Treatments for stage 1 esophageal cancer

The following are treatment options for stage 1 esophageal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

You may have a feeding tube put in, so that you can gain weight and maintain good nutrition during treatment.

Chemotherapy is usually combined with radiation therapy to treat stage 1 esophageal cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Chemoradiation may be offered for stage 1 esophageal cancer:

• before surgery (neoadjuvant therapy)
• after surgery to lower the risk that the cancer will come back (adjuvant therapy)
• by itself as the main treatment for tumours that are in the upper part of the esophagus that is in the neck

Chemotherapy without radiation therapy may be offered before surgery for stage 1 esophageal tumours at the gastroesophageal (GE) junction.

People with stage 1 esophageal cancer that aren't healthy enough to have surgery, or don't want to have surgery, may be offered chemotherapy or chemoradiation instead.

The most common chemotherapy drugs to treat stage 1 esophageal cancer are:

• capecitabine (Xeloda)
• cisplatin and capecitabine
• cisplatin and etoposide (Vepesid)
• cisplatin and fluorouracil
• cisplatin and irinotecan
• carboplatin and fluorouracil
• carboplatin and irinotecan
• carboplatin and paclitaxel
• epirubicin, carboplatin and fluorouracil
• epirubicin, carboplatin and capecitabine
• epirubicin, cisplatin and capecitabine
• epirubicin, cisplatin and fluorouracil
• fluorouracil and leucovorin
• docetaxel (Taxotere), oxaliplatin, fluorouracil and leucovorin
• oxaliplatin, fluorouracil and leucovorin
• oxaliplatin and capecitabine

Targeted therapy drugs may be used to treat stage 1 adenocarcinoma tumours at the gastroesophageal (GE) junction. They are usually combined with chemotherapy.

Trastuzumab is used with chemotherapy drugs to treat HER2-positive tumours. The most common combinations are:

• trastuzumab, cisplatin and fluorouracil
• trastuzumab, cisplatin and capecitabine

Nivolumab (Opdivo) is an immunotherapy drug that may be offered for stage 1 esophageal cancer. It may be given to people who still have cancer remaining after neoadjuvant therapy with chemoradiation and surgery to completely remove the tumour.

Esophagectomy is surgery to remove all or part of the esophagus and lymph nodes around it. Part of the stomach may be removed as well. Before you are offered surgery, your healthcare team will do tests to make sure that you are healthy enough to have it done.

Esophagectomy is the type of surgery offered for stage 1 esophageal cancer when the person is healthy enough to have surgery. You may be offered surgery by itself or after chemoradiation.

External radiation therapy is the most common type of radiation therapy used to treat esophageal cancer.

Radiation therapy is most often combined with chemotherapy to treat stage 1 esophageal cancer. This is called chemoradiation. The 2 treatments are given during the same time period. Chemotherapy can make radiation therapy more effective in treating esophageal cancer.

Chemoradiation may be offered for stage 1 esophageal cancer:

• before surgery (neoadjuvant therapy)
• after surgery to lower the risk that the cancer will come back (adjuvant therapy)

Radiation therapy may be given alone for stage 1 esophageal cancer if you aren't healthy enough to have surgery or if you don't want to have surgery.

Endoscopic treatments may be offered for stage 1 esophageal cancer if you aren't healthy enough to have surgery or radiation, or if you don't want to have these treatments.

The types of endoscopic treatments that may be offered for stage 1 esophageal cancer are:

• endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD)
• radiofrequency ablation (RFA)

Talk to your doctor about clinical trials open to people with esophageal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.