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There are 2 main types of esophageal cancer – squamous cell carcinoma and adenocarcinoma. In the United States, adenocarcinoma is the more common of the two. Adenocarcinoma is usually caused by chronic reflux of stomach acid into the lower portion of the esophagus. This is why esophageal adenocarcinoma is usually located in the lower portion of the esophagus. Over time, the acid injures the inner-most lining of the esophagus and causes a change called Barrett’s esophagus. Continued injury can lead to genetic mutations in the esophagus that manifest as cancer.
Approximately 16,000 people are diagnosed with esophageal cancer each year. The majority of people are diagnosed with adenocarcinoma.
Many people may have a longstanding history of esophageal reflux or heartburn. They may have even been on reflux medicine for their symptoms. As the cancer starts to grow, most people experience problems with swallowing food. They may feel like food “gets stuck” in their esophagus. They find themselves chewing food longer before swallowing or avoiding certain foods. If untreated, the difficulty with solid foods can progress to difficulty drink liquids. Patients will often become malnourished and loose a significant amount of weight over a short period of time.
Most esophageal adenocarcinoma is treated with a combination of chemotherapy, radiation and surgery. In some very early cancers, surgery alone can be curative.
At TriHealth, we believe in a multidisciplinary approach to treating esophageal cancer. This means coordination of your care to include multiple specialists working together for one common goal – you. This multidisciplinary care starts at the time of your diagnosis. Your GI doctor will notify our nurse navigator. The nurse navigator will then schedule you an appointment in our esophageal cancer multidisciplinary clinic and schedule any additional tests that you may need prior to your office visit. In our multidisciplinary clinic you will meet with multiple specialists who will be involved in your care. This will likely include a medical oncologist, a radiation oncologist and a surgical oncologist. We also have dietitians and licensed genetic councilors available at this appointment. Together, these specialists will develop a comprehensive treatment plan for you.
There are many ways to perform an esophagectomy. Key concepts are to remove the lower half of the esophagus and the upper portion of the stomach, so as to remove the mass or cancer in its entirety. Additionally, it is very important to remove all of the lymph nodes in the area surrounding the esophagus and stomach. At TriHealth, we perform this procedure in a minimally invasive fashion. This means making smaller incisions so that you have less pain and recover faster. TriHealth is a high-volume center and has the largest experience in the region performing the minimally invasive esophagectomy using robotic surgical technology.