Research can show how certain treatment approaches for esophageal cancer, such as surgery, compare with other approaches or no treatment. However, an individual’s options and outlook will depend on the cancer stage at diagnosis and other factors.

The chance of living another 5 years after an esophageal cancer diagnosis ranges from 5–47% with treatment, according to the National Cancer Institute.

This range reflects the differences in survival rates when doctors find esophageal cancer early versus when the tumor has spread to other parts of the body and become harder to treat.

In this article, we will explore the treatment options available for esophageal cancer and their success rates.

It is worth noting, however, that while certain treatments may appear to have a higher success rate than others, the treatment a doctor can offer and the likely outcome will depend on many factors, including the stage at diagnosis.

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The aim of treatment for oesophageal cancer is to either remove the tumor and other cancerous cells or stop the tumor from growing.

To do this, a doctor may recommend options such as:

Factors that will affect the options available include:

  • the type of esophageal cancer
  • the stage
  • a person’s overall health, age, and medical history

Local treatments target the tumor in a specific location — in this case, the esophagus and nearby tissues — without having major effects on the rest of a person’s body.

The following treatments are more likely to be effective for early stage cancers, although a doctor may also recommend them at other stages.

Surgery

An esophagectomy is a minimally invasive procedure that involves removing the part of the esophagus that contains the tumor. An esophagogastrectomy also removes part of the stomach and nearby lymph nodes.

Common risks of surgery include:

Rarely, complications can be life threatening.

Surgery can fully remove some cancers. People who have surgery for esophageal cancer have, on average, a 30–45% chance of surviving another 5 years or longer compared with someone who does not have surgery. However, this depends on the stage of the cancer.

If a tumor is going to recur after surgery, it will usually do so soon after. If a recurrence does not happen within 5 years, it is unlikely to do so in the future, researchers say.

Radiation therapy

Radiation therapy uses high energy X-rays to destroy cancer cells and stop them from growing. Combining it with chemotherapy can make treatment more effective.

One study found that the 5-year survival rate for people who had combined chemotherapy and radiation therapy was 20–27%, compared with 0% for radiation therapy alone.

Rarely, radiation therapy may lead to long-term breathing problems due to esophageal narrowing and chest damage.

Endoscopic treatment

Several treatment options involve passing an endoscope down the throat and into the esophagus.

Endoscopic treatment is a minimally invasive treatment that can destroy and remove early stage esophageal cancer.

Photodynamic therapy (PDT) is one example of an endoscopic procedure. PDT is a type of light therapy that can remove early stage cancers or stop them from developing.

Endoscopic procedures, including PDT, can also help relieve symptoms of advanced cancer that cannot be cured, for instance, when a tumor makes swallowing difficult.

Research suggests that the average survival rate for people receiving PDT as palliative treatment is 34 months, but this will depend on various factors. Survival times range from 50.9 months for people who received PDT as their first treatment and 17.3 months for those who had already had other types of treatment.

Other endoscopic options include endoscopic mucosal resection and radiofrequency ablation.

Systemic treatments are therapies that affect the whole body. They come as oral or intravenous drugs that travel through the body and destroy cancer cells wherever they are.

Depending on the type and stage of esophageal cancer, a doctor may recommend several approaches.

Chemotherapy

Treatment with chemotherapy may take place before surgery, after surgery, or both, and it may be given along with radiation therapy.

Chemotherapy rarely cures esophageal cancer, but it can help:

  • remove cancer
  • delay or prevent a recurrence
  • slow progression
  • relieve the symptoms of advanced cancer

Chemotherapy can have severe side effects. These usually go away after finishing treatment, but long-term issues such as nerve damage and hand-foot syndrome may occur.

What are some common side effects of chemotherapy?

Targeted drug therapy

Targeted drug therapy targets the cancer’s specific genes or proteins, or the tissue environment contributing to cancer growth and survival.

Treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Some esophageal cancers have too much HER2 protein on the surface of their cells, which encourages cancer cell growth. Drugs such as trastuzumab that target the HER2 protein may help treat HER2-positive cancers. However, it may increase the risk of long-term problems, such as heart damage.

Immunotherapy

Immunotherapy boosts the immune system’s ability to attack cancer cells.

Some research suggests that immunotherapy may be more effective than chemotherapy, but more research is needed.

What is the difference between immunotherapy and chemotherapy?

Supportive or palliative treatments can help manage symptoms and improve a person’s comfort and quality of life in the later stages of cancer.

Options include:

  • pain management
  • esophageal dilation
  • endoscopic procedures to help keep the esophagus open when a person has trouble swallowing

Here are answers to some commonly asked questions about esophageal cancer:

Can you fully recover from esophageal cancer?

The overall 5-year survival rate for esophageal cancer is approximately 21%, but it can vary from 5.6 to 48.8%, depending on the stage at diagnosis.

A person who receives an early diagnosis has a 48.8% chance of surviving at least another 5 years after diagnosis compared with people who do not have this disease.

How curable is cancer of the esophagus?

An early diagnosis improves the chances of recovery. However, only around 18% of people with esophageal cancer receive a diagnosis in the early stage. In the later stages, it is treatable but rarely curable.

Esophageal cancer is treatable. A person with an early diagnosis has a 48.8% chance of surviving another 5 years compared with those who receive a later diagnosis.

Treatment options such as surgery, PDT, and radiation therapy can remove a tumor or decrease its size and halt its growth.

Other options include chemotherapy, radiation therapy, and targeted therapy.

Overall, surgical therapy is the most effective treatment, but various factors will affect treatment decisions and outcomes, including the stage and type of esophageal cancer. Surgery may not be suitable for everyone.