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
– this method kills cancer cells
by freezing them with liquid nitrogen that is
sprayed through an endoscope.
– this method kills
cancer cells using heat from electrodes that
are passed through an endoscope.
– 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.
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