Treatment of Stage I Esophageal Cancer

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Patients with stage I esophageal cancer have cancer that penetrates beneath the surface lining of the esophagus, but not into the muscle wall of the esophagus, the lymph nodes or other locations in the body.

The following is a general overview of the treatment of stage I esophageal cancer. Circumstances unique to your situation and prognostic factors (factors that help your physician estimate your chance of recovery or the chance that your cancer will come back) may ultimately influence how your physician applies these general treatment principles to your situation. The information on this website is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.

Most new treatments come about through clinical trials. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Developing more effective cancer treatments requires cancer patients to help evaluate these new and innovative therapies.

Participating in a clinical trial may offer you access to better treatments and advance the existing knowledge about treatment of this cancer. Clinical trials are available for most stages of cancer. If you’re interested in participating in a clinical trial, you should discuss the risks and benefits of clinical trials with your physician. To ensure that you’re receiving the optimal treatment for your cancer, it’s important to stay informed and follow the cancer news to learn about new treatments and clinical trial results.

Types of Treatment

Optimal treatment of patients with stage I esophageal cancer often requires more than one therapeutic approach. It is therefore important to receive treatment at a medical center that can offer treatment that involves specialists in a variety of fields: medical oncologists, radiation oncologists, surgeons, medical gastroenterologists, and nutritionists.

Stage I esophageal cancer is relatively uncommon. It’s difficult to estimate the outcomes of patients with stage I esophageal cancer not undergoing surgery as primary therapy because clinical staging is often inaccurate. After your surgery for stage I disease, your physician may discover that you have more extensive cancer than first believed.

• Primary treatment with surgery alone - The current preferred treatment for patients with stage I esophageal cancer and who are in good clinical condition is esophagectomy (removing the esophagus completely). In addition, when patients truly have cancer that does not invade the muscle wall of the esophagus, surgery can frequently be performed through an endoscope (VATS).
• Primary treatment with radiation and chemotherapy - Patients who are not well enough or who do not wish to undergo major surgery may receive treatment with a combination of radiation therapy and chemotherapy. Chemotherapy involves treating cancer with anticancer drugs. Chemotherapy has the ability to kill cancer cells. Chemotherapy and radiation therapy may act together to increase the destruction of cancer cells.

Research is in progress to refine existing treatments and develop new ones. For information on some of the techniques currently under investigation, see Strategies to Improve Treatment.