Dr. Shanda Blackmon answers questions about esophageal cancer treatment

By Mayo Clinic staff

The esophagus has a vital job of carrying food and liquids to the stomach. When esophageal cancer occurs, the effects of the disease and its treatment can affect everyday life and make basic functions like eating and swallowing difficult.

Fortunately, a variety of innovative approaches for esophageal cancer aim to make life as normal as possible for people diagnosed with this disease.

The Mayo Clinic Cancer Center Blog team recently sat down with Shanda Blackmon, M.D., a Mayo Clinic thoracic surgeon, to get answers to common questions she receives from her patients about esophageal cancer treatment, surgery and recovery:

Do you have advice for newly diagnosed patients?

Finding a care team that can guide, support and educate you about next steps after your esophageal cancer diagnosis is important. A good care team should help you understand the role each member will play in your care, help you navigate important decisions, and prepare you for treatment so you can have the best outcome possible.

Make sure you understand the details about your specific type of esophageal cancer and ask questions about the treatments available to you. Learn about your case from the experts who will be involved in your care and can help you make an informed decision about your treatment.

Hear Dr. Blackmon's answer in this video:

If I need surgery, will my esophagus be removed entirely?

Surgery might be recommended in combination with other treatment or alone.

If the tumor is small, superficial and has not spread, your health care professional might remove it with an endoscope in a procedure called an endoscopic mucosal resection.

If your health care provider determines the cancer has spread, they might need to remove some or all of your esophagus. This procedure is called an esophagectomy.

Fortunately, advanced surgical options make it possible to reconstruct the esophagus so you can eat and drink normally.

Hear Dr. Blackmon's answer in this video:

Why do I need surgery if I've completed chemotherapy/radiation treatment?

Chemotherapy and radiation are often needed in addition to surgery, especially if esophageal cancer has spread to other organs. During an esophagectomy, your surgeon will remove tumors and surrounding tissue, but sometimes, cancerous tissue can be left behind.

Chemotherapy, radiation therapy or a combination of both can kill undetected cancer cells to reduce the chance of esophageal cancer recurrence. They also can be used before surgery to relieve symptoms you might be experiencing or reduce the size of a tumor, especially if it's causing difficulty or discomfort.

Hear Dr. Blackmon's answer in this video:

How does esophageal reconstruction work?

If cancer has spread beyond your esophagus and into your stomach or surrounding lymph nodes, and your health care professional recommends an esophagectomy, your esophagus can be rebuilt through advanced reconstruction techniques.

Typically, if only some of the stomach and esophagus needs to be removed, your surgeon can attach the remaining part of your stomach to the remainder of your esophagus.

If your entire stomach needs to be removed, your surgeon can extend the small intestine and attach it to the remaining part of your esophagus. While you heal, you will likely need a feeding tube. But with time and your health care professional's guidance, you can resume a normal diet.

Hear Dr. Blackmon's answer in this video:

Are there minimally invasive options for esophageal cancer surgery?

Esophagectomies can often be performed through a minimally invasive approach. This means that rather than making large incisions in your neck, chest or abdomen, your surgeon can perform the esophagectomy through small incisions in your abdomen or chest using a camera-tipped instrument or robotic assistance. Smaller incisions also can mean less pain after surgery; less time in the hospital; and fewer complications, including infection and blood loss.

Not everyone is a candidate for minimally invasive surgery, but your health care professional can go over the details of your case to find out if it's an option for you.

Hear Dr. Blackmon's answer in this video:

What can I expect from esophagectomy recovery?

An esophagectomy is major surgery, but recovery time can vary depending on your case and your surgeon's approach. After surgery, your care team will provide instructions to help you stay on track toward recovery. Be sure to follow these instructions carefully to avoid complications, like dumping syndrome, and report any pain, changes or concerns to your health care team right away.

After you recover and you resume your normal diet, you might find yourself having to adjust to new habits like eating smaller, more frequent meals.

Hear Dr. Blackmon's answer in this video:

Learn more

Learn more about esophageal cancer and find an esophageal cancer clinical trial at Mayo Clinic. Also read this article: "Esophageal cancer is one of the deadliest cancers," and join the Esophageal Cancer Group on Mayo Clinic Connect.