Esophagus Cancer Overview

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Treating Esophagus Cancer TOPICS

Other types of treatments for cancer of the esophagus

Several types of treatment can be done by passing an endoscope (a long, flexible tube) down the throat and into the esophagus. Some of these may be used to try to cure or even prevent very early stage cancers. Others are used mainly to help relieve symptoms from more advanced cancers that can’t be removed.

Endoscopic mucosal resection

Endoscopic mucosal resection (EMR) is a treatment where the inner lining of the esophagus is removed with instruments attached to the endoscope. EMR can be used for dysplasia (pre-cancer or cell changes that have not yet become cancer) and some very early, single, small tumors of the esophagus. Drugs that reduce stomach acid are given after the abnormal tissue is removed. This can help keep the disease from coming back.

Radiofrequency ablation (RFA)

This may be used to treat areas of abnormal cells (called dysplasia) in Barrett’s esophagus.

In this method, a balloon with many small electrodes is passed into an area of Barrett’s esophagus. It is inflated so that the surface of the balloon is in contact with the inner lining. Then high-power energy is passed through the balloon to kill the cells in the lining by heating them. Over time, normal cells grow in to replace the Barrett’s cells.

The patient needs to stay on drugs to block the stomach from making too much acid after the treatment. Endoscopies (with biopsies) are then done to watch for any further changes in the lining of the esophagus.

PDT (photodynamic therapy)

This method may be used when the cancer has been found very early or to help with symptoms for some cancers that are too advanced to be removed. First, a harmless chemical is put into the bloodstream. It collects in the tumor for a few days. Then a special type of laser light is focused on the cancer through an endoscope. The light “turns on” the chemical in the tumor so that it can kill cancer cells.

PDT is useful because it can kill cancer cells with very little harm to normal cells. But because the light must be used, it can reach only cancers near the surface of the esophagus. It doesn’t work for cancers that have spread deeper or into other organs.

Side effects of PDT include swelling in the esophagus for a few days, which may lead to some problems swallowing. Scar tissue that narrows the esophagus (strictures) also occurs in some patients. Other side effects could include bleeding or holes in the esophagus. PDT can also cause redness of the skin and sensitivity to the sun or other light sources. Because of this, people having this treatment may be told to stay indoors for about 6 weeks.

PDT is used to relieve symptoms of advanced cancer that is blocking the esophagus. It is also being used to treat Barrett’s esophagus and very early changes (pre-cancers) found in Barrett’s esophagus.

To find out more, please see our document, Photodynamic Therapy.

Laser ablation

This method uses a laser that is aimed through the endoscope to kill cancer cells. It is used to open up the esophagus when it is blocked. This can make swallowing problems better. The cancer often grows back, so the treatment may need to be done again every month or two.

Argon plasma coagulation

This is a method something like laser ablation but it uses argon gas. It is also used to unblock the esophagus when the patient has trouble swallowing.

Electrocoagulation

This method involves burning the tumor off with electric current. In some cases, this treatment can help relieve esophageal blockage.

Esophageal stent

A stent is a device made of mesh. Most often stents are made out of metal, but they can also be made out of plastic. Using endoscopy, a stent can be placed into the esophagus across the length of the tumor. Once in place, it self-expands (opens up) to become a tube that helps hold the esophagus open.

The success of the stent depends on the type of stent that is used and where it is placed. Stents will relieve trouble swallowing in most patients that are treated. They are often used after other treatments to help keep the esophagus open.


Last Medical Review: 12/26/2012
Last Revised: 12/26/2012