The esophagus is a 10-inch long, hollow, muscular tube that connects the throat to the stomach. When a person swallows, the walls of the esophagus contract to push food down into the stomach. Esophageal cancer (also called esophagus cancer) begins when cells in the lining of the esophagus grow uncontrollably and eventually form a tumor.

Cancer of the esophagus begins in the inner layer of the esophageal wall and grows outward. If it spreads through the esophageal wall, it can invade lymph nodes, blood vessels in the chest, and other nearby organs. Esophageal cancer can also spread to the lungs, liver, stomach, and other parts of the body.

There are two major types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma arises in squamous cells that line the esophagus. This type of cancer usually develops in the upper and middle part of the esophagus. Adenocarcinoma begins in the glandular tissue in the lower part of the esophagus at the junction between the esophagus and the stomach. Treatment is similar for both of these types. Very rare tumors of the esophagus (less than 1% of esophageal cancers) include small cell neuroendocrine cancers, lymphomas, and sarcoma.

Statistics

In 2009, an estimated 16,470 adults (12,940 men and 3,530 women) in the United States will be diagnosed with esophageal cancer. It is estimated that 14,530 deaths (11,490 men and 3,040 women) from this disease will occur this year. Esophageal cancer is three to four times more common among men than women, and black people are twice as likely as white people to have this cancer. Esophageal cancer is the seventh most common cause of cancer death among men. The five-year relative survival rate (percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) of people with esophageal cancer is about 16%.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with esophageal cancer. Because the survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. These statistics also combine the survival rates of people with advanced esophageal cancer that has spread and people with cancer that is located only in the esophagus. People with cancer that has not metastasized (spread) are likely to have a higher survival rate compared with those with more advanced disease.

Statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2009.

Find out more about basic cancer terms used in this section.

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A risk factor is anything that increases a person’s chance of developing cancer. Some risk factors can be controlled, such as smoking, and some cannot be controlled, such as age and family history. Although risk factors can influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and communicating them to your doctor may help you make more informed lifestyle and health-care choices.

The following factors may raise a person’s risk of developing esophageal cancer:

Age. People between the ages of 45 and 70 are at greatest risk.

Gender. Men are three to four times more likely than women to develop esophageal cancer.

Race. Black people are twice as likely as white people to develop esophageal cancer.

Tobacco. Using any form of tobacco, including cigarettes, cigars, pipes, chewing tobacco and snuff, raises the risk of esophageal cancer.

Alcohol. Heavy drinking over the long term increases the risk of squamous cell carcinoma of the esophagus, especially when combined with tobacco use.

Barrett's esophagus. This condition can develop in some people who have chronic gastroesophageal reflux disease (GERD) or esophagitis (inflammation of the esophagus), even when a person does not experience symptoms of chronic heartburn. Damage to the lining of the esophagus causes abnormal changes in cells. People with Barrett's esophagus are more likely to develop adenocarcinoma of the esophagus.

Diet/Nutrition. A diet that is low in fruits and vegetables and certain vitamins and minerals can increase a person's risk of developing esophageal cancer.

Obesity. Being severely overweight and having excess body fat can increase a person's risk of developing esophageal adenocarcinoma.

Lye ingestion. Lye ingestion by children is associated with an increase in squamous cell carcinoma. Lye can be found in some cleansing products, such as drain cleaners.

Achalasia. Achalasia, a condition when the lower muscular ring of the esophagus fails to relax during swallowing of food, increases the risk of squamous cell carcinoma.

People with esophageal cancer may experience the following symptoms. Sometimes, people with esophageal cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

• Difficulty and pain with swallowing, particularly when eating meat, bread, or raw vegetables (As the tumor grows, it can block the pathway to the stomach. Even liquid may be painful to swallow.)
  
  
• Pressure or burning in the chest
  
  
• Indigestion or heartburn
  
  
• Vomiting
  
  
• Frequent choking on food
  
  
• Unexplained weight loss
  
  
• Coughing or hoarseness
  
  
• Pain behind the breastbone or in the throat

Doctors use many tests to diagnose cancer and determine if it has metastasized. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
  
  
• The type of cancer suspected
  
  
• Severity of symptoms
  
  
• Previous test results

Routine screening tests to detect early esophageal cancer are not used in the United States. People with Barrett's esophagus may be advised to have endoscopic examinations (looking inside the esophagus through a flexible, lighted tube) and biopsies (removal of a small amount of tissue for examination under a microscope) on a regular basis to help detect cancer early.

In addition to a physical examination, the following tests may be used to diagnose esophageal cancer:

Barium swallow (also called an esophagram). The patient swallows a liquid containing barium and then a series of x-rays (pictures of the inside of the body) are taken. Barium coats the surface of the esophagus, making tumors or other abnormalities easier to see on the x-ray. If there is an abnormality, doctors may order an upper endoscopy and biopsy to determine if cancer is present.

Upper endoscopy (also called esophagus-gastric-duodenoscopy, or EGD). This test allows the doctor to see the lining of the esophagus. A thin, flexible tube with a light and video camera on the end, called an endoscope, is passed down the throat and into the esophagus. If an abnormality is found, a biopsy will be performed to determine if it is noncancerous or cancerous. An endoscopy can also help expand the blocked area, so that food can temporarily pass through until treatment can begin.

Endoscopic ultrasound. This procedure is often done at the same time as the upper endoscopy. During an ultrasound, sound waves provide a picture of structures inside the body. During an endoscopic ultrasound, a transducer (the machine that produces the sound waves) is inserted into the esophagus through the mouth. The ultrasound can identify if the tumor invades the wall of the esophagus, how deep the tumor is, and whether lymph nodes are involved.

Bronchoscopy. Similar to an upper endoscopy, the doctor passes a thin, flexible tube with a light on the end into the mouth or nose, down through the windpipe, and into the breathing passages of the lungs. A bronchoscopy may be performed if a patient’s tumor is located in the upper two-thirds of the esophagus to determine if the tumor is invading the person’s airway, including the trachea (windpipe) and bronchial tree (area where the windpipe branches out into the lungs).

Biopsy. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The tissue sample removed during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.

To learn more about what to expect during common diagnostic tests, read Cancer.Net: Tests and Procedures.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: Newly Diagnosed.

Staging is a way of describing a cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

• How large is the primary tumor and where is it located? (Tumor, T)
  
  
• Has the tumor spread to the lymph nodes? (Node, N)
  
  
• Has the cancer metastasized to other parts of the body? (Metastasis, M)

Tumor. Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below.

TX: The primary tumor cannot be evaluated.

T0: There is no cancer in the esophagus.

Tis: Refers to carcinoma (cancer) in situ. Carcinoma in situ is very early cancer, where cancer cells are found only in one small area and have not spread at all. Cancer cells are in only the top lining of the esophagus without any spread into the lining.

T1: There is a tumor in the lamina propria and submucosa (the two inside layers of the esophagus). Cancer cells have spread into the lining of the esophagus.

T2: The tumor is in the muscularis propria (the third layer of the esophagus). Cancer cells have spread into but not through the muscle wall of the esophagus.

T3: The tumor is in the adventitia (the outer layer of the esophagus). Cancer cells have spread through the entire muscle wall of the esophagus into surrounding tissue.

T4: The tumor has spread outside the esophagus into areas around it. Cancer cells have spread to structures surrounding the esophagus, including the aorta (large blood vessel coming from the heart), windpipe, and diaphragm.

Node. The “N” in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that help fight infection. In esophageal cancer, lymph nodes near the esophagus and in the chest are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The lymph nodes cannot be evaluated.

N0: The cancer was not found in the lymph nodes.

N1: The cancer has spread to the lymph nodes within the chest, near the tumor.

Distant metastasis. The "M" in the TNM system indicates whether the cancer has spread to other parts of the body. In esophageal cancer, metastasis is described depending on what part of the esophagus the cancer started in: the lower thoracic esophagus (closest to the stomach), middle or midthoracic esophagus, or upper thoracic esophagus (closest to the neck).

MX: Metastasis cannot be evaluated.

M0: The disease has not metastasized.

M1: There is metastasis to another part of the body.

Tumors of the lower thoracic esophagus

M1a: The cancer has spread to the celiac nodes (the lymph nodes in the abdomen).

M1b: The cancer has spread to other parts of the body.

Tumors of the midthoracic esophagus

M1a: This term is not used.

M1b: The cancer has spread to distant lymph nodes or other parts of the body.

Tumors of the upper thoracic esophagus

M1a: The cancer has spread to the cervical nodes (the lymph nodes in the neck).

M1b: The cancer has spread to other parts of the body.

Grading

Tumor grade. Grade may also be used to describe the tumor, using the letter “G,” in addition to the TNM system. Grade is determined based on how similar the tumor cells are to normal cells when viewed under a microscope. Normal tissue usually has different types of cells grouped together (also called differentiated tissue). Tissue that is cancerous usually is made up of cells that look more like each other. In general, the more differentiated the tissue, the better the prognosis.

G1: The tissue looks more like normal cells (well differentiated).

G2: The cells are somewhat more abnormal (somewhat differentiated).

G3: The tumor cells look very much abnormal and barely resemble normal cells (poorly differentiated).

G4: The cancer cells look almost alike and do not look like normal cells (not differentiated).

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

Stage I:This is the same as T1 cancer, in which the cancer is located in only the two inside layers of the esophagus. (T1, N0, M0)

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Stage IIA: Cancer is in either of the two outer layers of the esophagus. (T2 or T3, N0, M0)

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Stage IIB: Cancer is in the inner layers of the esophagus and has spread to some lymph nodes near the tumor. (T1 or T2, N1, M0)

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Stage III: Cancer is in the outside layer of the esophagus or in the tissues near the esophagus. Cancer is also in the lymph nodes, either near the tumor or somewhere else in the body. (T3 or T4, N1, M0)

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Stage IV: Cancer has spread to other parts of the body. (Any T, Any N, M1)

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Stage IVA: Cancer has spread to the lymph nodes in the abdomen or neck. (Any T, Any N, M1a)

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Stage IVB: Cancer has spread to other parts of the body besides the lymph nodes. (Any T, Any N, M1b)

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Recurrent: Recurrent cancer is cancer that comes back after treatment. It may come back in the esophagus or in another part of the body.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.springer-ny.com.

The treatment of esophageal cancer depends on the size and location of the tumor, whether the cancer has spread, and the patient’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the clinical trials section.

Often, doctors recommend combining three types of treatment for people with a tumor that has not spread beyond the esophagus and lymph nodes: radiation therapy, chemotherapy, and surgery. The order of treatments varies, but more commonly chemotherapy and radiation therapy are being recommended before surgery (or instead of surgery in some cases). Two important studies show a benefit to using chemotherapy plus radiation therapy before surgery, rather than surgery alone. For advanced esophageal cancer, treatment usually involves chemotherapy and radiation therapy.

Surgery

Surgery has traditionally been the most common treatment for esophageal cancer. A doctor may remove the esophagus in an operation called an esophagectomy and then connect the remaining healthy part of the esophagus to the stomach, so the patient can swallow normally. The stomach or part of the intestine may sometimes be used to make the connection. The doctor also removes lymph nodes around the esophagus.

If the surgeon cannot remove the entire tumor, a combination of chemotherapy (see below) and radiation therapy (see below) may be used before surgery to shrink the tumor. For people who cannot undergo surgery, the best treatment option is often a combination of chemotherapy and radiation therapy.

To help patients eat and relieve symptoms caused by the cancer, surgeons can also:

• Put in a percutaneous gastrostomy or jejunostomy (also called a feeding tube), so a person can receive nutrition directly into the stomach or intestine. This may be done before chemotherapy and radiation therapy is given to ensure that the patient can eat enough food to maintain his or her weight and strength during treatment.
  
  
• Dilate (expand) the esophagus (this procedure may have to be repeated if the tumor grows)
  
  
• Put an esophageal stent into the esophagus. An esophageal stent is a metal, mesh device that is expanded to keep the esophagus open.
  
  
• Use photodynamic therapy (lasers or light therapy; see below) to destroy cancerous tissue and relieve blockages
  
  
• Create a bypass, or new pathway, to the stomach (if a tumor blocks the esophagus but cannot be removed); this procedure is rarely used.

People who have had trouble eating and drinking may need intravenous (IV) feedings and fluids for several days before and after the operation, as well as antibiotics to prevent or treat infection. Patients learn special coughing and breathing exercises to keep their lungs clear.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. When radiation treatment is given directly inside the body, it is called internal radiation therapy or brachytherapy. For esophageal cancer, this involves temporarily inserting a radioactive wire into the esophagus using an endoscope (see Diagnosis).

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net’s Drug Information Resources, which provides links to searchable drug databases.

Photodynamic therapy

Photodynamic therapy is used to make swallowing easier, especially for people who cannot, or choose not, to have surgery, radiation therapy, or chemotherapy. In photodynamic therapy, a light-sensitive substance is injected into the tumor and stays longer in cancer cells than in normal cells. A laser is directed at the tumor, destroying the cancer cells. Although photodynamic therapy may relieve swallowing problems for a brief period, it does not cure esophageal cancer.

Advanced and recurrent esophageal cancer

Cancer of the esophagus is most successfully treated when it is found in the earliest stages, before it has spread. However, since early esophageal cancer causes few symptoms, it is usually advanced at the time of the diagnosis. In advanced or recurrent esophageal cancer, the goal of treatment is usually to prolong life, while relieving symptoms such as pain and problems with eating.

Treatment for advanced esophageal cancer usually involves chemotherapy. Radiation therapy can help relieve pain or discomfort. An esophageal stent, laser therapy, or photodynamic therapy may help keep the esophagus open.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: During Treatment.

Doctors and scientists are always looking for better ways to treat patients with esophageal cancer. A clinical trial is a way to test a new treatment to prove that it is safe, effective, and possibly better than a standard treatment. Patients who participate in clinical trials are among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that finding new drugs and therapies is the only way to make progress in treating esophageal cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with esophageal cancer.

To join a clinical trial, patients must complete a learning process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials, including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.

Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when such side effects do occur.

Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your health-care team. Before treatment begins, talk with your doctor about possible side effects of the specific treatments you will be receiving. The specific side effects that can occur depend on a variety of factors, including the type of cancer, its location, the individual treatment plan (including the length and dosage of treatment), and the person’s overall health.

Ask your doctor which side effects are most likely to happen (and which are not), when side effects are likely to occur, and how they will be addressed by the health-care team if they do happen. Also, be sure to communicate with the doctor about side effects you experience during and after treatment. For more information on the most common side effects of cancer and different treatments, along with ways to prevent or control them, visit, Cancer.Net’s section on Managing Side Effects , based on ASCO’s curriculum.

In addition to physical side effects, there may be psychosocial (emotional and social) effects are well. Learn more about the importance of addressing these needs in Cancer.Net’s section on Caring for the Whole Patient.

For more information on late effects or long-term side effects, please read the After Treatment section or talk with your doctor.

After treatment for esophageal cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. If the treatment has destroyed the tumor, follow-up treatment may include evaluation with CT scans and upper endoscopy to watch for possible recurrence.

People who have undergone an esophagectomy (removal of the esophagus) should sleep with the head of the bed elevated to avoid acid reflux, as the stomach has been surgically moved up into the chest.

People recovering from esophageal cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. For esophageal cancer survivors who smoke, quitting smoking can help recovery and reduce the risk of cancer recurrence. Learn more about Tobacco.

Moderate exercise can help you rebuild your strength and energy level. Talk with your doctor about helping you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about Healthy Living After Cancer.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: After Treatment.

Research for esophageal cancer is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this time. Always discuss all diagnostic and treatment options with your doctor.

Chemoprevention.Some evidence suggests that epigallocatechin, a compound found in green tea, may reduce the risk of esophageal squamous cell cancer. Researchers found that people who had this chemical in their urine had a reduced risk of esophageal and stomach cancer. Other clinical trials are looking at the use of aspirin and antacids to prevent esophageal adenocarcinoma in people with Barrett’s esophagus. Research is still ongoing, and people are encouraged to talk with their doctor before taking any medications or dietary supplements.

Combination therapy. Recent research studies have explored the addition of either chemotherapy, or a combination of chemotherapy and radiation therapy, before surgery. Some research has shown that adding these therapies to surgery improves survival compared with surgery alone. Doctors continue to evaluate the use of these treatments before surgery.

Doctors are also studying combinations of different drugs, such as cisplatin (Platinol), fluorouracil (5-FU, Adrucil), paclitaxel (Taxol), irinotecan (Camptosar), docetaxel (Taxotere), oxaliplatin (Eloxatin), and capecitabine (Xeloda).

Targeted therapy. Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. Several promising treatments for esophageal cancer block the molecular pathways used by growing cells. In cancer, these pathways are permanently switched "on," causing uncontrolled cell growth.

• A monoclonal antibody that binds and inactivates the epidermal growth factor receptor (EGFR) is being tested in clinical trials for advanced disease, and in combination with radiation therapy. EGFR is a protein that regulates cell growth and is overly active in cancer cells, causing them to grow uncontrollably.
  
  
• A growth factor called vascular endothelial growth factor (VEGF) that controls the development of blood vessels is also a target for therapy. Researchers have found that patients with late-stage or advanced esophageal cancer have high levels of this protein in their blood. Stopping the effect of VEGF using drugs or monoclonal antibodies to prevent the development of the blood vessels that help a tumor grow and spread is now being studied for advanced disease and in combination with radiation therapy.

Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:

• What type of esophageal cancer do I have?
  
  
• Is the cancer located only in my esophagus?
  
  
• What is the stage of the disease? What does this mean?
  
  
• Can you explain my pathology report (laboratory test results) to me?
  
  
• What are my treatment options?
  
  
• What clinical trials are open to me?
  
  
• Are there local radiation therapy and surgery options to treat my cancer?
  
  
• Is surgery required as part of therapy of my localized esophageal cancer?
  
  
• How experienced is the surgeon with this type of surgery?
  
  
• Can chemotherapy control the cancer?
  
  
• What is the goal of each treatment?
  
  
• What treatment, or combination of treatments, do you recommend? Why?
  
  
• What are the possible side effects of each treatment, both in the short term and the long term?
  
  
• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
  
  
• What is my prognosis?
  
  
• What follow-up tests will I need, and how often will I need them?
  
  
• What support services are available to me? To my family?

Cathy's EC Café
www.eccafe.org

Esophageal Cancer Awareness Association
P.O. Box 55071 #15530
Boston, MA 02205
Toll Free: 800-601-0613
www.ecaware.org

Esophageal Cancer Education Foundation
http://fightec.org

View all of Cancer.Net's Patient Information Resources.