Esophageal Cancer

Overview
Doctors & Specialists

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Esophageal cancer affects the esophagus, the thin tube that connects the back of the throat to the stomach. Your esophagus carries swallowed food to your stomach to be digested. Esophageal cancer can happen anywhere along the esophagus, but in the United States, it happens most often in the lower part that is closer to the stomach.

The UVM Medical Center and the UVM Cancer Center provide specialized expertise in the screening, diagnosis and treatment of esophageal cancer.

Esophageal Cancer Care at UVM Medical Center

A cancer diagnosis can be frightening. We are committed to providing you experienced, compassionate care.

Quick diagnosis - Waiting for a plan forward is hard. The University of Vermont Medical Center's multidisciplinary team provides a complete evaluation of each patient and develops a personalized esophageal cancer treatment plan - in one day - that includes all appropriate resources.
Comprehensive services - We are here to help coordinate your care and streamline your overall experience. Our skilled nurses will help you through the clinical aspects of your care and schedule initial tests and consultations with the appropriate physician. They will also provide education regarding your diagnosis and treatment plan and act as a single point of contact for you and your family. We will assist with the logistics of your care, helping you find the resources you need, and be providing support for transportation, financial and insurance issues.
Research-based approach - Our nationally recognized physicians are also researchers and teachers who are up-to-date with the latest developments in their fields. We are proud to offer clinical research practices that may one day lead to future cures.

Esophageal Cancer: An Overview

The two most common forms of esophageal cancer are named for the type of cells that become cancerous, or malignant.

Squamous cell carcinoma (also called epidermoid carcinoma) is cancer that forms in squamous cells, the thin, flat cells lining the esophagus. This cancer is usually found in the upper and middle part of the esophagus, but can happen anywhere along the esophagus.

Adenocarcinoma is cancer that starts in glandular (also called secretory) cells. Glandular cells in the lining of the esophagus make and release fluids like mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.

Esophageal cancer symptoms include:

Painful or difficulty swallowing
Weight loss without trying
Chest pain, pressure or burning
Tiredness
Repeated choking while eating
Indigestion or heartburn
Coughing or hoarseness

Typically, early esophageal cancer causes no signs or symptoms.

The exact cause of esophageal cancer is unknown, but several factors can increase your risk of developing it, including:

GERD, gastroesophageal reflux disease
Barrett's Esophagus, a condition in which the tissue cells at the lower end of the esophagus are abnormal
Drinking too much alcohol
Cigarette smoking or chewing tobacco: The UVM Medical Center offers a quit smoking program.
Obesity
Eating few fruits and vegetables
Gender: The condition is more common in men than women.
Race: African-Americans are more likely to have esophageal cancer.
Age: Older adults between the ages of 45 and 70 are more likely to have esophageal cancer.

There are steps you can take to reduce your risk for esophageal cancer:

Quit smoking or chewing tobacco: The University of Vermont Medical Center offers a quit smoking program.
Drink alcohol in moderation, if at all
Maintain a healthy weight
Eat plenty of fruits and vegetables

Esophageal Cancer Diagnosis

Persistent irritation of your esophagus may contribute to the genetic changes that cause esophageal cancer. Your physician will want to take a close look at your esophagus to determine if you have esophageal cancer.

The University of Vermont Medical Center's knowledgeable doctors use advanced medicine to perform more than 9,000 various diagnostic and therapeutic endoscopic procedures every year.

Endoscopy uses a flexible, lighted scope (called endoscope) that is inserted through the mouth and gently moved down your throat into the esophagus, sometimes all the way into your stomach. During endoscopy, your doctor may take a tissue or cell sample (called biopsy) to examine it later under a microscope for cancer.
Barium swallow (also called upper gastrointestinal series) is when you're given a thick liquid (called barium) to drink that coats your esophagus for a short time so it shows up clearly on a series of X-rays.

After an esophageal cancer diagnosis, your doctor will need to determine the extent, or stage, of cancer to help guide your treatments. Often more testing is needed, and some of the tests are:

Endoscopic ultrasound (EUS) - uses an endoscope fitted with an ultrasound probe down the throat into the esophagus and sometimes into the stomach.
Computed Tomography (CT or CAT) scan - creates a detailed 3D image of your esophagus using x-rays
Magnetic Resonance Imaging (MRI) - uses magnets and radio waves to take images of the esophagus
Positron Emission Tomography (PET) - takes 3D images of the esophagus with the assistance of a radioactive substance injected through an IV

Treatments for Esophageal Cancer

Esophageal cancer treatment depends on the stage and location of cancer as well as other factors such as your age, overall health, and personal preferences. Your team of doctors will take all of that into account in recommending a course of treatment.

Esophageal cancer treatment options at The UVM Medical Center include:

Chemotherapy - treats cancer by destroying cancer cells using different types of medication
Radiation Therapy - uses high-energy beams, such as X-rays and protons, to destroy cancer cells
Surgery - the most common treatment for esophageal cancer, and it may be used alone or combined with other treatments. Esophageal cancer surgeries include:
- Esophagectomy - The surgeon removes the cancerous part of your esophagus and nearby lymph nodes. The remaining esophagus is reconnected to your stomach, usually by pulling the stomach up to meet the remaining esophagus. Sometimes, a part of the colon is used to replace the missing section of the esophagus.
- Esophagogastrectomy - In this surgery, your surgeon removes part of your esophagus, nearby lymph nodes and the top part of your stomach. The rest of your stomach is pulled up and reattached to your esophagus. If necessary, part of your colon helps join the two.
Endoscopic Placement of Stents - If esophageal cancer is partly blocking your esophagus, making it hard to eat, your doctor may recommend endoscopic placement of stents. Surgeons use endoscopy to place an expandable metal tube (called stent) inside the esophagus to help keep it open.
Clinical Trials - The UVM Medical Center has a history of clinical trial experience. Clinical trials are research studies that test the newest cancer treatments and new ways of using existing cancer treatments. Clinical trials can't guarantee a cure. Ask your doctor about enrolling in a clinical trial. Together you can weigh the potential benefits and risks.

For information call 877-540-HOPE (4673).