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Esophagus

Problems

The esophagus is a muscular tube that connects the throat to the stomach. It is behind the windpipe (trachea) and in front of the spine. In adults is about 10 to 13 inches long. It carries food and liquids to the stomach.

There are 2 main types of cancer of the esophagus:

Squamous cell carcinoma: Squamous cells line the inside layer of the esophagus. Cancer that starts in these cells can grow anywhere along the length of the esophagus. Less than half of all cancers of the esophagus are squamous cell carcinomas.

Adenocarcinoma: These cancers start in gland cells. This type of cell is not normally part of the inner lining of the esophagus. These cancers are mainly in the lower esophagus. Adenocarcinomas that start where the esophagus joins the stomach or in the first part of the stomach tend to behave like esophagus cancers (and are treated like them, as well), so they are grouped with esophagus cancers.

Rare cancers: Other types of cancer can also start in the esophagus. But these cancers are rare and are not discussed further in this document.

Treatment Options

Surgical treatment of the esophagus:

Esophagectomy is the surgical treatment for esophageal cancer as well as other esophageal abnormalities. It involves removal of part or all of the esophagus and reconstruction utilizing stomach or large bowel.

Often a small amount of the stomach is taken out, too. The top of the esophagus is then reattached to the stomach, or the surgeon may replace the removed part of the esophagus with a piece of intestine. There are different ways to do an esophagectomy, but all of them are complex.

Open Esophagectomy

In a standard, open esophagectomy, the surgeon operates through one or more large cuts (incisions) in the neck, chest, or abdomen. The main incision is often in either the chest or the belly (abdomen).

Minimally Invasive Esophagectomy

For some early (small) cancers, the esophagus can be removed through several small incisions. The surgeon puts a scope (like a tiny telescope) through one of the incisions to see everything during the operation. Then long, thin surgical instruments go in through other small incisions. To do this type of surgery well, the surgeon needs to be highly skilled and have a great deal of experience removing the esophagus this way. When successful, this surgery allows the patient to leave the hospital sooner and recover faster.

No matter which approach is used, esophagectomy is not a simple operation, and it may require a long hospital stay. Surgeons who do this surgery must be experts. Ask your surgeon how many of these operations he or she has done and how many were successful. It is very important to have this surgery done at a center that has a lot of experience treating these cancers.

If the cancer has not yet spread far beyond the esophagus, taking out the esophagus might cure the cancer. But most esophageal cancers are not found early enough for doctors to cure them with surgery, so it’s important to know whether the goal of surgery is to try to cure the cancer or to ease symptoms.

Information acquired from cancer.org