Esophageal Cancer

Because esophageal cancer is usually diagnosed in the later stages, it has often spread, making it difficult to treat. Esophageal cancer is relatively rare in the United States and few clinicians specialize in its treatment. It is important to choose a treatment center with an experienced team that has treated many patients with esophageal cancer.

The Center for Esophageal and Gastric Cancer at Dana-Farber Brigham Cancer Center brings together a team of experts who specialize in treating esophageal cancer. Our center sees more than 200 cases of esophageal cancer a year, and offers patients the most advanced treatments, including clinical trials. Some of these therapies are not available elsewhere and are developed by research scientists in our own laboratories.

Personalized treatment plans

We are a highly specialized center, and we focus on the distinct needs of people with esophageal cancer. This enables us to provide a very personalized approach to your care.

Our specialists work closely together and collaborate regularly to ensure that your care plan offers the best possible outcomes and that all your needs are met. Your health care team will take the time to listen, understand your needs and preferences, and help you gain a sense of control over your life. We offer the most effective therapies possible, while also helping you maintain your quality of life during treatment. We encourage you to be actively involved in the decision-making process.

Multidisciplinary approach

Your team of specialists — medical oncologists, radiation oncologists, surgical oncologists, pathologists, radiologists, nurses, and nutritionists — works closely together from your initial diagnosis and throughout your entire treatment process, ensuring that your care is coordinated. Because specialists from each discipline regularly discuss your case, we ensure that all feasible approaches to treatment are considered, and that you receive the combination of treatments that works best for you.

Clinical trials and genetic screening

Our specialists are actively involved in research, and apply the latest knowledge to patient care. Our many clinical trials are a significant part of our treatment approach, and many of our patients choose to participate. We also screen for known mutations for which targeted therapies may be applied.

Supportive resources

Patients have special nutritional needs during treatment for esophageal cancer. Many people find it hard to eat because they have trouble swallowing due to a narrowing of the esophagus, caused by a tumor or a side effect of treatment. You will work closely with a nutritionist who will help you with these challenges.

To address all of your physical and emotional needs, we provide a comprehensive range of support services and complementary and integrative therapies. We offer individual and family counseling, rehabilitation and physical therapy, pain and symptom management, acupuncture, massage, Reiki and support groups.

If you would like a second opinion or to have our team consult on your care plan...

If you have been diagnosed with esophageal cancer by another doctor, and would like a second opinion or to talk with us about your care plan, please contact us.

We regularly consult with patients at all stages of esophageal cancer. We perform surgery on patients with esophageal cancer from around the world, who then return to their local hospitals for further treatment.

Our expertise can be invaluable when deciding what kind of treatment to pursue.

Some reasons to consider a second opinion include:

• To confirm your diagnosis
• To learn more about your esophageal cancer from a knowledgeable specialist who has treated other patients just like you
• To better understand your options for treatment
• To learn if you are eligible for a clinical trial

Contact us

877-442-3324 or 877-442-DFCI or 617-632-3476
Or complete the online form.
If you cannot travel to Boston in person, you can take advantage of our Online Second Opinion service.

Treatment for Barrett's esophagus

Barrett's esophagus is a condition (caused by acid or bile reflux) that increases the risk of developing esophageal cancer. Treatment for Barrett's esophagus has changed dramatically in the past three years. Previously, all patients would have had significant surgery – the removal of the majority of the esophagus. Today, we can also offer a much less aggressive treatment approach.

If you are diagnosed with an early form of Barrett's esophagus, you'll be closely monitored and your reflux will be controlled with medication and lifestyle changes. If you have a high-grade form of Barrett's esophagus, meaning there are signs of dysplasia (cell abnormalities that indicate a progression toward cancer), we offer an outpatient therapy called radiofrequency ablation to remove abnormal tissue and allow normal tissue to grow back, in combination with an endoscopic resection (surgery).

Treatment by stage for esophageal cancer

Early stage diagnosis of esophageal cancer is rare. However, if you are diagnosed with stage 0 or I esophageal cancer, you will likely have surgery.

Most people are diagnosed in stage II or III, and treatment is usually radiation and chemotherapy followed by surgery.

Stage IV treatment is chemotherapy, with or without radiation.

Your care team will strategize to develop an approach that will work best for you.

Surgery

We commonly perform surgery as part of the treatment for patients with most stages of esophageal cancer. Surgical oncologists use the most advanced technology available to complete surgery with exacting precision. Our skilled surgeons regularly perform leading-edge, minimally-invasive surgeries whenever possible. Surgery to treat esophageal cancer is particularly challenging, and we have dedicated thoracic surgeons who specialize in these kinds of surgeries.

• Surgeons from Dana-Farber Brigham Cancer Center's Center for Esophageal and Gastric Cancer are among the world's leading experts specializing in thoracic surgery. Many of the procedures, including some of the most complex techniques, are completed using minimally-invasive, image-guided approaches.
• We have a dedicated Thoracic Intensive Care Unit (ICU) where we care for patients with esophageal cancer who need extra support. This allows us to focus on the distinct needs of people with this disease, and it's given us an invaluable level of familiarity with the subtleties involved with treating it.
• As a result of our surgical experience and techniques, and personalized care, we have been very successful in minimizing adverse outcomes and complications following surgery.

Usually, surgery involves removing the section of the esophagus with the cancer, as well as a small amount of tissue around the cancer, and nearby lymph nodes. During this operation, called an esophagectomy, a portion of the esophagus is removed and the stomach is pulled up and joined to the remaining esophagus.

Sometimes, part or all of the stomach is also removed:

• Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor
• Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor

Chemotherapy

Chemotherapy is the use of anticancer drugs to treat cancer. Chemotherapy reaches all parts of the body, not just the cancer cells. Our medical oncologists are highly experienced in optimizing chemotherapy and reducing side effects. Many of the treatments used in the United States today were developed by the medical oncologists at Dana-Farber Cancer Institute, including the most commonly used frontline treatment. Throughout your treatment, our team of nurses, nutritionists, social workers, and others will work to minimize the toxicities and side effects of chemotherapy, and maximize your quality of life.

Radiation therapy

Radiation therapy is a non-invasive cancer treatment that uses high-energy X-rays to kill cancer cells, often resulting in dramatic reduction of esophageal cancers. Our radiation oncologists use state-of-the-art equipment and the latest imaging techniques, and are assisted by experienced and expert staff. Each patient's radiation plan is carefully developed to treat the tumor while minimizing the impact on surrounding healthy tissues.

In most cases we recommend radiation before surgery to reduce the size of the tumor and make it easier to remove. In some cases, radiation and chemotherapy are combined for maximal benefit.

Clinical trials and targeted therapy

Many of our patients choose to participate in a clinical trial. Targeted therapies may be applied for some types of esophageal cancer with known genetic mutations.

For referring physicians

Because the patient's primary care physician or referring specialist is an integral part of the patient's care team, we are committed to collaborating in the care of your patient.

If you are a referring physician and have a patient with esophageal cancer, we look forward to working with you.

Find out more about how to refer a patient to Dana-Farber Brigham Cancer Center.

Esophageal Cancer Support Services and Follow-Up Care

At Dana-Farber Brigham Cancer Center, we understand that an esophageal cancer diagnosis can be challenging both physically and emotionally. When you become a patient at our Center for Esophageal and Gastric Cancer, you and your loved ones have access to our extensive array of support programs and services before, during, and after your treatment.

Symptom management, support programs, and follow-up care

We work closely with our patients to make sure any discomfort and side effects from either the cancer itself or its treatment are properly monitored and managed. We help patients manage their symptoms with nutritional guidance, speech therapy, pain management, counseling, complementary and integrative therapies, and exercise.

We also offer support groups, ethics consultations, personal consultation about appearance changes, and resources for patients, families, and caregivers.

Learn more about the services we offer to our esophageal cancer patients.

Survivorship care and follow-up testing

All patients in the center receive expert post-treatment care just the way they receive outstanding cancer care – in a comprehensive, personalized way. We provide each patient with a personalized care plan, with clear steps for monitoring and maintaining your health after treatment ends.

Find additional information, resources, and support for living well beyond cancer.

Explore additional programs and services for our patients and their families at Dana-Farber Cancer Institute and Brigham and Women's Hospital.