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NCCN Guidelines for Patients


Esophageal Cancer, Version 1.2016


Overview of cancer treatments Surgical treatment


Ablation destroys very small tumors with little harm to

nearby tissue. There is more than one way to “ablate”

a tumor. An endoscope is used for all methods to

deliver the treatment. The recommended types of

ablation are:


– this method kills cancer cells

by freezing them with liquid nitrogen that is

sprayed through an endoscope.

Radiofrequency ablation

– this method kills

cancer cells using heat from electrodes that

are passed through an endoscope.

Photodynamic ablation

– this method kills

cancer cells using a laser that activates a

cancer-killing drug in the tumor that was

injected into a vein days before.

Side effects of endoscopic treatment

Side effects are unhealthy or unpleasant physical

or emotional responses to treatment. Endoscopic

treatment may cause a sore throat, pain in the chest,

or gas. More serious but less common problems

are bleeding, a tear through the esophageal wall,

or narrowing of the esophagus. The chances for

bleeding and tears are greater for ESD than for EMR.

Photodynamic ablation may make your skin and eyes

sensitive to strong light.

Not all side effects of endoscopic treatment are listed

here. Please ask your treatment team for a complete

list of common and rare side effects. If a side effect

bothers you, tell your treatment team. There may be

ways to help you feel better.

Surgical treatment

Surgery is a primary treatment for early and some

locoregional esophageal cancers. Primary treatment

is the main treatment used to rid the body of cancer.

The goal of surgery is to remove the entire tumor

and some normal-looking tissue around its rim. The

normal-looking tissue is called the surgical margin.

You will be given instructions on how to prepare for

your surgery. The week before your surgery you may

have to stop taking some medicines. On the day of

your surgery, you should not eat or drink. General

anesthesia will be used. In some people, general

anesthesia causes nausea with vomiting, confusion,

muscle aches, and itching.


An esophagectomy removes some or the entire

esophagus along with nearby lymph nodes. How

much of your esophagus will be removed depends

on the cancer stage and where the tumor is in your

esophagus. An esophagogastrectomy removes the

lower esophagus, the top part of the stomach, and

nearby lymph nodes.

Surgery removes tissue from your body through

cuts (incisions) made with a surgical knife. There is

more than one way to remove esophageal cancer.

Depending on the method, the surgery can take 3 to 6

hours to complete. Most people stay in the hospital 10

to 14 days to recover.

Standard open esophagectomy removes tissue

through large surgical cuts. There are two common

types of open surgery. An Ivor Lewis transthoracic

esophagectomy removes tissue through cuts in your

chest and abdomen. A McKeown esophagectomy

involves cuts in the chest, abdomen, and neck.

Minimally invasive esophagectomy removes tissue

through a few small cuts. It is done with either the