Esophageal Surgery
Types of Esophageal Cancer
There are two main types of esophageal cancer. Both types are diagnosed, treated, and managed in similar ways.
The two most common types are named for how the cancer cells look under a microscope. Both types begin in cells in the inner lining of the esophagus:
- Adenocarcinoma of the esophagus: This type is usually found in the lower part of the esophagus, near the stomach. In the United States, adenocarcinoma is the most common type of esophageal cancer. It's been increasing since the 1970s
- Squamous cell carcinoma of the esophagus: This type is usually found in the upper part of the esophagus. This type is becoming less common among Americans. Around the world, however, squamous cell carcinoma is the most common type
Symptoms
Early esophageal cancer may not cause symptoms. As the cancer grows, the most common symptoms are:
- Food gets stuck in the esophagus, and food may come back up
- Pain when swallowing
- Pain in the chest or back
- Weight loss
- Heartburn
- A hoarse voice or cough that doesn't go away within 2 weeks
These symptoms may be caused by esophageal cancer or other health problems. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated as early as possible.
Treatment
People with esophageal cancer have several treatment options. The options are surgery, radiation therapy, chemotherapy, or a combination of these treatments. For example, radiation therapy and chemotherapy may be given before or after surgery.
The treatment that's right for you depends mainly on the following:
- Where the cancer is located within the esophagus
- Whether the cancer has invaded nearby structures
- Whether the cancer has spread to lymph nodes or other organs
- Your symptoms
- Your general health
There are several types of surgery for esophageal cancer. The type depends mainly on where the cancer is located. The surgeon may remove the whole esophagus or only the part that has the cancer. Usually, the surgeon removes the section of the esophagus with the cancer, lymph nodes, and nearby soft tissues. Part or all of the stomach may also be removed. You and your surgeon can talk about the types of surgery and which may be right for you.
The surgeon makes incisions into your chest and abdomen to remove the cancer. In most cases, the surgeon pulls up the stomach and joins it to the remaining part of the esophagus. Alternatively a piece of intestine may be used to connect the stomach to the remaining part of the esophagus. The surgeon may use either a piece of small intestine or large intestine. If the stomach was removed, a piece of intestine is used to join the remaining part of the esophagus to the small intestine.
During surgery, the surgeon may place a feeding tube into your small intestine. This tube helps you get enough nutrition while you heal. Information about eating after surgery is in the Nutrition section.
You may have pain for the first few days after surgery. However, medicine will help control the pain. Before surgery, you should discuss the plan for pain relief with your health care team. After surgery, your team can adjust the plan if you need more relief.
Your health care team will watch for signs of food leaking from the newly joined parts of your digestive tract. They will also watch for pneumonia or other infections, breathing problems, bleeding, or other problems that may require treatment.
The time it takes to heal after surgery is different for everyone and depends on the type of surgery. You may be in the hospital for at least one week.
