Our Approach to Esophageal Cancer

Patients who come to the Siteman Cancer Center for treatment of esophageal cancer are seen by a team of Washington University Physicians— surgical, medical and radiation oncologists — often during the same visit.  A health psychologist is also available as needed.

Experienced nurses spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses can offer patient literature on your condition, chemotherapy, radiation therapy, surgery and other related issues. Siteman has created a patient support network that can allow you to reach out to previous patients who have volunteered to share their experiences and provide advice on navigating the therapy and its predictable side-effects. As a unique feature of your care, we also offer the services of a palliative care specialist who can help you fit treatment into your own special circumstances, if needed.

Esophageal cancer starts in the lining of the esophagus, the hollow muscular tube that moves food and liquid from your mouth to your stomach. Its walls are made up of several layers, starting from the inside: mucous membrane, muscle and connective tissues. Cancer starts in the mucous membrane, and spreads outward through the other layers as it grows. It may then spread throughout the lymph system to other parts of the body.

The two most common forms of cancer of the esophagus are:

  • Squamous cell carcinoma (cancer): Cancer forms in the squamous cells of the lining, usually in the middle or upper part of the esophagus.
  • Adenocarcinoma: Cancer forms in the glandular cells that release fluids like mucus, usually in the lower part of the esophagus near the stomach.

Types of treatment used for esophageal cancer depend on the stage at which it is diagnosed. Treatments include: surgery to remove the diseased section of the esophagus, chemotherapy and radiation (chemoradiation) followed by surgery or chemoradiation alone. Alternatives include clinical trials of chemotherapy, an esophageal stent to relieve symptoms, laser or electrocoagulation treatment to relieve obstructive symptoms and other measures to improve quality of life.

Washington University Physicians at the Siteman Cancer Center treat an average of 130 esophageal patients a year, and are internationally recognized for their expertise.

Physicians at Siteman are actively involved in clinical trials that investigate new chemotherapy regimens and other approaches to cure. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.