Cancer of the esophagus

Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Esophageal cancer can be of two types. The first type is adenocarcinoma , which is the most common, and the second type is epidermoid cancer, also called squamous cell cancer.

The risk factors for esophageal adenocarcinoma  are Barrett's esophagus, gastroesophageal reflux disease , tobacco, and obesity. The risk factors for esophageal epidermoid cancer are alcohol consumption and certain diets, regular ingestion of very hot drinks in large quantities, and smoking.

Symptoms and diagnosis of esophageal cancer

Manifestations of cancer of the esophagus include dysphagia , and / or unexplained weight loss. In some cases, esophageal cancer is discovered during a follow-up gastroscopy for Barrett's esophagus or during the diagnostic workup for gastroesophageal reflux disease.

The diagnosis requires various examinations, such as eso-gastroscopy with biopsies, echo-endoscopy, laryngoscopy and bronchoscopy in cases of epidermoid cancer, CT scan of the thorax and the abdomen, as well as PET-scan in some cases. 

INFO +  Medical examinations in the Radiology Division (FR)

Surgical treatment for esophageal cancer

Each cancer case is discussed during a weekly multidisciplinary meeting named tumor board  

In case of low tumors localized in the abdominal esophagus, a surgical exploration by laparoscopy prior to definitive surgery may be recommended. 

If the tumor can be removed, surgery is the treatment of choice. A neoadjuvant radio-chemotherapy is sometimes considered.

Depending on the type of cancer and its location, an esophagectomy  is suggested. This procedure is performed under general anesthesia by laparotomy or laparoscopy , and includes a right mini-thoracotomy . Surgical reconstruction (with the stomach or colon) is performed to reconnect the digestive tract. Thereafter, chemotherapy with or without radiotherapy is usually indicated.

In certain situations and in cases of early stage cancer, i.e. limited to the superficial layers of the wall of the esophagus, ablation of the tumor by endoscopy may be proposed.

When the tumor is not operable, chemotherapy with or without radiation therapy can be given.

Lorsque la tumeur n’est pas opérable, une chimiothérapie avec ou sans radiothérapie peut être administrée.

INFO +  Cancer Center

Adenocarcinoma
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Common cancerous tumor that develops from cells in a glandular lining or from the gland itself
Gastroesophageal reflux disease
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Ascent of acid from the stomach causing discomfort: burning sensations starting from the stomach toward the mouth (pyrosis), regurgitation or coughing.
INFO +  Gastroesophageal reflux disease
Dysphagia
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Difficulties in swallowing food which may cause pain or a sensation of mass.
Tumor board
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A meeting between specialists from several disciplines related to cancer, to determine the best possible treatment for each patient. 
INFO +  The Digestive Cancers Program
Laparoscopy
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A surgical technique using small incisions and insertion of a camera
Neoadjuvant radio-chemotherapy
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Prior treatment to reduce the size of the tumor
Esophagectomy
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Ablation surgery of the esophagus
Laparotomy
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Open surgery of the abdomen
Laparoscopy
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A surgical technique using small incisions and insertion of a camera
Right mini-thoracotomy
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Incision of the thorax
Endoscopy
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Method to visualize the internal organs and cavities for diagnostic or therapeutic purposes, carried out using an endoscope, a tube to which the end is attached to a lamp and a camera
INFO + Echo-endoscopy

More information

Last update : 04/01/2022