Scott Reznik, M.D. Answers Questions On: Esophageal Cancer

There are two main types of esophageal cancer – squamous cell carcinoma and adenocarcinoma of the esophagus. There are also related cancers of the EG junction, but they have some different clinical behaviors.

Adenocarcinoma of the esophagus is one of the fastest rising cancers in North America. We aren’t completely sure why, but it may have to do with the obesity epidemic and associated incidence of reflux and diabetes.

It’s typically diagnosed by a gastroenterologist, but our role is in evaluating and helping coordinate and execute the overall treatment strategy with medical and radiation oncologists and gastroenterologists.

Most esophageal cancers, unfortunately, are diagnosed at a very advanced stage and many of them are metastatic at the time of diagnosis. If the patient does not have metastatic disease, he or she may be a candidate for surgical resection, most commonly in combination with chemotherapy and radiation.

Our role is to help decide if the patient would benefit from surgery and if he or she is healthy enough to undergo the procedure.

Yes. The esophagus exists in three body cavities – the neck, the chest, and the abdomen. An esophagectomy (surgery to remove part or all of the esophagus) always involves the chest and the abdomen and often the neck, depending on the location of the tumor and how the operation is done. You have to work in two or three vital body compartments in order to conduct the operation. This can be hard on a patient. It helps if we can use minimally invasive techniques to minimize the effect of the incisions on the patient.