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Esophageal Cancer

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The esophagus connects the throat to the stomach. It is a hollow muscular tube. Cancer of the esophagus starts in the mucous membrane that lines this tube. This cancer can spread outward through the other layers. It has few symptoms.

The two main esophageal cancers are:

  • Squamous cell carcinoma grows in the cells lining the esophagus. These cells are called squamous cells. This cancer usually occurs in the middle or upper part of the esophagus.

  • Adenocarcinoma is the most common form of esophageal cancer. It forms in the glandular cells that release fluids like mucus, usually in the lower part of the esophagus near the stomach.

At Sylvester Comprehensive Cancer Center, South Florida's most experienced gastrointestinal (GI) cancer team will care for you. From minimally invasive surgeries to new targeted drugs, immunotherapies, and clinical trials, Sylvester offers you innovation leading to improved esophageal cancer outcomes.

Why Choose Sylvester Comprehensive Cancer Center?

High volume experience with esophageal and stomach cancer. This results in better survival length and fewer complications than if treated by surgeons who see only a few esophageal cancer cases a year.

Our reconstructive specialists can rebuild an esophagus or stomach after surgery. You can regain the quality of life you are accustomed to living.

Advanced radiation therapy options like ViewRay (one of just five centers nationwide), RapidArc, and a Siemens 40-slice 4D-CT scanner, offering intensity modulated external radiation therapy (IMRT). You receive more efficient and effective treatments, shorter treatment times, improved accuracy and less damage to surrounding healthy tissue near the tumor.

The only designated Cancer Center of Excellence in South Florida. We treat cancer, and only cancer, giving you the best potential outcomes. The likelihood of a patient surviving cancer after five years at a Dedicated Cancer Center is 17 percent higher than at other hospitals.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with the very newest ways to treat and potentially cure your cancer.

Multidisciplinary care teams with nationally recognized expertise. Your care team is made up of experts in your exact type of cancer, and every single aspect of it.

Access to precision medicine. We define your cancer and its treatment by the genes driving it, rather than solely its location and stage.

Nurse navigators ensure you’re never alone on your cancer journey. We make sure all your records from outside Sylvester are received, coordinate specialty appointments, and testing, and answer your questions.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Treatments


Esophageal cancer has a wide range of treatments that can be used alone or in combination to give the best outcome. Treatments for both types of esophageal cancer are the same options. Your care plan will be based on your individual case, medical history, and how far any cancer has progressed. We will also base treatment options on how aggressive the cancer cells are in growing. This is called the cancer grade. Current treatments include:

  • Surgery

    Adenocarcinoma is typically treated with surgery to remove any cancerous glandular tissue. Some surrounding tissue is also removed. Minimally invasive surgery techniques can reduce healing time and minimize potential infection. Surgery is the only curative treatment for gastric cancer. Chemotherapy is often done first before surgery of the stomach and gastric tract.

    • Minimally invasive endoscopic mucosal resection (EMR): For earlier stage esophageal cancer, EMR is performed on an outpatient basis by a gastroenterologist. An endoscope is a thin, flexible tube with a lens, light and camera attached to it. An endoscope gets inserted through the mouth and into the esophagus. The camera shows the doctor very detailed images. The gastroenterologist can suction small nodules or growths; trap them in a small, rubber band; then cut and remove them.

    • Esophagectomy: Removing the diseased part of the esophagus and a margin of healthy tissue. In most cases, after that is done, the stomach is pulled up and joined to the remaining esophagus. More complicated cases may involve using a part of the intestine to replace the removed esophagus and make the connection.

  • Chemotherapy (Systemic Medical Therapy)

    Chemotherapy can be administered intravenously or by a pill and is usually a combination of cancer-fighting drugs. Chemotherapy is the main treatment for advanced esophageal cancer. Over the last few years, several new drugs have increased the options for esophageal cancer. Having chemotherapy or chemoradiation before surgery is called neoadjuvant therapy.

    • Intravenous (infusion) chemotherapy is available at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, or Deerfield Beach locations.

  • Chemoradiation

    This therapy combines chemotherapy and radiation therapy to increase the effects of both. For esophageal cancer, chemoradiation may be used before or after surgery. It also may be part of the treatment for people who can't have surgery.

  • Targeted Therapy

    These treatments are designed to attack the molecular changes that make the cancer cell grow and spread. They have the potential to be more effective and with fewer side effects than chemotherapy. Some of these medicines are given along with chemotherapy medicines, while others are used by themselves. Your doctor at Sylvester will share which approach is best for your cancer.

  • Radiation Therapy

    Most esophageal radiation treatment at Sylvester is external beam radiation therapy, which is delivered from outside the body. Advanced technology tools working for you include RapidArc®, an advanced technology used with a linear accelerator to deliver intensity modulated external radiation therapy (IMRT). This shortens treatment times to one-half to one-eighth that of conventional radiation therapy, resulting in better targeting, and less damage to healthy tissue.

  • Photodynamic Therapy (PDT)

    PDT uses a light-activated medicine and a laser to kill cancer cells. It can be used to treat some very early-stage cancers. It is most often used to help relieve symptoms, such as trouble swallowing, in people with advanced cancer.

  • Laser Therapy

    Laser therapy uses laser beams rather than surgery to destroy and remove cancer cells.

  • Electrocoagulation

    This treatment uses an electrical current to kill cancer cells.

  • Cryotherapy

    Cryotherapy freezes a tumor’s cells to destroy them.

  • Nutrition, Pain Management, and Supportive Care

    The esophagus is the primary route for food and liquids to get to the stomach. People with esophageal cancer may experience special nutritional needs during and after treatment. They may have difficulty eating because the esophagus is narrowed by the tumor or by the scarring effects of treatment. A feeding tube can help patients get the nutrients they need until fully recovered.

  • Psychosocial Support

    The Courtelis Center for Psychosocial Oncology at Sylvester provides a team of mental health professionals including psychiatrists, psychologists, licensed clinical social workers, and a chaplain to help you and your family cope with your cancer. This program addresses the impact of the mind-body relationship on health, disease, prevention, and recovery. To schedule an appointment, please call 305-243-4129.


Tests


Procedures for diagnosing esophageal cancer after a physical and medical history review may include:

  • Chest X-ray with Barium Swallow (Upper GI Series)

    This diagnostic test examines the upper digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). Your care team will ask you to swallow a liquid form of barium. Barium is a metallic chalky liquid used to coat the inside of organs so that they will show up on an X-ray.

  • Upper Endoscopy (EGD)

    An upper endoscopy is a procedure to review the inside of the esophagus, stomach, and duodenum. The test uses an endoscope — a thin, flexible, lighted tube with a tiny video camera on its end. Through the endoscope, the doctor can also insert instruments to remove a sample of tissue for biopsy (if necessary).

  • CT Scan (CAT Scan)

    CT scans create a series of detailed pictures from inside the body using an X-ray machine and a computer. We will inject a colorful dye into a vein. The dye might also be given in liquid form. The dye helps the organs and tissues to show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

  • Endoscopic Ultrasound

    Ultrasound uses sound waves help to create images of the esophageal wall, stomach, and nearby lymph nodes. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach.

  • PET Scan (Positron Emission Tomography)

    You will lie down on the PET scan machine, as the PET scanner rotates around your body. Radioactive glucose, a sugar, is injected into one of your veins. The PET scanner photographs where the glucose is used as energy in your brain. Malignant tumor cells will show up brighter because they are more active and take up more glucose than healthy cells. PET is also used to tell the difference between a primary tumor and a metastatic or secondary tumor.

  • Thoracoscopy and Laparoscopy

    These tests allow your doctor to examine the lymph nodes inside the chest or inside the abdomen. A hollow, lighted tube is inserted into a small cut in the skin. Any suspicious areas are removed for study under a high-powered microscope.

  • Genomic Tumor Profiling

    Also called somatic DNA testing, this breakthrough blood test is the driver for precision medicine. It looks at your tumor’s molecular signature to identify characteristics indicating how aggressive it is and what types of treatment will work best.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care