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Frequently Asked Questions

As a leading center of excellence in esophageal cancer treatments and diagnosis, the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center is here to help answer your concerns and questions. We welcome your questions and if you would like more information, our esophageal cancer specialists are just a phone call away.

Diagnosing and Staging Esophageal Cancer

What are the symptoms of esophageal cancer?

Esophageal cancer is frequently diagnosed late in the spread of the disease because it is often asymptomatic (without symptoms) in the earlier stages. However, sometimes there are noticeable symptoms in the early stages, including:

  • Mild or intermittent difficulty swallowing (sometimes called dysphagia) or pain while swallowing
  • Chronic heartburn or acid reflux
  • Unexplained weight loss

Learn more about esophageal cancer warning signs.

What are the risk factors?

It is believed that lifestyle factors contribute to the development of esophageal cancer, including:

  • Heavy alcohol intake
  • Cigarette smoking
  • Excessive weight (obesity)
  • Chronic acid reflux

Learn more about esophageal cancer warning signs.

How is esophageal cancer staged?

Staging is done according to the TNM classification system (T stands for tumor depth of invasion, N for regional lymph node metastasis and M for distant organ metastasis).

The resulting classifications are grouped into five stages, including Stage 1, Stage IIA, Stage IIB, Stage III, Stage IV. Stage I indicates tumors that have not metastasized while Stage IV indicates metastasis. Learn more about esophageal cancer diagnosis.

What happens after a patient is diagnosed with esophageal cancer?

An oncologist (a doctor who specializes in cancer treatment), working with other specialists, develops a treatment plan. The plan may include surgery, chemotherapy and radiation–or a combination of therapies.

Our multi-disciplinary clinic for esophageal cancer patients brings together an oncologist, surgeon, gastroenterologist, and radiation oncologist to meet with a patient and the patient's family to review the diagnosis and develop a treatment plan.

Learn more about esophageal cancer diagnosis.


Esophageal Cancer Chemotherapy & Immunotherapy

What is chemotherapy?

Chemotherapy is a type of cancer treatment that uses drugs to interfere with the DNA of cancer cells. It usually involves daily or weekly treatment sessions over a period of time.

Immunotherapy is a type of cancer treatment that uses drugs to reactivate your own immune system’s cancer-fighting T cells.

Learn more about esophageal cancer chemotherapy and immunotherapy.

How many chemotherapy treatments can an esophageal cancer patient expect?

The number of chemotherapy treatments will depend on the patient’s overall condition and health as well as the stage of the cancer when it is diagnosed. The amount of time chemotherapy will last ranges from a few weeks to a number of months.

Learn more about esophageal cancer chemotherapy.


Esophageal Cancer Radiation Therapy

How many radiation treatments does someone with esophageal cancer typically need?

Radiation treatments last approximately 15 minutes a day and are typically given daily for five to six weeks. A patient is usually treated with 25 to 30 treatments (or fractions) of radiation.

Learn more about esophageal cancer radiation therapy.


Esophageal Cancer Surgery

Are all stages of esophageal cancer treated with surgery?

As with most types of cancer, determining the treatment, which may include surgery, depends on the patient’s individual needs. Generally, we perform surgery (often, in combination with chemotherapy and radiation) for all stages of esophageal cancer except for Stage IV. Stage IV cancers are usually treated with chemotherapy only. Surgery and radiation may be used in some cases for relief from symptoms, such as to relieve pain or help with swallowing.

Learn more about esophageal cancer treatments.

How much recovery time is needed after surgery?

It will vary according to the type of surgery, but generally, patients will be in the hospital for five to 10 days.

Learn more about esophageal cancer surgery.


Therapeutic Services for Esophageal Cancer

What type of post-surgery care will a patient need?

Esophageal cancer patients will probably need services to:

  • Help with learning to swallow
  • Use a feed tube during recovery
  • Learn to manage a stent, which may be placed in the esophagus during surgery

In addition, patients may work with a physical therapist to gain strength or work with a dietician for advice on nutrition and dietary needs.

Esophageal cancer patients at Johns Hopkins receive patient support services from a range of experts, including dieticians and physical therapists. They may also receive additional endoscopies for treatment or other complications and/or for surveillance.

Learn more about our patient support services.

How long does post-treatment follow-up last? Should a patient expect to come to Johns Hopkins for weeks or months?

The esophageal cancer experts at Johns Hopkins usually recommend that patients receive chemotherapy and radiation before surgery, so pre-surgery treatment will take longer than post-treatment follow-up. Radiation and chemotherapy are usually given in courses that last anywhere from a week to several weeks.

Post-treatment follow-up generally involves regular medical appointments in the months after treatment to ensure that any treatment complications are taken care of and to check for recurrence. If there is no recurrence, the time between appointments will lengthen. We continue to check patients regularly to ensure there is no tumor recurrence.

Hopkins is an international cancer center and many of our patients come from around the country and other international sites to be treated by our specialists. As a result, we offer resources to help coordinate housing during treatment.

Find more patient information to learn about all of the services Johns Hopkins offers, including housing information.

What is palliative care?

Palliative care focuses on the whole person and the relief of symptoms, such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, depression and difficulty sleeping. It can help patients carry on with daily life, including tolerating medical treatments. Palliative care is appropriate at any stage of an illness and can be provided at the same time as your cancer treatment. Learn more about our patient support services.


Esophageal Cancer Clinical Trials

What is a clinical trial?

A clinical trial is a type of study that enrolls volunteer patients to answer questions about drug or other medical interventions. While it can often be beneficial for esophageal cancer patients to participate in trials, the biggest value of clinical trials is the contribution those trials make to future treatments and procedures, often offering future patients a chance at extended life, or even a cure. Read more about esophageal cancer research and clinical trials.

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