Esophageal Cancer

If you or a loved one has been diagnosed with an esophageal cancer, you may be familiar with some of the symptoms.

Esophageal cancer symptoms can include:

• Reverse flow of food back up through the esophagus
• Difficulty swallowing food or drink
• Pain or sensation that food is catching after swallowing
• Chest pain a few seconds after swallowing food
• Weight loss due to difficulties with eating
• Heartburn
• Vomiting blood
• Persistent cough

If an esophageal tumor is suspected, patients may have tests such as:

• Imaging tests such as a barium swallow study,MRI scan and/or CT scan
• An upper endoscopy procedure that uses fine needle aspiration biopsy to remove samples of cells from the esophagus for evaluation under a microscope
• A biopsy, in which cells are collected and then studied by a pathologist, who determines if they are cancerous. The pathologist also determines which type of esophageal cancer is present.
• Staging is done based on the tumor size, how far deep it extends into the layers of the esophagus, whether or not it involves nearby lymph nodes, and whether or not it has spread to other organs. Together, this information helps doctors determine the best options for treatment.

When esophageal cancer has not spread to other parts of the body, the standard treatment is surgery to remove the diseased part of the esophagus. Rarely, esophageal cancer is detected in its early stages, when it may be able to be treated through therapeutic endoscopy. Most often, surgery is necessary, either before or after radiation therapy and chemotherapy. If radiation treatment is needed to shrink the tumor before surgery, there is usually a four-week recovery period between radiation and surgery. For smaller, early stage tumors, surgery may be the first treatment.

EsoGuard^™ and EsoCheck^™

The GERD and Esophageal Cancer Center offers EsoGuard™ diagnostic screening. The leading-edge procedure pairs a biomarker test with new technology for a five-minute, non-invasive screening done in an office setting without sedation.

EsoGuard™ uses next-generation sequencing that detects precancerous cells in the esophagus. The procedure uses a device called an EsoCheck™, which consists of a textured balloon roughly the size of a daily vitamin or gel capsule attached to a thin silicone catheter. The patient swallows the EsoCheck™, which inflates when it reaches the stomach; most patients have minimal or no discomfort.

Once the placement is confirmed, the balloon is pulled back through the esophageal junction. Textured ridges on the surface collect sample cells from the esophagus. Before removing the EsoCheck™, negative pressure retracts the balloon into the capsule to protect the contents from contamination during retrieval. It is then placed into a preservation solution and transported to the testing facility. Results are typically available within two to three weeks.

Before being scheduled for EsoGuard™, patients must meet certain criteria. Most have a history of chronic reflux for at least five years and are age 45 or older.