Treatment Options Oesophageal Cancer | Dr Meenu Walia | DNB Medical Oncologist

ENDOSCOPIC THERAPIES

Early oesophageal cancer is often treated with endoscopic therapies rather than with surgery by Dr. Meenu Walia.. Our Surgical Oncologists are among the world’s most experienced in the use of these techniques, which preserve the oesophagus, cause minimal trauma and have a low risk of complications. Most people need a minimum of three endoscopic treatments, spaced eight to twelve weeks apart, to remove abnormal cells and allow healthy, new cells to grow in their place.

Specialists at all three Dr. Meenu Walia offer advanced endoscopic treatments and precisely tailor them to meet the needs of each patient. These therapies include:

1. Endoscopic mucosal resection: During EMR, a saline solution is injected under a nodule or lesion in the oesophagus. The solution forms a blister that allows oncologists to cut or suction away the lesion, while leaving the rest of the oesophagus intact. Patients who undergo this procedure have the same outcomes as people who undergo surgery to remove the entire oesophagus.
2. Radiofrequency ablation (RFA): In this outpatient procedure, controlled bursts of radiofrequency energy burn away thin layers of abnormal tissue on the surface of the oesophagus, leaving healthy tissue intact. Radiofrequency ablation takes about 45 minutes, and patients can usually return to their normal activities the next day, though some patient may experience chest pain and difficulty swallowing for about a week.
3. Photodynamic Therapy (PDT): Photodynamic therapy uses a light-sensitive drug and laser light to destroy cancer cells in the oesophagus. At the start of treatment, patient was given an intravenous drug called porfimer sodium that makes cancer cells sensitive to light. A few days later, oncologist activates the drug inside the patient’s oesophagus with a laser light inserted through an endoscope. The laser destroys the targeted cells without harming healthy ones. Photodynamic therapy may also be used to treat cancer that recurs after surgery, radiation or chemotherapy or in conjunction with endoscopic mucosal resection. PDT produces the deepest tissue destruction of any ablative method, but also carries a higher risk of complications.

SURGERY

# When cancer is more advanced, surgery to remove the oesophagus (esophagectomy) is usually necessary. During the procedure, surgical oncologist removes the damaged portion of the oesophagus and sometimes nearby lymph nodes and the upper part of the stomach (fundus).

# To re-establish the continuity of the digestive tract, the stomach is formed into a tube and pulled upward to join the remaining portion of the oesophagus. Dr. Meenu Walia offer both transhiatal Esophagectomy, which is performed through the neck and abdomen and is usually effective for cancer higher in the oesophagus, and transthoracic esophagectomy, which uses incisions in the abdomen and chest.

# When possible, surgical oncologists at Dr. Meenu Walia perform oesophageal surgery using laparoscopic techniques. Unlike traditional open surgery, which requires long abdominal and chest or neck incisions, minimally invasive Esophagectomy uses four or five small incisions that require just a stitch or two to close. This approach causes fewer traumas to the body, and usually leads to shorter hospital stays, reduced postoperative pain and a faster recovery. Minimally invasive Esophagectomy is a complex surgery, but it can produce excellent results in the hands of a skilled surgical oncologist.

COMBINED-MODALITY TREATMENTS

Depending on the extent of the cancer, surgical oncologists may recommend radiation combined with chemotherapy (chemoradiation) before or after surgery. For patients with more advanced disease, chemotherapy and radiation may be the primary treatment.

PALLIATIVE CARE

# When cancer is so widespread that treatment options are limited, Dr. Meenu Walia offers palliative care to ease symptoms and improve quality of life. In every case, an experienced, integrated team of care providers serves the social, psychological and spiritual needs of patients and their families.

# The team may include physicians from a number of fields as well as dietitians, medical social workers, psychologists, pharmacists and pain management specialists. If the patient is facing a serious illness, the primary treatment team will consult with a Dr. Meenu Walia palliative care expert who then works with your primary consultants to address the needs of the patient and their family. Dr. Meenu Walia is committed to providing every patient with compassionate end-of-life care.