MANAGEMENT OF CANCER ESOPHAGUS

Abstract

The definitive diagnosis ofEsophageal cancer is usually made by histologic examination. The goal of any therapy designed to manage patients with esophageal cancer is to treat the underlying cancer and to relieve symptoms (predominantly dysphagia. An ideal therapy would accomplish both safely and effectively. Currently three main treatment strategies exist. The first uses single modalities (e.g.; surgery, radiation, or chemotherapy), the second involves Combination therapies and the third utilizes endoscopic palliative techniques to control the tumor locally.

Definitive management decisions for patients with invasive esophageal carcinoma involves the use of surgery, radiation therapy, chemotherapy or some combination of these modalities according to the stage, patients factors and operability factors.

Although palliation for patients with esophageal cancer is still the most realistic aim in more than 40 percent of patients, esophagectomy should be considered the treatment of choice for esophageal cancer whenever a curative resection can be performed at an acceptable risk, since it offers both the best quality of life and the only hope of cure.

Chemotherapy is no longer used only to palliate metastatic disease but is becoming an integral part of the primary management of the patient with locally confined disease The most active agents are cisplatin, methotrxate and fluorouraci l for squamous cell carcinoma of the esophagus. Certainly the