Radiotherapy
In most cases, esophageal cancer responds well to radiotherapy. In some cases, radiotherapy is applied before surgery (neoadjuvant) in order to reduce the tumor and make it operable. If radiotherapy is initiated after surgery (adjuvant), the risk of a recurrence of the tumor can be reduced.
Even patients who have little chance of recovery are sometimes subjected to radiotherapy (palliative radiation). Radiation therapy can reduce tumor masses and thus alleviate tumor pain and difficulty swallowing. Radiation therapy can be administered from the outside, i.e. through the skin (percutaneously).
In the case of tumors that constrict the esophagus, small room irradiation (brachytherapy) can be performed from the inside (intraluminal afterloading). In this type of radiation therapy, a tube is inserted into the esophagus through which a small radioactive radiation source is inserted on site. In this way, the tumor can be irradiated specifically from the inside.
Chemotherapy
Oesophageal cancer responds only moderately to chemotherapy, so that in most cases radiotherapy and chemotherapy are combined (radiochemotherapy) to increase the therapeutic benefit. For the treatment of this type of cancer, the cytostatic agents 5-fluorouracil, cisplatin and taxanes are administered preferentially.
Stent placement
To keep the esophagus open for food passage, a plastic tube (stent) must occasionally be inserted into the esophagus. Stents are also used after partial esophageal removal surgery. Here, the connection between the oesophageal remnant and the raised section of the intestine, the so-called anastomosis, can be sealed and stabilized with a stent.
Laser therapy
If the tumor can no longer be operated on and food intake is severely impaired, laser therapy can provide symptom relief. Here, parts of the tumor are vaporized by the laser, which reduces the extent of the esophageal narrowing and makes it easier for food to pass through the esophagus again. Unfortunately, the tumor often grows back from the lower layers, so that the treatment sometimes has to be repeated after 7-14 days. If laser therapy is combined with small area irradiation (brachytherapy), the time until re-treatment can be significantly extended. In tumor stage 0, where only the uppermost cell layer of the esophagus is affected, laser treatment can also be used to remove the tumor.
