Treatments and Therapies for Esophageal Cancer

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Fred Hutch Cancer Center offers comprehensive care for esophageal cancer. We offer advanced treatments and new options available only through clinical trials. The most common treatments for esophageal cancer are surgery, endoscopic mucosal resection (a minimally invasive surgery), chemotherapy, radiation and immunotherapy. Often, patients have a combination of treatments. But not everyone needs all of these. We’ll tailor your treatment to you.

At Fred Hutch, many people with esophageal cancer see providers at our Esophageal Cancer Specialty Clinic. At this clinic, all the specialists who will be part of your care come together. In a meeting called a tumor board, they discuss treatment options and design treatment to meet your needs.

Esophageal Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.

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How We Treat Esophageal Cancer at Fred Hutch

Endoscopic Mucosal Resection

If you have small, early-stage cancer that has not gone deeper than the lining (mucosa) of your esophagus, physicians may be able to remove all of it using an outpatient method called endoscopic mucosal resection (EMR). Therapeutic gastroenterologists at the Digestive Health Center at UW Medical Center  – Montlake do this procedure.

EMR can be used both to diagnose cancer and, if all the cancer is removed this way, to treat cancer. It is less invasive than surgery and allows patients to resume their life immediately with better outcomes.

Surgery

Your Fred Hutch team may recommend surgery to remove part or all of your esophagus (esophagectomy) if you have early stage cancer that can’t be removed with an EMR or if you have locally advanced cancer.

As a patient at Fred Hutch, you’ll have surgery by a UW Medicine surgeon. Your surgeon will be specially trained and board certified in thoracic and esophageal surgery. They will recommend the best procedure to match your needs.

Read About Esophageal Cancer Surgery

Chemotherapy

Some people with esophageal cancer have chemotherapy either as a main treatment, or before or after surgery. Chemotherapy helps to destroy cancer cells wherever they may be in your body. Usually, it means you get anti-cancer medicine through an intravenous (IV) line. Then the medicine travels throughout your body through your bloodstream.

Read About Chemotherapy for Esophageal Cancer

Immunotherapy

Immunotherapies are some of the latest innovations at Fred Hutch. They use the power of your immune system to fight your cancer.

Your tissue biopsy can be tested to see if immunotherapy would be helpful for your cancer.

Read About Immunotherapy for Esophageal Cancer

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It can be used with chemotherapy to make the radiation work better.

Your Fred Hutch team may recommend radiation therapy:

  • Before surgery to shrink your tumor 
  • After surgery to destroy any remaining cancer cells 
  • To control your disease if you’re not a candidate for surgery 
  • To help with the effects of your cancer, such as a blocked esophagus 

A radiation oncologist decides on the type, dose, field and schedule of your treatment.

Learn About Radiation Therapy for Esophageal Cancer

Targeted Therapy

Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. They target a gene or protein responsible for allowing cancer to grow, they seek out and damage cancer cells, or they prompt your immune system to attack particular cells (also called immunotherapy).

Trastuzumab (Herceptin) is a type of targeted therapy called monoclonal antibody therapy. It uses antibodies to identify substances on cancer cells that may help cancer cells grow. The antibodies attach to these substances and kill the cancer cells, block their growth or keep them from spreading.

Trastuzumab preferentially attacks cancer cells that make too much of the HER2/neu protein. If you have adenocarcinoma that tests positive for HER2/neu, you would be a candidate for trastuzumab.

Why Choose Fred Hutch for Esophageal Cancer Treatment

At Fred Hutch, we understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.  

Team-Based Care from Specialists

Fred Hutch has surgeons, medical oncologists and pathologists who specialize in esophageal cancer. We offer the most advanced diagnostic, treatment and recovery programs. Along with treating your cancer, we also offer a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease. From registered dietitians to Spiritual Health clinicians to social workers, our experts know how to care for people with esophageal cancer.

Treatment Tailored to You

We view treatment as a collaborative effort. Your Fred Hutch physicians will explain all your options. We’ll recommend a treatment plan to get you the best results based on the stage and size of your cancer, where it is and your overall health.

Clinical Trials to Improve Outcomes

Many of our patients receive promising therapies by taking part in esophageal cancer clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine. They test new treatments or new ways to use current treatments. Every advance in cancer treatment in recent years has come out of clinical trials. Through the Fred Hutch/University of Washington/Seattle Children's Cancer Consortium, we typically have more than 750 active clinical trials, which means more treatment options for people like you.

Esophageal Cancer Treatment FAQ

The most common treatments for esophageal cancer are surgery, endoscopic mucosal resection (a minimally invasive surgery), chemotherapy, radiation and immunotherapy. Often, patients have a combination of treatments. But not everyone needs all of these. We’ll tailor your treatment to you.

If your care team determines you need an endoscopic mucosal resection (EMR), it will be done by a UW theapeutic gastroenterologist as an outpatient procedure.

  • You are sedated (given medicine to make you sleepy and relaxed). 
  • The physician inserts a thin, flexible tube (endoscope) into your mouth or nose and down into your esophagus. 
  • The endoscope has a light and a tiny camera on the end to take close-up images, which show on a video monitor in the exam room. 
  • The physician uses instruments to remove (resect) a small amount of tissue. 
  • A pathologist checks the tissue under a microscope to determine if cancer is present and what type of cancer it is.

In general, people who have the same stage of esophageal cancer often have the same or similar treatments. Your Fred Hutch care team will determine a treatment plan with you based on your diagnosis and situation.

During and after your treatment for esophageal cancer, it’s important to maintain good nutrition so you’re as strong and healthy as you can be. At times, this may be challenging because both the disease and its treatments might affect your desire and ability to eat and drink.

The best time to get nutritional advice is before you develop any nutritional problems. With the right guidance, you may be able to prevent problems before they start. But no matter where you are in your treatment, your Fred Hutch team is ready to help.

Registered dietitians at Fred Hutch are available to work with you to:

  • Prepare your body for treatment by eating well before treatment starts. 
  • Set specific goals for adequate nutrition and fluid intake, and check whether you’re getting enough. 
  • Figure out which foods are easiest to tolerate with your symptoms. 
  • Find ways to maintain or increase protein intake to help keep up muscle mass and weight. 
  • Choose nutrient-dense foods to get as much nutrition as possible with every meal. 
  • Change your diet after surgery, such as eating smaller portions of soft foods, avoiding high-fat and spicy dishes and not drinking liquids with meals. 

Learn more about Nutrition Services.

Fred Hutch offers all standard treatment for esophageal cancer. Our patients also have access to newer options or treatment combinations that you can only get through clinical trials.

Fred Hutch researchers are always looking for better ways to treat esophageal cancer. We are doing clinical trials of new drugs and drug combinations to treat different types of bladder tumors. Our scientists are also developing new methods to tell which tumors are likely to respond best to which treatments.

Learn more about esophageal cancer research.