Esophageal Cancer – Four More Questions That Could Make The Difference

If you have been diagnosed with esophageal cancer, you may wish to ask your physician the following additional four questions:

1. What diagnostic tests will I be taking besides the biopsy that has already been done or recommended?
Doctors can run a combination of diagnostic tests to confirm the size, location, malignancy, and spread of the tumor. The common diagnostic tests are:

• Barium Swallow Test – Imaging of the swallowed barium as it passes through the patient’s esophagus and stomach. Also known as the upper GI series, the barium coating brings out better contrast in X-rayed images and allows for better understanding of the presentation.

• Chest X-ray
• CT scan – Computerized axial tomography scans may be performed on the chest, abdomen, and/or brain to examine for metastatic cancers. This is a high resolution imaging procedure showing organs from different angles to a certain depth.
• PET Scan - Positron emission tomography helps determine whether a tumor tissue is actively growing and determines the type of cells within a tumor.
• Biopsy – Tissues suspected of being cancerous need to be examined under a microscope for their malignancy. Tissue samples are taken from the suspicious site in the esophagus, lung, by passing a special scope for this purpose.
• Esophagogastroduodenoscopy (GERD) – This involves the passing of a flexible tube down the esophagus and visualizing the wall.
• Laryngoscopy - This helps visualize the larynx or voice box with the help of a lighted tube.
• Bronchoscopy – Bronchoscopy is done with a thin fiber optic probe to obtain samples of the tumor for further tests such as biopsy. It is also used to visualize the tumor.
• Laproscopy – An incision is made in the abdomen through which a lighted tube is inserted to examine the spread of the cancer to other organs or to take samples for biopsy.
• Endoscopic Ultrasound – Also known as endosonography, it provides "staging" information regarding the level of tumor invasion, and possible spread to regional lymph nodes.
• Thoracoscopy – Here, an incision is made in the chest through which a lighted tube is inserted to check for the cancer in the esophagus.

2. What route of treatment will be prescribed for me?
The treatment path will depend squarely on your medical history as well as factors such as symptoms, size of the tumor, malignancy, stage, whether non-small cell lung cancer or otherwise and metastases to multiple lymph nodes etc. However, some popular treatment options which are used in combination are:*

Stage 0 – Surgery is recommended at this stage where the small tumor(s) or a very small part of the esophagus is removed.
Stage I – Surgery, chemotherapy and radiation.
Stage II – Surgery, chemotherapy and radiation or clinical trials of new therapies.
Stage III – Surgery, chemotherapy and radiation or clinical trials of new therapies.
Stage IV – Treatment inn this stage involves pain reduction in this advanced stage. However, chemotherapy, laser, clinical trials and radiation are given as well.

Radiation Therapy – High-energy X-rays are used to kill multiplying cancer cells. The radiation is either delivered externally or internally by placing radioactive substances in sealed containers within the body where the tumor is located. It can either shrink the tumor or halt its growth.

Chemotherapy – This achieves similar goals as radiation but is through drug or chemical delivery via pills and/or intravenous infusion. A combination of drugs is given in a series of treatments, called cycles, over a period of weeks with breaks in between cycles. Chemotherapy also kills normally dividing cells in the body, thus causing unpleasant side effects and reducing immunity.

Surgery – This can be performed in combination with other treatment procedures such as radiation and/or chemotherapy. Surgery may be done to either remove small tumors (when cancer cells are confined to the top/upper layers of the lining of esophagus) or a portion of the esophagus itself along with the lymph nodes. The remaining part of the esophagus is connected to the stomach and can use part of the colon to reconstruct the removed esophagus. Surgery is a potentially infectious procedure here and may carry complications such as bleeding, etc.

Laser Surgery – Cancer cells are destroyed using a laser beam directed to the site.

Electrocoagulation – Cancer cells are destroyed using a electric current directed to the site.

Clinical Trials – These are the latest in cancer treatment but do not guarantee a cure. They must be methods and drugs that have been approved by the United States Food and Drug Administration.

3. What is the prognosis for esophageal cancer?
Sadly, the prognosis for esophageal cancer is not a good one. By the time a person begins to develop symptoms, the cancer has often already progressed into the advanced stage. It is thus individual and stage dependent. According to the American Cancer Society, the percentages of people who live for at least five years after being diagnosed with esophageal cancer is 16 percent for Caucasian patients and 9 percent for African-American patients. Quitting smoking, drinking, regular follow-ups, maintaining a healthy weight through regular exercises and eating a healthy diet with lots of fresh greens reduces the chances of developing cancers of the esophagus and speeds up recovery after treatment.

4. What lifestyle changes should I be making?
For awhile after undergoing treatment, you will still be on a liquid and soft food diet to enable easy swallowing. You will be expected to eat small portions frequently and include nourishing and healthy food choices. It is recommended that at the time of recovery, you are a part of a good support system of family, friends and those who have experienced esophageal cancer. Social workers, counselors and clergy members can help too. Information specialists at 1-800-4-CANCER and at LiveHelp (http://www.cancer.gov/help) can help you locate programs, services, and publications. (Source: National Cancer Institute – U.S National Institutes Of Health – http://www.cancer.gov/cancertopics/wyntk/esophagus/page14)

*Benefits, side-effects, prior preparations, costs, duration of procedure, stay at the hospital, recovery and resumption of daily activities as well as support issues should be discussed with your doctor for each type of treatment option before starting on your treatment.

ALL INFORMATION GIVEN IN THIS ADVOCACY SHEET IS TO BE CHECKED WITH YOUR DOCTOR BEFORE IMPLEMENTING THEM OR TAKING THEM AS STANDARD OR VERIFIED.

Mamta Singh is a published author of the books Migraines for the Informed Woman (Publisher: Rupa & Co.), the upcoming Rev Up Your Life! (Publisher: Hay House India) and Mentor Your Mind (Publisher: Sterling Publishers). She is also a seasoned business, creative and academic writer. She is a certified fitness instructor, personal trainer & sports nutritionist through IFA, Florida USA. Mamta is an NCFE-certified Holistic Health Therapist SAC Dip U.K. She is the lead writer and holds Expert Author status in many well-received health, fitness and nutrition sites. She runs her own popular blogs on migraines in women and holistic health. Mamta holds a double Master's Degree in Commerce and Business. She is a registered practitioner with the UN recognised Art of Living Foundation. Link: http://www.migrainingjenny.wordpress.com and http://www.footstrike.wordpress.com

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