Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Overview

Esophageal cancer starts in the hollow tube that connects the throat to the stomach (esophagus). It carries the food and liquids you swallow to your stomach.

Cancer develops when normal cells in the esophagus lining change and grow uncontrollably. Over time, a tumor may form inside the lining of your esophagus. The cancer may then grow outward through additional layers of the esophagus.

In some cases, this cancer might spread to: 

  • Blood vessels and lymph nodes in the chest and other nearby organs.
  • Other parts of the body (metastatic cancer). 

Treatment may include surgery, chemotherapy, radiation therapy, and other methods. You might also need nutritional support.

Understanding what to expect: 

  • Helps you make informed decisions about your care.
  • Gives you the tools you need to cope with the disease.

We know a cancer diagnosis can be overwhelming. We’re here to give you the best care possible.

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Types

There are 2 main types of esophageal cancer, depending on the type of cancer cell. 

Squamous cell carcinoma. Squamous cells are thin, flat cells that line the esophagus. This type of cancer can be found anywhere along the esophagus. It most often forms in the upper and middle part.

Adenocarcinoma. This type is found in the lower part of the esophagus, close to the stomach. It develops in gland cells, which are not normally found inside the esophagus lining. If you have Barrett’s esophagus, you’re at risk for this type of cancer.

Adenocarcinoma is now the most common type of esophageal cancer in the United States.

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Risk Factors

The risk factors for esophageal cancer are: 

  • Age (55 or older).
  • Gender (male).
  • Gastroesophageal reflux disease (GERD). Over time, stomach acid can damage the esophagus and lead to cancer.
  • A condition that causes backward flow of stomach acid into the esophagus (Barrett’s esophagus).
  • Smoking or other tobacco use.
  • Heavy alcohol use (drinking more than 3 alcoholic beverages a day).
  • A diet low in fruits and vegetables.
  • Obesity.
  • A condition that prevents the end of the esophagus to relax properly when swallowing foods and liquids (achalasia). 

Having one or more risk factors doesn’t mean you’ll develop esophageal cancer. However, you can lower your risk by leading a healthy lifestyle.

Symptoms

Common symptoms of esophageal cancer include:

  • Difficulty and pain when swallowing, the most common symptom. You may feel like food gets stuck in your throat or chest. Pain can occur a few seconds after swallowing, once food or liquid reaches the tumor and cannot easily get past it. As the tumor grows larger and the esophagus becomes narrower, this problem gets worse.
  • Chest pain or discomfort. It may feel like burning or pressure in your chest, caused by heartburn.
  • Weight loss. You may lose weight when pain and discomfort prevent you from eating or from a decreased appetite.  

It’s possible you won’t have symptoms until the cancer grows larger. Also, some symptoms may be caused by other problems, such as GERD. It’s important for us to assess your symptoms early on.

Screening and Diagnosis

Screening

If you have GERD or Barrett’s esophagus, we watch you closely for early signs of cancer. 

We may recommend:

  • Tests to view cells inside your esophagus.
  • Medications to prevent reflux.

You can help prevent esophageal cancer by living a healthy lifestyle, including:

  • Avoiding smoking.
  • Maintaining a healthy weight.
Diagnosis

We’ll learn your medical history and perform a physical exam.

We may recommend tests, such as:  

  • Barium swallow, to see a tumor on X-ray.
  • Upper endoscopy, to remove a sample and evaluate abnormal tissue (biopsy).
  • Endoscopic ultrasound, to see the size of a tumor and if it’s spread.
  • Bronchoscopy, to see if the cancer has spread to your airway.
  • Thoracoscopy (VATS) and laparoscopy, to view and biopsy areas around the esophagus to look for cancer spread. 
  • Imaging scans (such as CT, MRI, PET), to learn how far the cancer has spread.

Staging

We use information gathered from diagnostic tests to determine the size and spread of your cancer. This information helps us identify the best treatment plan. 

The size and spread of cancer is defined by certain stages.

  • Stage 0. The cancer is found only in the top layers of the lining of the esophagus.
  • Stage I. The cancer has spread from the top layer of tissue to the next layer of tissue in the wall of the esophagus. 
  • Stage II. The tumor has invaded deeper layers of the wall and possibly nearby lymph nodes.
  • Stage III. Cancer has spread through the outer layer of the esophagus to lymph nodes and possibly nearby tissues and structures, such as the windpipe (trachea).
  • Stage IV. Cancer is found in lymph nodes or other parts of the body away from the esophagus.
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Treatments

After we learn everything we can about your esophageal cancer, we talk about the treatment options and develop a plan that’s right for you.

Standard treatment options for esophageal cancer include: 

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Endoscopic treatments

If the tumor makes it difficult or impossible for you to eat, you may:

  • Receive nutrients through an intravenous (IV) line or feeding tube until you’re able to eat on your own.
  • Have a procedure to open the esophagus. For example, we might place a mesh tube (stent) into the narrowed or blocked esophagus to keep it open and allow you to swallow.
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Lifestyle Changes

Eating can become uncomfortable or painful. Loss of appetite and poor nutrition causes weight loss and weakness. You may require a feeding tube until you’re able to eat on your own.

To regain lost weight and maintain nutrition:

  • Eat foods high in calories and protein, for example, nuts, cheese, eggs, beans, and whole milk.
  • Choose foods that are soft or moist for easier swallowing. These include pudding, milkshakes, yogurt, hummus, and pasta. Add broth or gravy to meats so they’re easier to swallow.
  • Eat small frequent meals instead of 3 large meals, especially if part of your stomach is removed.
  • Sit upright for at least 2 hours after you eat to prevent backflow of stomach acid into your esophagus. Sleep with the head of the bed raised 6 to 8 inches, or use a foam wedge under your head and shoulders.

Follow-Up Care

After you complete your treatment, we’ll develop a plan for follow-up care. You’ll have regular checkups to:

  • Monitor your recovery.
  • Catch any signs that the cancer has returned or worsened. 

Follow-up appointments are an important part of your cancer care. During these regular visits, we:

  • Perform a physical examination.
  • Recommend diagnostic tests to check your esophagus.
  • Talk about any side effects.
  • Make sure you’re getting proper nutrition.  

Let us know if you start having trouble swallowing or experiencing other problems that affect your ability to eat.

Support from a health care professional or through a support group can help you cope with life during and after cancer. We also encourage you to follow these guidelines for good health to help you recover:

  • Eat a healthy diet.
  • Avoid smoking.
  • Get regular exercise.

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