Endoscopic Treatment for Esophageal Cancer

NYU Langone doctors at the Center for Esophageal Disease and the Advanced and Interventional Endoscopy Program may use endoscopic treatments, in which a thin, lighted tube is inserted into the esophagus, to treat early esophageal cancer.

Doctors use sedatives during all endoscopic treatments, so people are relaxed and feel less pain. They may also apply a local anesthetic to the area of the esophagus being treated.

Endoscopic Mucosal Resection

Doctors use endoscopic mucosal resection to remove cancerous esophageal tumors. During the procedure, doctors pass an endoscope—a thin, flexible, lighted tube with a video camera on the end—through the nose or mouth and into the esophagus to view the cancer. They may insert small surgical tools through the scope.

To remove the growth, our doctors use a thin wire loop with an electric current running through it. They also remove a small border of healthy looking tissue.

A pathologist, which is a doctor who studies diseases in a laboratory, examines the tumor and the border of healthy tissue under a microscope to ensure that the entire tumor was removed. If it wasn’t, the procedure can be repeated, or other endoscopic techniques can be used to remove remaining cancer cells.

After the procedure, most people are able to go home as soon as the sedation wears off. They may experience some discomfort in the back of the throat for a few days. Sometimes this treatment is combined with other endoscopic therapies to ensure that no cancer cells remain.

Cryospray Ablation

If endoscopic mucosal resection does not fully remove a large tumor, doctors may perform cryospray ablation. This procedure uses extreme cold to freeze tissue, in order to destroy any remaining cancer cells. This technique may also be used on its own to treat very early esophageal cancers.

During the procedure, doctors spray liquid nitrogen through an endoscope onto the esophageal cancer cells, which causes them to freeze and die. Normal, healthy cells usually grow in place of the destroyed tissue. Doctors may need to repeat this procedure every few weeks until they can no longer see any potentially cancerous cells in the esophagus.

After the sedative wears off, you can go home. You may experience temporary pain and swelling in your chest where the liquid nitrogen was applied. This can be treated with pain medication.

Radiofrequency Ablation

Doctors can also destroy cancer cells with a technique called radiofrequency ablation, which uses high-energy radio waves to destroy esophageal growths.

In this procedure, doctors use an electrode that is placed on the end of the endoscope or on a catheter, a long flexible tube that’s placed next to the endoscope. The electrode generates heat, which destroys cancer cells. The diseased cells are replaced by healthy cells over the next several weeks.

After the sedative wears off, you can go home. You may experience mild pain and swelling for a few days.

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