FACS, MBBS, MS - General Surgery
Oncologist, Gurgaon
Have you tried changing your diet along with the medication? Are there any other symptoms you are experiencing? H pylori usually causes gastritis and ulceration. In most cases, taking antacids helps with the symptoms. Long term unhealed ulcers may shape up to become cancerous. Having an endoscopy done and if required a biopsy is not harmful.
4 people found this helpful

Hello! My grandpa had esophageal cancer had has undergone a surgery one year back but we did not do the chemotherapy as her age is 65 above. Now she experiences loss of appetite, vomiting, regurgitation, indigestion, weakness. Doctor said that some part of her digestive tract has swollen up so are there any chances of growth of cancer cells once again?

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Dear lybrate-user, hi Welcome to Lybrate.com I have evaluated your query for Sulochana.* There are more chances of recurrence of cancer depending upon the narration.* Must take an endoscopy examination and CT scan with contrast. Hope this clears your query. Regards dear take care.
1 person found this helpful

As my grandfather is suffering from esophagus cancer stage 1, and he is not able swallow the food,only few liquid foods are taking. Is there any tablets advisable for the pain. How long he can survive with liquid food?

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
He should be given pain killers from where he gets treatment . Ultracet is a good pain killer in severe cases like this

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Endoscopy
Hello everybody,

I am Doctor G.S Lamba, Gastroenterologist. I look after diseases of the liver and the digestive system. So today we are going to talk about investigation which is very commonly used investigation these days but about which lot of patients have got lot of queries and questions and they appear in their minds and they are generally apprehensive of getting that investigation done and investigation I am talking about is Endoscopy.

You all must have heard of this term Endoscopy which is generally done to diagnose many of the digestive disease problems and it is often prescribed by doctors. So what I have seen is that there are lot of myth and misunderstandings about this procedure in the patient s mind and they are reluctant to get this, they have heard things from people around without any substantive evidence or anything and they are generally not very willing to get this investigation done. So what I am going to enlighten you today is about Endoscopy.

Now, believe me, it s a very very simple investigation, the upper GI endoscopy as we call, is to see the about the problems which may be there in the upper digestive track. With Endoscopy we can see the food pipe, we can see the stomach and we can see the upper part of the intestine. So any disease in this area which can be seen directly, we can put endoscope and we can see these regions directly and then accordingly we can do the treatment. So it s a very very useful tool, it s a very simple investigation. It doesn t require any admission. It can be done on openly basis. It can be done without any anesthesia or without any sedation but suppose somebody is very apprehensive, so in those patients we can always give a short sedation for few minutes and do the Endoscopy procedure. In every Endoscopy procedure, diagnostic don t take more than 2 minutes to finish. So it s a very brief simple procedure and one can go to one s work or one can go to whatever he has to do after the Endoscopy.

You don t have to take any leave, you don t have to miss any appointments because of it. So it is a very simple thing and it is done with the help of a flexible you can say flexible long camera. It s a very sophisticated instrument made from very sophisticated rubber material with some light fibers. It s a very smooth flexible instrument which causes no trauma to the body, which causes no injury to the body in any way and it s a costly instrument and the Endoscopy is done through that and the patient is generally in lying done position, we put him the endoscope in his mouth and then within 2 minutes we examine his whole upper digestive track through it and lot of things and lot of diseases which can be diagnosed through it specially ulcers in the stomach, ulcers in the food pipe, severe acidity, tumors of the food pipe, tumors of the stomach, diurnal ulcers.

There are so many different diseases. It s very useful tool in liver disease patients where we can pick up some veins which get dilated and their food pipe and the stomach. So all these disease can be seen with the help of this endoscope. Endoscopy is not only a diagnostic tool, it s a very important therapeutic tool also. There are lots of diseases which we can treat with Endoscopy also. For example a patient comes with the bit blood in vomiting. It s a very common situation we get such patients every day. They vomited and there was blood in it. So our aim is to do the Endoscopy quickly in that patiently, see from where the bleeding is occurring and suppose there is a tear in his mucosa, suppose there is a ulcer there which is bleeding, we can inject medicines there, we can spray medicines over there, we can do laser therapy over it, we can put some clips over it to stop the bleeding if there is a vessel which has punctured and bleeding.

So there are lots of therapeutic applications also where a treatment can be done through Endoscopy and many of these treatments may be for example in case of bleeding, may be life-saving treatments and instead of the patient going in for an extensive long surgery which will which will require time, lot of rehabilitation time after the surgery, simple endoscopic procedure which can be finished in few minutes can take care of the problem. There are patients who have tumors which are bleeding, we have modalities which can control tumor bleed also. Then for diagnostic purposes we can also take samples from inside and get them tested. So all these things can be done with the help of Endoscope.

Another very interesting thing which we do with Endoscope is removal of foreign bodies. You may have seen there are many small children who swallow coins or pens or even some older patients also accidentally swallow something and it goes inside the stomach and obviously it may a needle, it may be a pen, it may be a clip anything. So all these things now don t require any surgery. We can with the help of endoscope in a few minutes almost every kind of foreign body which has gone inside and which is still there in the upper GI can be removed with the help of Endoscope.

Then we can do many pediatric procedure through Endoscope for example somebody who would have tumor of the food pipe, he cannot eat. So we can insert a stent or an artificial food pipe and make him eat. If there is a blockage in the stomach and the food is not going ahead, we can again we can put in a pipe to open that blockage where the patient can then start eating. So these are the various things which can be done by Endoscope. It s a very useful and simple tool and I think it has helped us in saving many lives. It has helped us in reducing morbidity in many patients. It has helped us in diagnosing so many diseases.

So I think there should be no fear in getting endoscopy. It s a very simple harmless procedure. There are hardly any side effects of the procedure that matters in complication of the Endoscopy. So if an Endoscopy is prescribed by the specialist, don t hesitate to get it done and because it is very good tool to diagnose so many diseases and timely diagnosis will help us in treating the disease faster and in a much better way.

Thank you.
Having issues? Consult a doctor for medical advice