Treatment for Esophagus Cancer
Overview: Esophagus Cancer Treatment for Esophagus Cancer How Many People Get Esophagus Cancer? Some Questions to Ask Your Doctor
Treatment for Esophagus Cancer
You may want to get a second opinion. Your doctor should not mind your doing this. In fact, some insurance companies require you to get a second opinion. Surgery, chemotherapy, and radiation are used to treat cancer of the esophagus. Other treatments (palliative) can be used to help relieve pain but are not meant to cure the cancer. The best choice for you will depend on the stage of the cancer as well as your general health. Each of these treatments might have some side effects. Your cancer care team will be glad to discuss the side effects with you. Surgery How much surgery is done depends on the stage of the cancer. Surgery can also be used along with other treatments such as chemotherapy and radiation treatment. There are two common types of operations for this cancer. In one, esophagectomy (ee-sof-uh-JEK-tuh-me), the esophagus and nearby lymph nodes are removed. The esophagus is re-connected to the stomach, either directly or by adding a piece taken from the large intestine. The other surgery, esophagogastrectomy (ee-sof-uh-go-gas-TREK-tuh-me), is done to remove part of the lower esophagus, nearby lymph nodes, and the upper part of the stomach. The esophagus is again connected to the stomach. Both of these operations are complex. Surgeons who do this surgery must be quite expert. You should feel free to ask your surgeon about his or her experience with these operations and what percent were successful. The success rate is greater when the surgery is done in a hospital where it is done more often. Most people stay in the hospital for 2 weeks after surgery. And there can be risks and side effects. For example, after the operation the stomach may empty very slowly, causing nausea and vomiting. The place where the esophagus connects to the stomach can become more narrow, making it hard for the person to swallow. Also, acid from the stomach can enter the esophagus causing heartburn. Anyone who has problems with side effects should talk with
their doctor or nurse as there are often ways to help. Chemotherapy refers to the use of drugs to kill cancer cells. Usually the drugs are given into a vein or by mouth. Once the drugs enter the bloodstream, they spread throughout the body. Chemotherapy alone cannot cure cancer of the esophagus unless radiation treatment (and in some cases surgery) are also used.. Chemotherapy is used in 3 ways: it can be given along with radiation to shrink the cancer; it can be used before surgery to shrink a tumor; it can be used to ease the symptoms of advanced cancer. Chemotherapy can have some side effects. These side effects will depend on the type of drugs given, the amount taken, and how long treatment lasts. The most common side effects can include:
Most side effects go away once treatment is over. Anyone who has problems with side effects should talk with their doctor or nurse as there are often ways to help. Radiation Therapy Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. External radiation uses a beam from outside the body. This is the kind most often used for cancer of the esophagus. For internal or implant radiation, radioactive material is placed directly inside the body near the cancer. Radiation therapy by itself will not cure esophageal cancer. Often it is combined with surgery and/or chemotherapy. It is also used to relieve problems with swallowing, pain, or other symptoms of this cancer. Side effects of radiation treatment may include skin problems, upset stomach, diarrhea, and fatigue. Often these side effects go away when treatment ends. Radiation to the chest may cause lung damage and lead to trouble breathing and shortness of breath. If you have these or other side effects, talk with your doctor since there are often ways to relieve them. PDT (photodynamic therapy): This method may be used when the cancer has come back after radiation treatment. First, a harmless chemical is injected 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 changes the chemical into a new chemical that 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 redness or discoloration 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 6 weeks.
Because this cancer is usually found at an advanced stage, most people will die of the disease. But survival rates have been getting better. Talk with your cancer care team if you have questions about your own chances of a cure, or how long you might survive your cancer. They know your situation best.
How Many People Get Esophagus Cancer?
In the United States, the American Cancer Society estimates that there will be about 14,250 new cases of this cancer in 2004. About 13,300 people will die of the disease. This cancer is about three times more common among men than among women and three times more common among African Americans than among whites. Some countries such as Iran, northern China, India, and southern Africa have rates that are 10-100 times higher than that of the United States.
After The Tests: Staging
Staging is the process of finding out how far cancer has spread. This is very important because your treatment and the outlook for your recovery depend on the stage of your cancer. Your doctor will start with a barium swallow and/or endoscopy to find out the size of the tumor. Then a CT scan will help answer the following questions:
Sometimes endoscopic ultrasound is used as well to find out how deep the cancer goes into the tissue of the esophagus. Once the doctor has the answers to these questions, the stage of the cancer can be determined. Stages are often labeled using Roman numerals 0 through IV (0-4). In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious cancer. After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.
Some Questions to Ask Your Doctor
As you cope with cancer and cancer
treatment, you need to have honest, open discussions with your doctor. You
should feel free to ask any question that's on your mind, no matter how small it
might seem. Here are some questions you might want to ask. Be sure and add your
own.
Add Your Own Questions Below:
Source
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This web site is Copyright © 2004 by Karl Loren. Permission is granted to download, copy, distribute and use as long as the copyright notice remains attached to such use and the intended meaning is not altered.
There
is a lot for you to think about when choosing the best way to treat or manage
your cancer. There may be more than one treatment to choose from. You may feel
that you need to make a decision quickly. But give yourself time to absorb the
information you have learned. Talk to your doctor. Look at the list of questions
at the end of this piece to get some ideas. Then add your own.