NCCN Guidelines for Patients
Esophageal Cancer, Version 1.2016
Treatment guide: Adenocarcinoma
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
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
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.
• Endoscopic treatments are preferred for Tis and
• 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
• 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.