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Esophageal Cancer Treatments
Get supportive, expert care for your unique needs with our individualized approach to esophageal cancer treatment. Whether you are seeking a diagnosis for recently detected signs of esophageal cancer or searching for new hope for advanced esophageal cancer, we will set you on the care path that’s right for you.
- Specialized expertise in diagnosing and treating esophageal cancers at all stages.
- Advanced treatment options, including robot-assisted, minimally invasive approaches to improve healing, reduce pain and complications, and shorten hospital stays.
- Team-based approach from surgeons, medical oncologists, and radiation oncologists, working together to give you the best possible care.
- Clinical trials that offer eligible patients access to the latest breakthroughs in cancer detection, diagnosis, and treatment.
- Comprehensive support services to help you and your family focus on health and healing.
- Ease of access to cancer care at locations throughout the Bay Area.
Connect to Care
Let us help find personalized care options for you and your family.
Interested in an Online Second Opinion?
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Visit our online second opinion page to learn more.
At Stanford Health Care, our team takes the time to explain your treatment options and answer any questions you may have. We work closely with you to determine the most appropriate treatment plan based on:
- Your age, overall health, and medical history
- Type and stage of cancer
- Size and location of the tumor, and whether it has spread
- Your tolerance of specific medicines, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
These drugs destroy cancer cells or help your body fight them. Usually, your doctor gives you these medications intravenously (through an IV). You may take some of them by mouth (orally). You may need them along with other treatments. Drug therapy options for esophageal cancer include:
- Chemotherapy: Several types of medications shrink or destroy cancerous cells. Chemotherapy can also prevent cancer from spreading to other parts of your body.
- Immunotherapy: These innovative medications help your body’s immune system fight disease. The drugs enable your immune system to recognize and attack cancer cells.
- Targeted therapy: This type of drug therapy interferes with the growth of cancer cells. The medications destroy cancer cells or slow their growth.
- Medications to relieve pain: Several types of pain medications can reduce discomfort and improve your quality of life.
External radiation
Most commonly, doctors use external radiation (external beam therapy) to treat esophageal cancer. This painless treatment uses a machine to send high levels of radiation directly to the cancer cells, which destroys them. Our team is skilled at using several types of external radiation therapy:
- 3D conformal radiation therapy (3D-CRT): With this method, 3D images help the doctor better target the tumor. We create the images using a special machine—a computed tomography (CT) or magnetic resonance imaging (MRI) machine. Your doctor can aim the radiation beams from many different angles to match the exact shape of the cancer.
- Intensity-modulated radiation therapy (IMRT): IMRT is similar to 3D-CRT, but the doctor can adjust how much radiation you get from each beam. In certain situations, this adjustment enables the doctor to avoid nearby healthy cells to reduce the risk of side effects.
- Stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR): This method works like 3D-CRT and IMRT, and the total amount of radiation you get is similar. With SBRT, you receive fewer radiation doses, but each dose is stronger.
Internal radiation (brachytherapy)
Your care team may recommend internal radiation, or brachytherapy. For this type of radiation, your doctor places small amounts of radioactive material into the area where the cancer was found or removed. You may receive brachytherapy treatment in two ways:
- High-dose rate (HDR): The radioactive material stays in place for a few minutes at a time.
- Low-dose rate (LDR): Doctors place a lower dose of radiation close to the tumor and leave it in place for longer. They may leave it there for up to two days, then remove it. You will likely need to stay in the hospital during brachytherapy.
To achieve the best possible outcome, your care team may recommend combining surgery with other treatments, such as radiation therapy and/or chemotherapy. You may receive additional treatment in one of two ways:
- Neoadjuvant therapy: This treatment occurs before surgery to make it easier and more effective. Undergoing chemotherapy and/or radiation before surgery, for example, may shrink a tumor and make removal more successful.
- Adjuvant therapy: This treatment occurs after surgery to reduce the risk of the cancer coming back. Chemotherapy or radiation therapy after surgery can destroy remaining cancer cells.
Your care team may recommend an endoscopic procedure to destroy tumors, relieve symptoms, or prevent complications. During these procedures, your doctor places a flexible tube down your throat and into your esophagus. We offer two types of endoscopic treatments:
- Dilation and stent placement: Your doctor uses an endoscope to widen an esophagus that has been narrowed by a tumor. They may also place a stent in the esophagus. This small, mesh device keeps the esophagus from becoming too narrow.
- Endoscopic resection: In some cases of esophageal cancer that are discovered in a very early stage, the tumor can be removed using special endoscopic techniques.
For advanced esophageal cancers, many of these endoscopic procedures are palliative. That means the goal of these procedures may not be to cure the disease. Instead, surgeons focus on relieving symptoms or preventing complications. Doctors may also use endoscopy to insert a feeding tube when advanced cancer has caused significant swallowing problems and the inability to eat.
Esophagectomy
Your doctor may recommend a procedure called esophagectomy to treat esophageal cancer. During this operation, your surgeon removes a portion of the esophagus, part of the stomach, and the surrounding lymph nodes. They reshape the stomach and attach it to the remaining part of the esophagus. There are several esophagectomy techniques:
- Ivor Lewis esophagectomy, which removes the tumor through incisions in the abdomen and the side of the chest
- Transhiatal esophagectomy, which removes the tumor through incisions in the abdomen and left side of the neck
- Three-incision esophagectomy, which uses incisions in the abdomen, side of the chest, and left side of the neck
Esophagectomies can cause significant side effects, including lung complications and problems with swallowing and digestion. Your team will discuss the risks, benefits, and possible side effects of surgery with you.
These complex operations require a high level of training and expertise. At Stanford Health Care, we have extensive experience with these procedures. Our team performs between 40 and 60 esophagectomies every year with excellent outcomes.
Minimally invasive esophagectomy
Most commonly, our team performs minimally invasive esophagectomy. This procedure uses multiple small incisions in the abdomen and chest, so it involves less recovery time than traditional (open) surgeries. It also decreases the chance of complications, like pneumonia.
At Stanford Health Care, we use video-assisted thoracic surgery (VATS) and robot-assisted techniques for minimally invasive procedures. This groundbreaking technology makes surgeries more precise and reduces the risk of complications.
During a VATS procedure, the surgeon uses a video camera to see inside the chest cavity. For robot-assisted techniques, your surgeon controls the surgical tools with the help of a specially designed robot. We have one of the highest volume video-assisted thoracic surgery (VATS) programs in the nation.
Clinical Trials for Esophageal Cancer
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest advanced clinical trials through the Stanford Cancer Institute.
Open trials refer to studies that are currently recruiting participants or that may recruit participants soon. Closed trials are not currently enrolling additional patients.
To request an appointment with a specialist, call 650-498-6000