NCCN Guidelines for Patients® | Esophageal Cancer - page 25

25
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 3: Preparing for treatment
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Definitions:
abdomen:
The belly area
carina:
Supportive tissue
at the base of the windpipe
endoscope:
A thin, long
tube through which tools
are inserted
gene:
A set of coded
instructions in cells needed
to make new cells and
control how cells behave
General anesthesia:
A controlled loss of
wakefulness from drugs
Local anesthesia:
A loss
of feeling in a small area of
the body caused by drugs
sedated:
A state of
relaxation caused by drugs
surface receptor:
A protein to which
substances attach
trachea:
The airway
between the throat and
bronchi; also called the
windpipe
HER2 testing
In normal esophageal cells, there are two copies of the gene that makes HER2.
HER2 is a surface receptor found in the membrane of cells. When activated, it
sends signals within the cell telling it to grow and divide.
Some esophageal cancers have cells with more than two copies of the HER2
gene, thus causing too many HER2 receptors to be made. Other esophageal
cancers have cells with only two HER2 gene copies, but still too many
HER2 receptors are made. With too many HER2 receptors, the cancer cells
grow and divide fast. However, there is treatment if the cancer is a stage IV
adenocarcinoma.
Due to high costs and the side effects of treatment, it is very important to have
tests that correctly show HER2 status. IHC (
i
mmuno
h
isto
c
hemistry) is the test
used to measure the amount of HER2 receptors. Another test of HER2 status is
ISH (
i
n
s
itu
h
ybridization). ISH counts the number of copies of the HER2 gene.
3.2 Treatment team meetings
Treatment of esophageal cancer takes a team of doctors and other experts. It
is important that all the experts involved in your care meet often to make joint
decisions about your health care. Two of these experts were discussed before.
The pathologist who reviewed your biopsy samples should be on your treatment
team. Also, the radiologist who reviewed your imaging test results should be
involved. Other experts may include:
• Oncology surgeon – an expert in cancer surgery,
• Medical oncologist – an expert in cancer drugs,
• Gastroenterologist – an expert in digestive diseases,
• Radiation oncologist – an expert in radiation treatment,
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