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86

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

6

Treatment guide: Adenocarcinoma

Advanced cancer

Esophageal blockage

The cancer may block (obstruct) food and liquids from

passing through your esophagus. Treatment is based

on the extent of the blockage. You may get a feeding

tube if you aren’t receiving enough nutrition.

A complete blockage doesn’t allow any food or liquids

to pass through your esophagus. Treatment options

include endoscopic methods, radiation therapy,

chemotherapy, and sometimes surgery. Dilation and

stents are endoscopic methods described below.

EBRT is the common radiation method. However,

internal radiation (brachytherapy) may be an option

as well.

A severe blockage allows only liquids to pass through

your esophagus. One treatment option is to stretch

open (dilate) your esophagus. Your esophagus can

be stretched using a small balloon or tube guided

down your throat to the right spot.

Another option for a severe blockage is a stent. A

stent is a thin metal or plastic tube. It can be placed in

your esophagus with endoscopic tools while you are

sedated. Placement of the stent can be done on an

outpatient basis. The stent will expand in the passage

and remain in your body to allow food to pass through.

Other options for a severe blockage are the same as

for a complete block. EBRT and brachytherapy work

well to unblock the esophagus. Symptom relief from

radiation is slower but more long-lasting compared to

endoscopic methods.

A moderate blockage allows liquids and semisolid

food to pass through your esophagus. An example of

semisolid food is applesauce. Treatment options are

the same as for complete and severe blockage.

Review

• Endoscopic treatments are preferred for Tis and

T1a tumors.

• For T1b tumors, an esophagectomy is

recommended if you can have surgery. If not,

you can receive endoscopic treatment. After an

esophagectomy, you may receive chemoradiation

to kill any remaining cancer cells.

• Invasive cancers are often treated with

chemoradiation. An esophagectomy may follow to

remove any remaining cancer.

• When there are no signs of cancer after treatment,

testing to check for new cancer growth should

be done. Medical history and physical exams are

needed. You may also receive blood, imaging, and

scoping tests.

• Cancer that returns after local treatment near to

where the esophagus is (or was) may be curable

with surgery or chemoradiation.

• Cancer that is unable to be cured can be treated

with supportive care. Supportive care includes

treatment to prevent or reduce symptoms caused

by the cancer.