Esophageal Cancer Care

The board-certified doctors and other specialists at Norton Cancer Institute use the latest equipment and procedures to make a precise diagnosis of your cancer. Our multidisciplinary approach with multiple specialists in one setting means we offer a full range of esophageal cancer treatments, including radiation and immunotherapy.

Our advanced testing options will help your specialist determine a care plan that’s tailored for you based on the stage of your cancer and your treatment goals. Your comprehensive care team of physicians and other health care providers meets regularly to review your case and plan the next steps.

In addition to our current leading-edge treatments, we offer our patients the opportunity to participate in innovative National Cancer Institute- and industry-sponsored clinical research studies.

What Is Esophageal Cancer?

The esophagus is the narrow tube that leads from the mouth to the stomach. When you swallow, muscles in the tube push food and liquid from the back of the throat down into the stomach. Cancer that starts here is called esophageal cancer, even if it spreads to other parts of the body such as bones or organs.

There are two kinds of esophageal cancer:

1. Adenosarcomas, the most common esophageal cancer, start in gland cells at the bottom of the esophagus, closer to the stomach.

• Squamous cell carcinoma starts primarily in the upper esophagus. Squamous cells are thin, flat cells that look like fish scales. They are found in tissues of the skin, lining of the hollow organs of the body and the lining of the respiratory and digestive tracts. 

What Are Signs of Esophageal Cancer?

Unfortunately, esophageal cancers do not usually show symptoms until they have reached an advanced stage, which makes them harder to treat. It is rare to be diagnosed with esophageal cancer with no symptoms, unless it is discovered accidentally during testing for other medical issues. It is important to remember that no two cancers are alike — you may have none of these symptoms, the symptoms may be a sign of something besides esophageal cancer or you may have a unique combination of symptoms.

The first sign of esophageal cancer is difficulty swallowing and the feeling that food is lodged in the throat. This will get worse as time goes on. Other signs of esophageal cancer include:

• Chest pain or discomfort that feels like acid reflux pain — a burning or pressure feeling in the middle of the chest, especially after swallowing, when food may pass through the area affected
• Hoarse voice or persistent coughing that does not go away or gets worse over time

Symptoms of advanced esophageal cancer include:

• Bone pain, if the cancer has spread from the esophagus to the bone
• Vomiting blood or blood in the stool

How Is Esophageal Cancer Diagnosed?

The first thing your doctor will do if you have symptoms of esophageal cancer is take a detailed medical history, including any risk factors you may have. Conditions of the esophagus affect your risk for developing cancer and other issues. From there, your health care provider will determine what is the appropriate next step. Those steps might include:

• During a barium swallow test, which can be done alone or with other tests, you will drink a thick, chalky liquid called barium to coat the walls of the esophagus. When X-rays are taken, the barium outlines the esophagus.
• Endoscopy features a flexible, narrow tube with a tiny video camera and light on the end that is used to look inside the body. Tests that use endoscopes can help diagnose esophageal cancer or determine the extent of its spread.
• Blood tests including a complete blood count (CBC), show whether you have low red blood cell counts, which can mean the tumor is bleeding. A liver enzyme test helps the doctor understand if cancer has affected the liver.

Esophageal Cancer Treatment

As with most other cancers, there are different types of treatments for esophageal cancer. Which treatment your health care team chooses will depend on factors such as:

• Your overall health
• The stage your cancer is in when it is detected
• Whether the cancer has spread

Your team may choose standard esophageal cancer treatments, either by themselves or with other treatments, including:

• Surgery treats the cancer by removing small tumors, part of the esophagus (esophagectomy) or part of the esophagus, the upper part of the stomach and affected lymph nodes (esophagogastrostomy).
• Radiation therapy uses beams of energy such as X-rays to kill cancer cells.
• Esophageal ablation uses small electrodes that are placed on the cancerous cells. An electrical current is sent through the electrodes and burns the affected cells.
• Chemotherapy uses powerful drugs to kill cancer cells.
• Chemoradiation therapy combines radiation and chemotherapies.
• Immunotherapy helps your body’s natural immune system fight cancer.

Clinical Trials for Esophageal Cancer

Norton Cancer Institute physicians are part of leading-edge cancer clinical trials. These are studies that research how the body responds to new drugs or other therapies. You might be a candidate for a clinical trial, depending on many factors.

Esophageal Cancer Survival Rate and Prognosis

No one can say exactly how your cancer or treatments will affect you. The statistics below are estimates used to describe how large groups of people have been affected by esophageal cancer. The odds of surviving esophageal cancer vary from person to person, depending on many factors including:

• What stage the cancer was in at the time of diagnosis and how far it has spread in the body (metastasized)
• The number of risk factors present
• The effectiveness of treatment
• Your overall health

The National Cancer Institute offers some more statistics about esophageal cancer including:

• The projected survival rate after five years is 21.7%.
• Between 2016 and 2020, the rate of new cases of esophageal cancer was 4.2 per 100,000 men and women per year. The death rate was 3.8 per 100,000 men and women per year.
• Approximately 0.5 % of men and women will be diagnosed with esophageal cancer at some point during their lifetime, based on data from 2017 to 2019.
• In 2020, an estimated 50,379 people were living with esophageal cancer in the United States.

Who Treats Esophageal Cancer?

A multidisciplinary medical team brings together a group of health care professionals to plan the best treatment for you. The specialists at Norton Cancer Institute use the latest equipment and procedures to make a precise diagnosis of your cancer. Our multidisciplinary approach with many specialists in one setting means we offer a full range of esophageal cancer treatments.

If you are diagnosed with esophageal cancer, there may be many specialty physicians who make up your care team.

Thoracic surgeons treat diseases of the chest with surgery.

Surgical oncologists use surgery to treat cancer in the whole body.

Radiation oncologists treat cancer with radiation therapy.

Medical oncologists treat cancer with medicines such as chemotherapy, immunotherapy or targeted therapy.

Gastroenterologists specialize in the diagnosis and treatment of diseases of the gastrointestinal (digestive) system. 

You might have many other specialists on your treatment team as well, including physician assistants, nurse practitioners, nurses, psychologists, nutritionists, social workers and other health professionals.

Support and Resources for Esophageal Cancer Patients

Cancer affects the patient as well as their circle of friends and family. That’s why Norton Cancer Institute offers a range of cancer support options for patients, their families and their caregivers.

Esophageal cancer patient support includes:

• Norton Cancer Institute Patient Navigator Program connects cancer patients and their families with oncology-certified nurses who can offer emotional support and other resources.
• Educational sessions offer information about a variety of topics, including meditation, nutrition and financial considerations.
• Norton Cancer Institute Resource Centers help address patients’ emotional and physical needs, including support groups, art and music therapies, massage, and more.

Frequently Asked Questions About Esophageal Cancer

Is esophageal cancer curable?

Esophageal cancer is almost always treatable, but it is rarely curable. The National Cancer Institute estimates the overall five-year survival rate for esophageal cancer is about 20%, but survival rates can range from 5% to 47%. When esophageal cancer is found early and when it is small, the five-year survival rate is higher. When it is already large or has spread to other parts of the body, treatment is more difficult, and the five-year survival rate is lower.

Who’s affected by esophageal cancer?

Although doctors aren’t sure exactly what causes esophageal cancer, there are many known risk factors that can increase the likelihood of developing this type of cancer, including:

• Smoking
• Heavy alcohol consumption
• Chronic heartburn or acid reflux
• Gastroesophageal reflux disease (GERD)
• Barrett’s esophagus
• Obesity
• Diet high in processed meat and low in fruits and vegetables
• Physical inactivity
• Genetic mutations
• HPV infection

What are the different stages of esophageal cancer?

Cancer is given a stage based on how far it has spread from its origin site. The National Cancer Institute gives a detailed list of the stages of esophageal cancer and what each means. No matter what level your cancer is staged, Norton Cancer Institute offers a multidisciplinary approach to esophageal cancer care.

Multidisciplinary Care Tailored to You

Norton Cancer Institute provides a multidisciplinary approach to esophageal cancer patient care, collaborating with colleagues in other medical specialties to offer a customized plan just for you. Norton Cancer Institute includes surgeons, medical and radiation oncologists, nutritionists, pathologists, anesthesiologists, and gastroenterologists. In addition, patients have full access to Norton Healthcare’s full array of diverse specialists, state-of-the-art facilities, patient resources and more.

Esophageal Cancer Care for the Whole Person

• Norton Cancer Institute has nine outpatient locations and multiple infusion centers in Louisville and surrounding counties and Southern Indiana. We have three radiation centers located just off major interstates, with free, self-service parking and valet parking.
• Our gastrointestinal cancer patient navigator guides you through the treatment process. The navigator is a registered nurse and advocate for patients and families who can help coordinate scheduling to minimize your visits. The navigator provides information and support throughout your diagnosis, treatment and beyond.
• The Norton Cancer Institute multidisciplinary approach to cancer care means you’ll have access to multiple specialists, including medical oncologists, radiation oncologists, surgical oncologists, interventional radiologists, interventional gastroenterologists, researchers, geneticists and dietitians.
• We pull together providers from various disciplines to help identify the best treatment for you. At Norton Cancer Institute review boards, you will be considered for innovative clinical trials, immunotherapy, minimally invasive procedures, state-of-the-art radiation and advanced diagnostics.

Why Choose Norton Cancer Institute

More patients in Louisville and Southern Indiana choose Norton Cancer Institute than any other provider in the area. We provide compassionate care for the whole person, not just the cancer.

Our Norton Cancer Institute oncologists are also researchers and principal investigators, offering patients sophisticated experience in the latest treatments and access to more than 200 clinical trials.

• Access to more than 100 specialists, including board-certified and fellowship-trained oncologists
• Multidisciplinary setting, meaning you get the benefit of opinions from multiple specialists across Norton Healthcare and often can schedule appointments for the same day in the same location
• Immunotherapies such as CAR-T cell therapy, genetic therapies tailored to combat the unique genetic makeup of your cancer and the latest in surgical treatments, chemotherapy and radiotherapy
• State-of-the-art Norton Cancer Institute Genomics Lab offering highly specialized testing that makes it possible to tailor advanced treatments based on a tumor’s specific genetic composition
• Robotic-assisted bronchoscopy for minimally invasive lung biopsies that can reach more parts of the lung without major surgery
• Medicare, Medicaid and most major commercial insurance accepted
• At Norton Specialty Pharmacy, patients receive regular consultations on their medications and treatment plan, making sure they get their prescriptions quickly and accurately. Our specialty pharmacists collaborate closely with your oncology team.
• Use your free Norton MyChart account to communicate with your provider, manage appointments, refill prescriptions, get on the wait list for an earlier appointment and more anytime from a mobile device or computer