Treatment of oesophageal cancer: surgical and oncological

Treatment depends on the condition of the esophageal cancer. The above-mentioned TNM system is used for evaulation, i.e. of the tumour itself, its relationship to the environment, invasive involvement of nearby structures, but also lymph nodes or possible metastasis.

Also, the overall condition of the affected person must be taken into account.

Histological examination of the collected material is important. This will determine whether the treatment should be curative or palliative.

The curative form includes primary cause treatment.

Palliative care seeks to improve the quality of life and alleviate the symptoms of an incurable disease.

Surgical treatment has several variations. The choice of method depends on the staging of the cancer, the placement of the tumour and the overall condition of the patient. Surgical resection treatment involves removal of the tumour and local lymph nodes.

The surgical approach can include open esophagectomy, mini-invasive esophagectomy, or thoracoscopic laparoscopic esophagectomy.

The following is used to replace the missing part of the esophagus:

• the stomach, in most cases
• a part of the small intestine
• the colon

Other ways include chemotherapy, radiotherapy, photodynamic therapy, laser therapy or esophageal stents. Treatment methods are combined in most cases. The surgical treatment is usually combined with radiation or chemotherapy.

Of course, associated lymph nodes are also removed in order to reduce the risk of recurrence.

A combination of radiotherapy and chemotherapy is used for cancers that cannot be removed surgically, especially tumours at a very advanced stage. However, in this case, the prognosis is not as good as in the case of surgical removal.

Difficulty swallowing can also be solved with an endoprosthesis, i.e. an artificial prosthesis. They are esophageal stents that allow food to be ingested, which is also used in tumours that cannot be removed.