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Cancer of the Esophagus

What is cancer of the esophagus?

Cancer of the esophagus (esophageal cancer) is an abnormal growth of cells that form tumors in the esophagus (the tube that carries food from the mouth to the stomach). If the cancer spreads to other parts of the body, it is still esophageal cancer, and is called metastatic esophageal cancer.

There are different types and stages of esophageal cancer based on what kind of cancer cells are found, where the tumor started and where it has spread. Knowing the type and stage of esophageal cancer you have helps your healthcare provider decide on the best treatment plan for you. It is important to diagnose and treat esophageal cancer as soon as possible. The main goals of treatment are to kill the tumor cells, prevent a localized cancer from spreading, and prevent metastatic cancer from spreading more than it already has.

The following things may increase the risk for esophageal cancer:

  • Gastroesophageal reflux disease (GERD)
  • A narrow esophagus or a bulge in your esophagus that allows food to get caught
  • Drinking large amounts of alcohol
  • Being obese
  • Tobacco use (either smoking or chewing)
  • Previous radiation to the chest
  • Not eating enough fruits and vegetables over a long period of time
  • Family history of esophageal cancer

What can I expect in the hospital?

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

  • You will be checked often by the hospital staff.
  • Your heart rate, blood pressure, and temperature will be checked regularly.
  • Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
  • Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
  • Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce.

Testing

Testing may include:

  • Blood tests to check for certain hormones, proteins, or chemicals that may be high if you have cancer.
  • Tests to look for abnormalities in your esophagus, which may include:
    • Barium swallow: An X-ray taken of the upper part of your digestive tract after you swallow barium. Barium is a liquid that helps your intestines show up well on the X-ray.
    • Endoscopy: A test in which a slim, flexible lighted tube is passed through your mouth to look at your esophagus and stomach. Sometimes one or more pieces of tissue are removed to help make a diagnosis. This is called a biopsy.
  • Tests to check if the cancer has spread to other parts of your body, including:
    • Blood tests to check for certain hormones, proteins, or chemicals that may be high if you have cancer
    • Bone X-rays: Pictures of your bones to check for cancer
    • Bone scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
    • Chest X-ray: Pictures of the inside of your chest to check for cancer
    • Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the throat, chest and other areas where the cancer may have spread
    • Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the throat, chest and other areas where the cancer may have spread
    • Positron emission tomography (PET) scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.

Treatment

The treatment for esophageal cancer depends on your symptoms, how well you respond to treatment, your overall health, and any complications you may have. Your chance of cure depends on how far the cancer has advanced. You may need to make lifestyle changes to stay as healthy as possible.

  • You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
  • You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help relieve pressure from air or fluids in your stomach and intestine.
  • You may need surgery to treat esophageal cancer. Surgery may include:
    • Tumor resection: Surgery to remove the tumor from the esophagus. This may be done if the tumor is very small and has not spread through the layers of the esophagus.
    • Esophagectomy: Surgery to remove the section of esophagus that contains the cancer. The rest of your healthy esophagus is then attached to your stomach.
    • Esophagogastrectomy: Surgery to remove a large section of your esophagus and part of your stomach. The rest of the esophagus may be attached to the stomach or a piece of healthy intestine may be used to replace the missing piece of esophagus.
    • Laser surgery: Surgery to remove as much of the tumor that is blocking the esophagus as possible. A stent may be used to help keep the esophagus open.
    • Lymph node dissection: Surgery to remove lymph nodes in the neck and chest to check if the cancer has already spread. It also allows the pathologist to determine the stage of the cancer accurately. This will allow your healthcare providers to determine if you need more treatment after you recover from surgery.
  • Treatments may include:
    • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells.
    • Radiation therapy, which uses high-energy X-rays to kill cancer cells.
  • Your provider may also prescribe medicine to:
    • Treat pain
    • Treat or prevent an infection
    • Treat or prevent anemia, which means you have too few red blood cells to carry enough oxygen to your body. Anemia may be caused by your cancer, your treatment, or other problems.
    • Treat or prevent side effects, such as nausea or constipation, from other treatments
    • Reduce the acid in your stomach to help relieve acid indigestion
    • Help your immune system fight cancer

What can I do to help?

  • You will need to tell your healthcare team if you have new or worsening:
    • Shortness of breath
    • Coughing up blood or mucus that is thick or blood-stained
    • Trouble swallowing
    • Heartburn
    • Loss of appetite
    • Nausea or vomiting
    • Depression
    • Redness, swelling, pain, warmth, or drainage from your surgical wound
    • Fever, chills, or muscle aches
  • Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with esophageal cancer is 7 to 10 days.

Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth.
Last modified: 2014-12-19
Last reviewed: 2014-12-18
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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