Esophageal Cancer

Esophageal cancer affects the long tube that connects the throat to the stomach and often doesn’t show symptoms until an advanced stage. It is not a common cancer; close to 18,000 cases are diagnosed in the U.S. each year.
There are two main types of esophageal cancer, and they occur in men more frequently than women:

  • Squamous cell cancer occurs in the upper to middle part of the esophagus and is related to smoking and alcohol consumption.
  • Adenocarcinoma, more common in the U.S., is related to obesity and reflux disease.

A condition called Barrett’s Esophagus can increase your risk of getting esophageal cancer. It occurs most frequently in people with gastroesophageal reflux disease (GERD), commonly known as heartburn or acid reflux. Acid from the stomach changes the normal tissue lining the esophagus to tissue that resembles the lining of the intestine. The abnormal tissue can become cancerous over time.

Diagnosing and Treating Esophageal Cancer

If you have esophageal cancer, you may need a combination of surgery, chemotherapy and radiation therapy. Our center brings all of our specialists together in one place so they can work together to present you with a customized care plan that addresses your cancer and your goals for care.

Diagnosis and Staging

Specialized computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans produce clear, precise images of tumors in the esophagus. In addition, radiologists focus on interpreting images of the GI tract, making them more attuned to subtle differences in the images.

At UC Health, our gastrointestinal (GI) physicians specialize in viewing the esophagus endoscopically (through a scope inserted through the mouth and into the esophagus). An endoscopic ultrasound is used to bounce sound waves off of the esophagus to create images that indicate tumor size and degree of growth into surrounding tissue.

If you have Barrett’s Esophagus, your doctor may recommend that you receive routine endoscopy screenings to make sure the abnormal tissue in the esophagus hasn’t become cancerous.

Other testing procedures using scopes – bronchoscopy, thoracoscopy and laparoscopy – help us check for the spread of cancer cells to the lungs, chest and abdomen by visualizing these areas and taking tissue samples called biopsies for further study.

With an accurate diagnosis, we can help you decide on the best action to take in treating your cancer.


At UC Health, we treat early cancers with endoscopy or surgery. Larger tumors or those that have spread to the surrounding lymph nodes generally require a combination of surgery, chemotherapy and radiation therapy. Advanced cancer that has spread will generally be treated with chemotherapy only or chemotherapy and radiation therapy (to improve swallowing).

We offer the most advanced non-surgical treatments for Barrett’s Esophagus and very early esophageal cancers, many of which are available in this region only at UC Health. Non-surgical treatments include:

  • Endoscopic mucosal resection (EMR), which allows us to remove small, early tumors through a scope
  • Radiofrequency ablation (RFA) for Barrett’s Esophagus, which uses heat energy to destroy cancerous tissue without damaging surrounding healthy tissue
  • Cryotherapy, an alternative for people who can’t have RFA. The technique freezes pre-cancerous cells or the abnormal cells of Barrett’s Esophagus.
  • Radiation therapy, often used with or without surgery, may be combined with chemotherapy. Radiation beams are delivered to the tumor through the skin to shrink or destroy the cancer.
  • Chemotherapy, in pill form or through an IV, is used to kill cancer cells throughout the body. At UC Health, we have novel chemotherapy agents not generally available at other cancer treatment facilities in the Greater Cincinnati area. Our GI oncologists also offer access to the latest medications available through clinical trials.


Your surgeon will remove the part of the esophagus that contains the cancer, as well as any lymph nodes near the esophagus. You may be a candidate for minimally invasive esophagectomy. Minimally invasive techniques include laparoscopy and video-assisted thoracoscopic surgery. Both require only a few small incisions in the abdomen and chest to insert small tools to remove all or part of the esophagus.

UC Health’s volume of esophageal surgeries is the highest in the Greater Cincinnati region. Centers with higher volumes have been proven to have fewer complications and better results following surgery. We perform the following procedures using minimally invasive and conventional surgical techniques, based on what will be best for you:

  • Ivor-Lewis esophagectomy – Our most common procedure involves incisions in the abdomen and right chest. Our surgeon removes two-thirds of the esophagus and surrounding lymph nodes. The stomach is then transformed into a tube to replace the esophagus. This procedure is used for tumors at the bottom part of the esophagus.
  • Three-hole esophagectomy – For longer tumors or tumors in the middle part of the esophagus, incisions are made in the abdomen, right chest and left neck to remove the esophagus and make the stomach into a new esophagus tube.
  • Trans-hiatal esophagectomy – Used for earlier cancers, this procedure requires an incision in the left neck and abdomen to remove the tumor.

In rare cases, a tumor may prevent a person from eating and drinking. We can insert an expandable tube into the esophagus to restore these vital functions.

For more information about surgical procedures for lung cancer, visit the Society of Thoracic Surgeons website.

Supportive Services

We offer you several services to help ease your journey through diagnosis and treatment.

UC Health’s Integrative Medicine team works closely with each patient who has lung cancer to provide services such as stress management, massage, yoga and acupuncture/acupressure to lessen the symptoms and side effects of your cancer.

Our oncology dietitian provides counseling to ensure that you get the nutrition you need for optimal health and healing during your cancer treatment

Clinical Trials

We have ongoing clinical trials for esophageal cancer.

Our physicians will talk with you about current trials for which you may be eligible. In addition, we offer you access to the most current therapies available through Phase I clinical trials.

We are one of only a handful of centers in the country offering a comprehensive Phase I experimental therapeutics program in which patients have access to treatment with the newest drugs and treatments that are not available elsewhere in the region.