Esophageal Cancer Staging and Treatment Options

Esophageal Cancer Stages

After a diagnosis has been made, your doctor will try to figure out if the esophageal cancer has spread, and if so, how far, through a process called staging. The stage of cancer determines how serious the cancer is as well as what the best form of treatment will be. 

The American Joint Committee on Cancer (AJCC) TNM system is the staging system most often used for esophageal cancer. In regards to staging, TNM refers to:

  • Tumor size and extent of tumors
  • Lymph node involvement
  • Presence or absence of distant metastasis (whether or not cancer has spread to other areas of the body)

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread from where it started. Below are the details of each class: 

  • Stage 0 - Abnormal cells are present but have not spread to nearby tissue.
  • Stage I, II, III - Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.
  • Stage IV - The cancer has spread to distant parts of the body. 

When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed.

Esophageal Cancer Treatment Options 

Different types of treatment are available for patients with esophageal cancer. Some treatments are standard (the most commonly used), and some are being tested in clinical trials.  Each patient’s treatment plan will be created based on the stage and location of the cancer and will likely include more than one of the following:

  • Surgery. An esophagectomy, which is a type of surgery, is commonly done to remove the cancerous part of the esophagus. 
  • Radiation therapy. The use of high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. The 2 main types of radiation therapy used to treat esophageal cancer are external-beam radiation therapy and internal radiation therapy (brachytherapy). 
  • Chemoradiation therapy. A combination of chemotherapy and radiation therapy is often recommended for certain types of tumors and/or when the cancer is located in the upper esophagus.
  • Chemotherapy. The use of drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. 
  • Laser therapy. The use of a laser beam to kill cancer cells. 
  • Electrocoagulation. The use of an electric current to kill cancer cells. 

Nutritional Needs For Patients Undergoing Treatment for Esophageal Cancer

Esophageal cancer may make it harder for patients to eat due to having trouble swallowing. Either the esophagus may become partially blocked by the tumor or as a side effect of treatment. Our registered dietitian at Compass Oncology helps our patients going through esophageal cancer treatment understand how to get the nutrition they need to stay strong during treatment. 

Some patients may receive a feeding tube (a flexible plastic tube that is passed through the nose or mouth into the stomach) until they are able to eat on their own. This will be discussed with the oncologist and dietitian to determine if this is needed and for how long.