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 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 treatments choices. They are listed from the most to the least common.
Surgery. This is the most common treatment for esophageal cancer. 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 surgery. Radiation before surgery can help shrink a tumor and make it easier to take out. After surgery, radiation can kill any cancer cells that are left.
Chemotherapy. For esophageal cancer, chemotherapy is used with other treatments. It may be used after surgery or radiation to kill cancer cells that are left. Or it can be used before photodynamic therapy or electrocoagulation to improve their outcomes.
Photodynamic therapy (PDT). This treatment uses a special drug and laser to kill cancer cells. PDT can only be used on cancers that are near the inner surface of the esophagus.
A newer alternative treatment to surgery 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 healthcare 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 healthcare 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.
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