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Esophageal cancer treatment Worldwide: Best Hospitals, Doctors, Options, & Cost

Esophageal cancer is a major global health concern, with more than 500,000 new cases recorded annually. The overall survival rate stands at roughly 20% after five years, and most patients are diagnosed when the disease is already in its advanced stages, making esophageal cancer treatment for stage 3 or 4 particularly challenging. However, when detected early, the five-year survival rate can reach up to 47%. Unfortunately, only a small fraction of these cases are identified at such an early stage.

Thus, strategies to combat this disease focus on early detection and research into new esophageal cancer treatment techniques. In addition, having a proper clinic & doctor that helps to cope with esophageal tumors is essential.

Update: Apr 16, 2024

Best esophageal cancer centers

Selecting the esophageal cancer treatment hospital

When asking for the best hospital for esophageal cancer treatment, it is important to consider expertise, technology, adherence to industry guidelines, surgical and endoscopic options, availability of advanced therapies, rehabilitation services, and success rates. The center or clinic should have a diverse team of experts who use advanced diagnostic techniques and adhere to international guidelines.

The center should offer a range of surgical techniques, including minimally invasive and robotic-assisted procedures and endoscopic treatments. The availability of advanced therapies in the hospital, like targeted therapies, radiation oncology, and immunotherapy, is essential. Post-treatment support, including swallowing rehabilitation, is key.

Additionally, high success rates indicate a commitment to quality care. Considering practical aspects like location, cost, and hospital for esophageal cancer treatment, reputation is equally important. AiroMedical is ready to assist you in this process.

Top esophageal cancer doctors

Prof. Dr. med. Tho­mas Vogl
Excellent
AiroScore
9.90
Dr. med. Anett Tillmann, MBA
Excellent
AiroScore
9.20
Prof. Dr. med. Roland Ladurner
Excellent
AiroScore
9.70
Academic Hospital Martha-Maria Munich
general, abdominal, thoracic, endocrine, vascular and minimally invasive surgery
Prof. Dr. med. Alexander Muacevic
Excellent
AiroScore
9.40
Prof. Dr. med. Harald-Robert Bruch, MSc, PhD
Excellent
AiroScore
9.70
Oncological and Haematological Praxis Clinic Bonn
gastroenterology, hepatology, infectious diseases, oncology, hematology, pain therapy and nutritionology
Prof. Dr. med. Hans Hoffmann
Excellent
AiroScore
9.90
Prof. Dr. med. Philipp M. Paprottka
Excellent
AiroScore
9.90
Prof. Dr. med. Roland M. Schmid
Excellent
AiroScore
9.90
University Hospital Rechts der Isar Munich
internal medicine, gastroenterology, endocrinology, diabetology, infectiology, hepatology
Prof. Dr. med. Florian Bassermann
Excellent
AiroScore
9.90

Esophageal cancer doctor choosing

Choosing an esophageal cancer doctor is a significant step, requiring careful evaluation. Look for professionals specializing in oncology, gastroenterology, and thoracic surgery, particularly those skilled in minimally invasive and robotic surgeries.

Membership in esteemed organizations like ESMO and ESSO indicates their commitment to quality care and staying updated with medical progress. A strong record of successful treatments, advanced diagnostic methods usage, and a multidisciplinary team approach further boost the profile of the esophageal cancer doctor you consider choosing. Doctors active in research with strong patient testimonials enhance their credibility.

In addition, clear communication, patient understanding, and a comforting environment are crucial. The location also matters in striking a balance between quality care and accessibility. AiroMedical can assist in locating an esophageal cancer doctor best suited to your specific needs.

Treatment of esophageal cancer

Esophageal cancer treatment is a comprehensive, customized procedure that employs various techniques adjusted to the patient's health, cancer stage, and location. The primary strategies for esophageal cancer treatment include surgery (mostly for early-stage esophageal cancer treatment), radiation therapy, immunotherapy, and chemotherapy and their combinations.

Esophageal cancer treatment surgery

Operation is the most used first-line treatment for some types of esophageal cancer, with the methods depending on the stage and location of the tumor.

Esophagectomy
Esophagectomy involves removing and reconstructing all or part of the esophagus using stomach or colon tissues. Depending on the tumor location, different types of esophagectomies are performed. Three surgical approaches for esophageal cancer treatment are used:

  • The transhiatal approach involves a neck incision to remove most of the esophagus and a bit of the stomach, then connecting the remaining stomach to the leftover esophagus.
  • The Ivor Lewis method of esophageal cancer surgical treatment requires cuts in the abdomen and chest to remove a section of the esophagus and click a part of the stomach to the chest's remaining esophagus.
  • The thoracoabdominal approach is used for lower esophagus or junction tumors. It involves cutting from the abdomen to the left chest, dividing the esophagus, and linking the stomach or small intestine to the left chest to create a new pathway. Survival rates depend on the cancer stage but generally fall 30% at 5 and 20% at 10 years.
Robotic-assisted minimal invasive esophagectomy (RAMIE)
This procedure leverages robotic technology to enhance precision during esophagus removal. It offers smaller incisions, lower risk of complications, and quicker recovery time. Data from studies show that the survival rate for patients who underwent RAMIE leads to a 1-year survival rate of 95.1% and a 3-year survival rate of 81.7%.
Endoscopic surgery
It is a technique where doctors use the endoscope to conduct laser mucous resection. In this procedure, a laser is used to remove cancerous growths from the mucous lining of the esophagus. This method is primarily employed for esophageal cancer treatment for stage 1 when the cancer hasn't extended beyond the esophagus. Data suggests that the survival rate is over 90% after endoscopic surgery in 10 years. However, the overall survival rate stays below 70%.
Palliative surgery
Palliative surgery is used only in about 20%, mostly for patients with advanced esophageal cancer treatment for stage 4 or those unfit for surgery. One of the methods is stent (small mesh tubes) placement for esophageal cancer dysphagia treatment. It can be inserted to keep the esophagus open, destroy the tumor, and alleviate difficulty swallowing to improve the patient's daily life. Although it doesn't cure the cancer, it brings noticeable comfort to the patient.
Esophageal reconstruction
After removing the esophagus, the surgeon will reconstruct the gastrointestinal tract to enable swallowing. It is usually done by pulling the stomach up and attaching it to the remaining esophagus (esophagogastrostomy), or if the whole esophagus is removed, colon interposition (CI), jejunal flap (JF), and skin or anterolateral thigh (ALT) musculocutaneous flaps have been suggested. In more than 80% of patients, JF is used due to the study.
Symptomatic & complication treatment
Esophageal cancer bleeding treatment might involve a range of endoscopic procedures. They are band ligation, which ties off the bleeding source, and sclerotherapy, which induces clotting and scarring by injecting a solution.

There's also an ablation, heat to clot blood, and endoscopic hemostatic clip placement, which uses small clips to close the bleeding vessel. Argon plasma coagulation is another method that uses argon gas and electricity to halt bleeding. Lastly, catheter embolization blocks the tumor's blood supply. In rare cases, surgery may be used to control the bleeding.

The choice among these procedures will depend on the cancer location, the patient's overall health, and the stage.

Radiation therapy

Radiation therapy uses high-energy rays or particles and is a powerful tool in esophageal cancer treatment. It can be used as the primary method for smaller cancers. Also, it can be performed post-operatively to destroy remaining cancer cells or combined with chemotherapy to shrink larger tumors before surgery. It's also applied in advanced stages and cases of cancer recurrence.

External beam radiation therapy (EBRT)
It uses high-energy rays to destroy tumors. The most common radiation therapy for esophageal cancer is beams aimed at the tumor from a machine outside the body.

The duration and frequency of the procedures depend on why the radiation is needed and other considerations. The esophageal cancer treatment can take a few days to several weeks. When used solely, radiation therapy leads to a survival rate of around 18% after 1 year and less than 5% after 5 years for patients with stages I-III.

Intraluminal brachytherapy
This radiation therapy is one of the advances in esophageal cancer treatment. It is delivered inside the esophagus, close to the tumor. It is an esophageal cancer treatment that uses high energy to kill esophageal cancer cells while not harming nearby tissues as much. It's often used for palliation, dysphagia treatment, or advanced or recurrent cancer, helping relieve dysphagia and improve quality of life.

The one-year overall survival rate for esophageal cancer patients undergoing brachytherapy was 19.4%, with dysphagia-free survival at 28.9%, and the treatment showed the best outcome compared to other esophageal cancer stage 4 treatment methods.

Radiosurgery
When esophageal cancer spreads to the brain, the Gamma Knife, a type of precision radiation treatment, is often used. This method precisely targets and destroys the tumor without harming the healthy tissues around it.

Studies have shown that this method can control cancer growth in 92.4% of cases. The Gamma Knife treatment doesn't involve any surgical incision or long recovery time, making it a great way to manage esophageal cancer that has spread to the brain.

Proton beams
Proton therapy, a kind of radiation therapy, uses protons to treat some kinds of cancer, like esophageal cancer. It targets the tumor better and harms less of the healthy tissue.

With this treatment, according to the study, about 67% of patients live for 3 years, and 56% live for 5 years. Survival rates are higher for earlier stages of cancer, from 79.3% for stage I, 66.3% for stage II, 43.2% for stage III, and 28.3% for stage IV.

Chemotherapy treatment for esophageal cancer

Chemotherapy can enhance the effectiveness of cancer treatment for esophageal cancer. It may be used before (neoadjuvant) or after (adjuvant) surgery to kill remaining cancer cells or make the tumor more susceptible to radiation. In some cases, it can be used for advanced stages.

Preoperative chemotherapy
It involves chemotherapy before surgery to shrink the tumor and make the surgical procedure more successful. Preoperative chemotherapy for esophageal cancer treatment has produced mixed survival results in trials. Some showed benefits with 2-year and 5-year survival rates of up to 43% and 38%, respectively. The 5-year survival rate was 55% in a Japanese trial, while adding radiation showed 3-year survival rates from 27% to 47%.
Chemotherapy followed by surgery
Here, chemotherapy drugs are used to shrink the tumor before surgery is performed. This approach is often used when the cancer is large or in a difficult location. It has improved surgical outcomes by making the tumor easier to remove. The overall 5-year survival rate is 73.1%.
Palliative chemotherapy
It is used for metastatic adenocarcinoma esophageal cancer treatment, a specific type of esophageal cancer that has spread. It's been shown to provide partial responses, slowing the disease and alleviating symptoms.

Chemoradiation

Combining chemo and radiation therapy is widely used in cases where cancer has spread or recurred. Chemotherapy damages cancer cells, making radiation therapy more effective. For squamous cell esophageal cancer, chemoradiotherapy is commonly recommended as the first-line treatment. Surgery may be used afterward, depending on the results. Recent studies show using chemoradiotherapy before surgery is better than surgery alone.

Chemoradiation therapy followed by surgery
It is a two-step process. First, patients receive chemotherapy and radiation therapy to shrink the tumor. Then, doctors perform surgery to remove any remaining cancer.

It's commonly used for stage IB- III and sometimes stage IVA esophageal cancer. It has shown promising results in increasing the chances of completely removing the tumor. After checking up on patients for an average of 84 months, it was found that 44% of the group who had chemoradiation before surgery didn't see their cancer progress for five years.

Definitive chemoradiation therapy
This treatment combines chemotherapy and radiation therapy as the main treatment, without surgery. It's often used for patients with advanced cancer or those who can't undergo surgery.

It's been effective in controlling cancer growth and relieving symptoms. The complete response and survival rates for three and five years were 62%, 47%, and 37%, respectively. Any immediate harmful effects were able to be effectively managed.

Immunotherapy

Immunotherapy is used in esophageal cancer treatment, leveraging the body's immune defense to fight cancer cells. Unlike chemotherapy, immunotherapy tends to involve fewer severe side effects.

Pembrolizumab (Keytruda) & nivolumab (Opdivo)
Checkpoint inhibitors are used when chemotherapy is ineffective in patients with recurrent or metastatic esophageal cancer. These drugs enhance the immune response against cancer cells, significantly improving treatment outcomes. Both initially showed a 30% response rate in treating advanced esophageal cancers.

Moreover, using Keytruda with chemotherapy reduced the chance of the disease worsening by 35% compared to chemotherapy alone. Trials (CheckMate 648, ESCORT-1st, KEYNOTE-590) suggest the combination has similar severe adverse event rates.

Targeted therapy

Targeted drugs address specific cancer cell changes. Esophageal cancer treatments such as Trastuzumab and Fam-trastuzumab deruxtecan target HER2 protein on esophagus cancer cells but can cause side effects like severe heart and lung damage. Ramucirumab slows cancer growth by blocking new blood vessel formation, while Entrectinib and Larotrectinib target abnormal gene fusion. Overall response rates of targeted treatment vary from 32% to 68%.

Alternative treatment for esophageal cancer

Alternative treatments for esophageal cancer should not replace conventional methods like surgery, radiation, and chemotherapy but can complement them. These complementary therapies include esophageal cancer natural treatments like acupuncture, mind-body therapies (meditation, yoga, tai chi), massage therapy, nutrition therapy, exercise, aromatherapy, music therapy, art therapy, hypnosis, and certain herbal or dietary supplements. They can help manage symptoms, reduce stress, improve mental and physical well-being, and manage the side effects of primary treatments.

The selection of esophageal cancer treatment depends on various factors, including the form, location, and stage of cancer, the patient's overall health, potential side effects, and personal preferences. Treatment often involves a multi-modality approach to provide the most effective strategy. Discussions with the healthcare team are essential for choosing the best treatment for esophageal cancer.

Cost of esophageal cancer treatment

Advantages of treatment abroad

Medical tourism is gaining popularity as patients worldwide seek the best care for conditions like esophageal cancer. Going abroad for esophageal cancer treatment can offer several benefits:

Why check medical travel for esophageal cancer?

Specialized treatment from the best in the industry
Medical tourism allows patients to receive esophageal cancer treatment from top-tier specialists, often not accessible in their home countries.
Cutting-edge modalities
Medical tourism provides patients access to state-of-the-art esophageal cancer treatment technologies and approaches. It includes less invasive surgical options, advanced radiation therapy techniques, and novel therapies such as targeted treatments or immunotherapies.
Budget-friendly options
For patients struggling with high healthcare costs in their home countries, seeking esophageal cancer treatment overseas can often be a more cost-effective choice.
Reduced waiting periods
One of the significant benefits of medical tourism is the potential for reduced wait times. Patients can start their esophageal cancer treatment sooner than they might be able to at home.
Customized treatment regimes
Many hospitals serving medical tourists offer comprehensive and customized esophageal cancer treatment packages. These include diagnosis, treatment, and follow-up care, such as nutritional counseling and physical therapy.
Scope for second opinions
Medical tourism provides an excellent opportunity for a second opinion. Patients can have their esophageal cancer treatment plans reviewed by globally acclaimed oncologists, leading to more refined treatment strategies and greater confidence in the selected treatment pathway.

Summarizing, when diagnosed with esophageal cancer, it's vital to consider all possible treatment benefits. Medical tourism is a valuable resource, offering access to potentially life-saving treatments, renowned specialists, and cutting-edge technology that might not be available or affordable locally.

At AiroMedical, we facilitate your journey towards better health by linking you with prestigious medical facilities worldwide, ensuring you receive the best esophageal cancer treatment. Our services span the entire process, from identifying the ideal medical destination and coordinating your treatment plan to managing travel arrangements. Geographical boundaries should not restrict your treatment options. Connect with AiroMedical today and explore a world filled with healthcare opportunities.

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