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Clinical Outcomes

For information about current clinical trials, please click here.

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Esophageal Cancer

Cancer of the esophagus is increasing, and its location and type of cancer are changing. In the past, most esophageal cancers were away from the stomach and came from squamous cells (like skin). Smoking and heavy alcohol consumption increased the risk of those cancers. Now it occurs more often at the junction with the stomach and comes from cells that form glands (adenocarcinoma). Severe, long-lasting acid reflux, which causes heartburn, is the main risk factor for this newer form of esophageal cancer. Acid reflux can cause a precancerous condition called Barrett esophagus, which can be watched closely with regular endoscope examinations. The patient’s prognosis and treatment depend on how far the cancer extends into the esophagus or into lymph nodes, which determine the stage (1-4). However, this can be hard to determine before surgery.

Treating Esophageal Cancer

Occasionally, very early cancers can be completely removed (resected) with surgery alone. However, most esophageal cancer treatment requires multidisciplinary treatment with cancer specialists working closely together. Chemotherapy combined with radiation is an alternative to surgery. When given before surgery (neoadjuvant therapy), chemoradiotherapy also improves outcomes in most studies. Most esophageal cancers, even when they have been completely resected, come back (recur). Because of the risk of recurrence, research trials are often available to try new approaches.

  • Surgery–If we believe we can completely remove a tumor by surgery, it is called resectable. About 15 percent to 20 percent of patients with esophageal cancer have resectable tumors.

  • Neoadjuvant Therapy–Cancer treatment given before surgery is called neoadjuvant therapy. It generally involves chemotherapy alone or, more often, chemotherapy with radiation therapy.

  • Chemotherapy–Chemotherapy drugs are usually administered through a vein into the bloodstream (intravenously), but some can be given by mouth (orally). Usually, patients receive chemotherapy as an outpatient treatment at a hospital, clinic or doctor’s office. The time needed for each treatment session depends on the type of chemotherapy.

  • Radiation Therapy–Radiation therapy uses high-energy X-rays or other types of high energy waves to kill cancer cells or prevent them from growing. Radiation treatment often stops esophageal cancers from growing and sometimes shrinks them. Since radiation therapy only affects the cancer cells in the area where it is aimed, it is considered a local treatment, like surgery.

  • Adjuvant Chemotherapy or Radiation Therapy–Radiation therapy uses high-energy X-rays or other types of high energy waves to kill cancer cells or prevent them from growing. Radiation treatment often stops esophageal cancers from growing and sometimes shrinks them. Since radiation therapy only affects the cancer cells in the area where it is aimed, it is considered a local treatment, like surgery.

The graph below shows the overall survival for all patients under age 80 diagnosed with esophageal cancer by stage. These results compare favorably with the results of esophageal patients in treatment trials, indicating the ability of our multidisciplinary teams to provide complex, integrated treatment programs.

Clinical Trials

Esophageal cancer clinical trials, or research studies, are necessary to determine whether new treatments developed in the laboratory are beneficial to people with esophageal cancer. The Food and Drug Administration (FDA) reviews and analyzes data from successful clinical trials to determine whether to approve an experimental treatment to treat a specific disease or disorder, such as esophageal cancer.

  • Clinical trials are the only way that researchers can get the information to find effective new treatments for esophageal cancer. Currently, only about 3 percent of adult cancer patients enroll in a clinical trial, which slows progress in finding better treatments. Many patients are not aware that taking part in a research study is an option.

  • It is important for you to know that inactive treatments, or placebos, are never used in place of effective cancer treatments in clinical trials. If you take part in a cancer clinical trial, you will receive either the standard treatment or the new treatment.

  • Clinical trials for esophageal cancer may test completely new treatments or whether treatments that work for other cancers are effective against esophageal cancer.


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