Endoscopic Therapies for Early-Stage Esophageal Cancer
Patients diagnosed with early stage esophageal cancer (stages 0-1) are often those who regularly see a gastroenterologist for a screening endoscopy. These patients are usually those who have Barrett’s esophagus or problems with acid reflux that increase the chances of developing esophageal cancer. The screening endoscopy involves a scope with a cancer on it being put down a patient’s throat and into the esophagus. The procedure is done under moderate or deep sedation, and it can alert the doctor to changes in the tissues of the esophagus such as bleeding, ulcers, nodules or a mass.
Esophageal cancer begins in the innermost layer of the esophagus, called the mucosa. As the cancer grows, it moves outward through the layers of the esophageal wall and also inward, blocking the esophageal opening. If the cancer is caught at an early stage and does not penetrate beyond the mucosa, a gastroenterologist can use a minimally invasive procedure with an endoscope. This procedure is called a mucosal resection, and it can often remove the cancer entirely.
Once the tumor is removed in this way, it is examined. If cancer cells are found at its edges, then the cancer has spread to the next layer, the submucosa. In this case, a surgery to remove a portion of the esophagus, called an esophagectomy, is often the recommended treatment.
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