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Esophageal Cancer

Barrett's esophagus and esophageal cancer are the focus of key prevention and treatment programs established by NewYork-Presbyterian Cancer Centers, where physicians offer the latest advances in the management of these diseases.

Barrett's Esophagus

Barrett's esophagus is a serious complication of chronic, severe acid reflux disease that has been recognized as a major risk factor for developing cancer of the esophagus. The Hospital's digestive diseases specialists offer promising new techniques for the treatment of Barrett's esophagus, with excellent outcomes in preventing the development of cancer.

NewYork-Presbyterian Hospital, in collaboration with Columbia University College of Physicians & Surgeons, is the site of a major clinical trial supported by the National Cancer Institute to study photodynamic therapy or endoscopic ablation, a novel treatment that involves laser destruction of the abnormal tissue in the lining of the esophagus. A special drug is injected into the bloodstream that is absorbed only by the dysplastic cells. These cells are then destroyed when exposed to a special frequency of red light. Another clinical trial focuses on chemoprevention using medications to prevent the progression of Barrett's esophagus toward cancer.

Esophageal Cancer

Over the past two to three decades, the incidence of esophageal cancer has been rising at an incredibly accelerated rate and today affects more Americans than ever before. At NewYork-Presbyterian Hospital, physicians from a wide range of specialties, including surgery, radiation therapy, and medical oncology, combine their expertise to provide patients with the best prospects for recovery.

Diagnostic Innovations

To aid in the identification of precancerous dysplasia and early cancer in patients with Barrett's esophagus, our physicians are studying new diagnostic methods, including high magnification endoscopy with dye staining and endoscopic optical coherence tomography imaging.

Therapeutic Excellence

Patients with very early cancers of the esophagus can be treated with a novel procedure called Endoscopic Mucous Resection, in which the portion of the diseased lining is removed using an endoscopic procedure. Photodynamic therapy is also used to open up esophageal blockages or treat small tumors endoscopically in patients who may not be candidates for surgery. Stents may also be used to enable patients with esophageal blockages to swallow.

Surgical Advances

The Hospital's surgeons are among the busiest and most well-known nationally and internationally for the treatment of esophageal cancer. Techniques of esophageal cancer resection pioneered at NewYork-Presbyterian Cancer Centers result in some of the highest cure rates ever reported. This expertise has led to the performance of definitive esophageal resections using minimally invasive techniques, procedures that preclude the need for major surgery. The ability of the Centers' surgeons to treat all esophageal cancers fluoroscopically and laparoscopically is on the horizon. Thoracic surgeons here are also spearheading the application of robotic technologies to improve minimally invasive treatment of esophageal cancer.

Radiation Oncology

Our radiation oncologists offer sophisticated treatment technology for patients with esophageal cancer, including the placement of very small catheters which are threaded to the site of the tumor to deliver a high dose of radiation. Radiation therapy may be used for curative intent or to relieve symptoms, such as an inability to swallow solid foods.

Research

Clinical Trials

Patients who come to NewYork-Presbyterian Cancer Centers for care have access to some of the most important and advanced clinical trials in the country for esophageal cancer. These trials include investigations related to:

• Endoscopic ablation in combination with medications to treat Barrett's Esophagus
• Multimodal approaches – chemotherapy, radiation and surgery – to treat esophageal cancer

Basic Science Research

Research endeavors in esophageal cancer at the Cancer Centers focus on Barrett's esophagus and esophageal adenocarcinoma, including the development of experimental models for studying causal factors of these conditions and the role of a selective Cox-2 inhibitor in prevention.