Esophageal Cancer

Esophageal Cancer

Temple is nationally recognized for its expertise in diagnosing and treating patients with esophageal cancer and related conditions such as Barrett's esophagus. Management strategies for these diverse malignancies and precancerous conditions are constantly evolving. Our faculty draw from the whole emerging toolkit, including the latest and most technically complex procedures, to custom-fit therapy for each patient's specific needs.

Diagnostic procedures may include barium esophagram, upper endoscopy (including high-definition endoscopy with narrowband imaging), CT, PET, PET-CT, MRI, endoscopic ultrasound, thoracoscopy and laparoscopy.

In most cases, patients with superficial esophageal cancers can avoid surgery with endoscopic procedures such as:

  • Radiofrequency ablation (RFA) to remove Barrett's metaplasia
  • Cryoablation (super-cooled liquid nitrogen) to destroy cancerous or pre-cancerous tissue
  • Endoscopic mucosal resection (EMR) to sample and remove deep tissue nodules and other focal abnormalities

We are also experienced with advanced laparoscopic techniques — such as the transhiatal esophagectomy for certain patients with high-grade esophageal dysplasia or early cancer.

When patients present with more advanced esophageal cancers, our team of specialists will design an aggressive approach that might include a combination of surgery, radiation therapy and/or chemotherapy. Maintaining patient quality of life during such treatment is always of paramount concern. Options for palliation have increased in recent years and now include chemotherapy, radiation therapy, cryoablation, laser ablation, argon plasma coagulation and endoscopic stenting.

Temple Esophageal Cancer Team

Oncologic Surgery
John Daly, MD, FACS

Case Study from the Temple Digestive Disease Center

In Esophageal Cancer, a Less Invasive Option for a Hesitant Patient

Robert K., 72, after complaining of rapid weight loss and blood in his stool, underwent a colonoscopy and endoscopy, which found evidence of a hiatal hernia and 2-3 centimeters of Barrett's esophagus. Biopsy showed intramucosal adenocarcinoma. He was referred by his gastroenterologist to the Temple Digestive Disease Center. Additional use of high-definition endoscopy with narrow band imaging revealed areas of nodularity within the Barrett's region. Based on previous experiences and despite encouragement to meet with Temple's surgical, medical and radiation oncologists, the patient ruled out surgery, chemotherapy, and radiation treatment options. He requested the endoscopic approach.

Temple gastroenterologists performed endoscopic mucosal resection (EMR) on the areas of nodularity as well as radiofrequency ablation (RFA) to remove the Barrett's metaplasia. After several treatments, Robert had a normal-appearing distal esophagus without any residual nodularity or areas of concern for Barrett's. Biopsies confirmed the absence of Barrett's metaplasia, dysplasia and carcinoma. The patient continues to be monitored with surveillance endoscopy.

For Referrals to the Esophageal Cancer Program

Physician to Physician Referrals: 215-707-5555