Question

Discuss Esophageal Cancer. Are these cancers limited to the gastrointestinal tract?. Are they limited to accessory structures?. What are the available treatments and success rates of such treatment.

Answer 1

#. Esophageal tumors that are usually fungating and infiltrating and nearly always fatal

Liver and lungs: common sites of metastasis

If symptom-producing, cancer usually already spread to lymph nodes

Includes two types of malignant tumors:

squamous cell carcinoma (usually occurring in the middle to lower two-thirds of the esophagus)

adenocarcinoma (usually beginning in the glandular tissue of the esophagus)

squamous cell carcinoma (usually occurring in the middle to lower two-thirds of the esophagus)

adenocarcinoma (usually beginning in the glandular tissue of the esophagus)

Grim prognosis because usually not detected until it has progressed to advanced, incurable stage

#. Treatment-General

Surgery and other treatments to relieve disease effects

Radiation therapy: external radiation, intraluminal brachytherapy, or both

Photodynamic therapy

Palliative therapy used to keep the esophagus open:

Dilatation of the esophagus via balloon or expandable metallic stents

Laser therapy

Radiation therapy

Installation of prosthetic tubes (such as Celestin's tube)

Dilatation of the esophagus via balloon or expandable metallic stents

Laser therapy

Radiation therapy

Installation of prosthetic tubes (such as Celestin's tube)

#. Treatment-Diet

Liquid to soft diet, as tolerated

High-calorie supplements

#. Treatment -Medication

Chemotherapy: cisplatin with 5-fluorouracil as the standard combination therapy; paclitaxel

Analgesics

#. Treatment-Surgery

Esophageal resection (esophagectomy)

Radical surgery to excise tumor and resect esophagus or stomach and esophagus

Gastrostomy or jejunostomy

#. Treatment-Other

Endoscopic laser treatment and bipolar electrocoagulation

#. Esophageal cancer is a treatable disease, but it is rarely curable. The overall 5-year survival rate in patients amenable to definitive treatment ranges from 5% to 30%. The occasional patient with very early disease has a better chance of survival.