Esophageal Cancer Therapy

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Esophageal Cancer Therapy
Esophageal Cancer Therapy
Video: Esophageal Cancer Therapy
Video: Treatment of Esophageal Cancer in 2021 | Zev A. Wainberg, MD | Professor of Medicine, UCLA 2023, February
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Esophageal cancer: therapy & aftercare

Which therapy is carried out in each individual case depends in particular on the stage of the disease. But the general health of the patient is also taken into account. Follow-up treatment or a cure is recommended after the treatment. In addition, regular check-ups should be carried out…

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therapy

In principle, the following options - sometimes combined - are possible for the treatment of esophageal cancer:

  • surgery
  • radiotherapy
  • chemotherapy
  • endoscopic procedures
  • Pain management
  • Palliative therapy

If the tumor stage and the general condition of the patient allow, surgery is the treatment of choice for esophageal cancer. The aim of the operation is to completely remove the tumor tissue and thus offer a chance of healing. The scope of the operation depends on the stage of the cancer. In the case of a very early tumor stage (so-called early cancer), in which the tumor is limited to the superficial parts of the esophageal mucosa, the cancer can be completely removed endoscopically while preserving the esophagus.

If the tumor has already developed beyond this early stage and no distant metastases have been discovered during the investigation, then the esophagus is removed from the chest and abdomen during the operation. In this context, it may also be necessary to operate on the neck. As part of such cancer surgery on the esophagus, the aim is to completely remove both the entire tumor tissue and the surrounding lymph nodes. These operations usually involve removing most of the esophagus. The actual extent of the disease can be determined through microscopic examinations during the operation. This allows the operation to be adapted to the extent necessary. The restoration of the food passage usually takes place with the stomach. This is exposed so thatthat it is shaped into a tube and then sewn to the remaining esophagus in the chest or neck. If the stomach is not suitable as an esophageal replacement, this can also be done with the large or small intestine.

The removed esophagus with tumor and lymph nodes is then microscopically worked up very precisely and the final tumor stage is diagnosed.

If the diagnosis of esophageal cancer reveals a tumor that is already somewhat extensive, chemotherapy or combined radiation and chemotherapy (radiochemotherapy) is carried out before the operation. Medically, this treatment before an operation is called "neoadjuvant therapy". This strategy aims to reduce the size of the tumor through this pretreatment, to destroy any cancer cells that may have spread in the body and thus to achieve better conditions for the subsequent operation and the overall prognosis.

Oesophageal operations are time-consuming and require an experienced team of surgeons, anesthetists and intensive care physicians. The selection of the therapy concept for each patient and the implementation of the operation are therefore carried out at specialized centers. In the Austrian health structure plan, at least ten operations per year are specified for such a center.

Aftercare

Removal of the esophagus is a serious procedure that affects food intake and digestion. In addition, as with all cancers, there is a risk of the cancer recurring after surgery. For this reason, check-ups are necessary either with the general practitioner, with the attending specialist or in the treating hospital. The focus is on the doctor-patient conversation and the physical examination. If necessary, further examinations can be added, e.g.

  • Laboratory tests
  • Ultrasonic
  • Endoscopy
  • CT
  • Lung x-ray

rehabilitation

After discharge from the hospital, follow-up treatment or a cure is often recommended to accelerate the recovery and recovery process. There are specially set up aftercare clinics for this. In addition, advice on nutrition and assistance in coping with psychological or social problems are offered.

Whom can I ask?

If warning signals occur, such as persistent swallowing difficulties in particular, you should contact your general practitioner or a specialist in surgery, gastroenterology or oncology immediately.

How are the costs covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

If hospitalization is required for treatment, hospital costs will be invoiced. The patient has to pay a daily contribution to the costs. Further drug treatment at home is provided by the general practitioner by prescription.

For more information, see What does a hospital stay cost?

For rehabilitation you have to submit an application to your social security agency. As a rule, the patient has to pay a deductible. For more information, see Rehabilitation & Cure Prim. Univ.-Prof. Dr. Reinhold Függer.

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