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Thursday, October 30, 2014
Esophageal Cancer Prognosis
I would like to know the survival rate for a 31 year old female with stage 3 esophageal cancer. Also, are there any new advancements in that area as far as treatment options are concerned?
Stage III esophageal cancer is defined as an esophageal tumor which extends through the wall of the esophagus. Lymph nodes in the region may or may not show evidence of cancer spread. It is described as "locally advanced" cancer. Even though surgical treatment for esophageal cancer has improved significantly, the long term outlook has not markedly improved in the past decades. Survival is described either as two year survival (35-40% if tumor is able to be completely removed) or as five year survival (5-10%). There are many variables present in each person which contribute to overall survival rates. Women may have a better survival rate than men. Appropriate therapy is currently controversial. There are 35 clinical trials listed by the National Institutes of Health (see ClinicalTrials website below) which look at combining surgery with different chemotherapeutic drugs, radiation therapy, photodynamic therapy, and even gene therapy. The article by HJ Stein is a good review of the current multidisciplinary approach. [Stein HJ, Sendler A, Fink U, Siewert JR (2000): Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am 80(2):659-82; discussions 683-6.] Photodynamic therapy is based on the discovery that certain chemicals known as photosensitizing agents, when combined with a laser light, will destroy cancer cells. It was approved by the U.S. Food and Drug Administration for use in esophageal cancer in December, 1995. For further information on photodynamic therapy and issues related to esophageal cancer, see the CancerNet website below.
Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University