Surgery for esophageal cancer can be either palliative or curative, depending on what stage the cancer is in and the patient's overall health.
In the early stages of the cancer, curative surgery is normally the first option. Surgery to remove the affected lymph nodes and mucosa and tumors is known as an esophagectomy, which is essentially removal of part or the entire esophagus, depending on the extent of damage.
Esophagectomy is said to provide complete reversal, especially if the lesions are in the early stages. For the early stages of cancer, ablation of the esophageal mucosa using an endoscope is still experimental.
The two types of esophagectomy are
In cases where the cancer is in its last stages and/or the patient is inoperable, palliative surgery is performed to ease the discomfort. Endoscopic dilation is a good palliative option for tracheoesophageal fistulas and dysphagia.
The type of surgery will depend on the location of the cancer and the extent of its spread. An esophagectomy may result in the removal of the entire or part of the esophagus, nearby tissues, affected lymph nodes, and even part or whole of the stomach.
The procedure for a trans-hiatal esophagectomy is as follows:
In advanced but curable cancers, the 5-year survival rate for esophageal cancer is almost 41%. For patients with stage 3 esophageal cancer, survival can be achieved in 25% to 35% of patients, if an esophagectomy is performed.
You may experience pain post-surgery, albeit this can be controlled with adequate medication. Complications to watch out for post-surgery include:
The occurrence of complications is frequent following esophageal cancer surgery. Hospitalization could be anywhere between 10 to 14 days after surgery.
While the focus is now shifting to neoadjuvant or preoperative chemoradiotherapy as a means to improve survival, surgery is still often the first line of treatment in resectable cancer.
In people who have undergone an esophagectomy, lingering health problems may result. In a study published in the Journal of Clinical Oncology, it was found that patients who had undergone esophageal cancer surgery and survived for five years experienced fatigue, breathlessness, eating discomfort, insomnia. Further, those who had experienced complications immediately after surgery had more severe symptoms.
Esophageal cancer treatment is determined based on the stage in which the cancer is, and it mostly comprises of one or all of the listed options:
Additional treatment options include: