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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.
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.
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.
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