Treatments


Esophageal cancer has a wide range of treatments that can be used alone or in combination to give the best outcome. Treatments for both types of esophageal cancer are the same options. Your care plan will be based on your individual case, medical history, and how far any cancer has progressed. We will also base treatment options on how aggressive the cancer cells are in growing. This is called the cancer grade. Current treatments include:

  • Surgery

    Adenocarcinoma is typically treated with surgery to remove any cancerous glandular tissue. Some surrounding tissue is also removed. Minimally invasive surgery techniques can reduce healing time and minimize potential infection. Surgery is the only curative treatment for gastric cancer. Chemotherapy is often done first before surgery of the stomach and gastric tract.

    • Minimally invasive endoscopic mucosal resection (EMR): For earlier stage esophageal cancer, EMR is performed on an outpatient basis by a gastroenterologist. An endoscope is a thin, flexible tube with a lens, light and camera attached to it. An endoscope gets inserted through the mouth and into the esophagus. The camera shows the doctor very detailed images. The gastroenterologist can suction small nodules or growths; trap them in a small, rubber band; then cut and remove them.

    • Esophagectomy: Removing the diseased part of the esophagus and a margin of healthy tissue. In most cases, after that is done, the stomach is pulled up and joined to the remaining esophagus. More complicated cases may involve using a part of the intestine to replace the removed esophagus and make the connection.

  • Chemotherapy (Systemic Medical Therapy)

    Chemotherapy can be administered intravenously or by a pill and is usually a combination of cancer-fighting drugs. Chemotherapy is the main treatment for advanced esophageal cancer. Over the last few years, several new drugs have increased the options for esophageal cancer. Having chemotherapy or chemoradiation before surgery is called neoadjuvant therapy.

    • Intravenous (infusion) chemotherapy is available at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, or Deerfield Beach locations.

  • Chemoradiation

    This therapy combines chemotherapy and radiation therapy to increase the effects of both. For esophageal cancer, chemoradiation may be used before or after surgery. It also may be part of the treatment for people who can't have surgery.

  • Targeted Therapy

    These treatments are designed to attack the molecular changes that make the cancer cell grow and spread. They have the potential to be more effective and with fewer side effects than chemotherapy. Some of these medicines are given along with chemotherapy medicines, while others are used by themselves. Your doctor at Sylvester will share which approach is best for your cancer.

  • Radiation Therapy

    Most esophageal radiation treatment at Sylvester is external beam radiation therapy, which is delivered from outside the body. Advanced technology tools working for you include RapidArc®, an advanced technology used with a linear accelerator to deliver intensity modulated external radiation therapy (IMRT). This shortens treatment times to one-half to one-eighth that of conventional radiation therapy, resulting in better targeting, and less damage to healthy tissue.

  • Photodynamic Therapy (PDT)

    PDT uses a light-activated medicine and a laser to kill cancer cells. It can be used to treat some very early-stage cancers. It is most often used to help relieve symptoms, such as trouble swallowing, in people with advanced cancer.

  • Laser Therapy

    Laser therapy uses laser beams rather than surgery to destroy and remove cancer cells.

  • Electrocoagulation

    This treatment uses an electrical current to kill cancer cells.

  • Cryotherapy

    Cryotherapy freezes a tumor’s cells to destroy them.

  • Nutrition, Pain Management, and Supportive Care

    The esophagus is the primary route for food and liquids to get to the stomach. People with esophageal cancer may experience special nutritional needs during and after treatment. They may have difficulty eating because the esophagus is narrowed by the tumor or by the scarring effects of treatment. A feeding tube can help patients get the nutrients they need until fully recovered.

  • Psychosocial Support

    The Courtelis Center for Psychosocial Oncology at Sylvester provides a team of mental health professionals including psychiatrists, psychologists, licensed clinical social workers, and a chaplain to help you and your family cope with your cancer. This program addresses the impact of the mind-body relationship on health, disease, prevention, and recovery. To schedule an appointment, please call 305-243-4129.