Stomach and Esophageal Cancers

Stomach and Esophageal Cancer

While stomach and esophageal cancers are rare, at Green Bay Oncology positive outcomes for these types of cancer are many.

Cancers of the stomach or esophagus are not among the most common types of cancer. However, success stories for stomach and esophageal cancers are most certainly on the rise.

At Green Bay Oncology, we’re proud to be contributing to the improved outcomes right here in Northeast Wisconsin and the Upper Peninsula. Each year, we treat more cases of stomach and esophageal cancer than anyone in the region and help people stay well after treatment.

In addition to having more cancer-fighting doctors and more depth of experience than any other provider in the region, Green Bay Oncology is one of only two participants in the National Cancer Institute’s Community Oncology Research Program in the region. We conduct national-level clinical trials for cancer right here in our communities.

Stomach and esophageal cancer diagnosis

Many patients diagnosed with esophageal cancer start with concerns about difficulty or pain during swallowing, weight loss, or a cough and hoarseness. Those diagnosed with stomach cancer often first notice a general discomfort in the stomach, loss of appetite, weight loss and vomiting.

Screening is generally done with a procedure called an upper endoscopy. While the patient is anesthetized, the doctor inserts a flexible tube with a miniature camera down the esophagus, viewing all areas of the upper part gastrointestinal (GI) tract: the esophagus, the stomach and the duodenum, the first section of the small intestine.

If cancer is revealed, the next test is for levels of advancement. Tests may include:

  • Endoscopic ultrasound examination, which uses ultrasound waves to create images that may reveal cancer in the walls of the esophagus, stomach or duodenum. This exam can fairly accurately predict the depth of invasion of the cancer, and reveal if there are suspicious lymph nodes, which could then also be biopsied.
  • Computer tomography (CT) and/or positron emission tomography (PET) scanning, which determines if cancer has spread to other parts of the body.
  • Bronchoscopy, to see if there is involvement of the trachea (windpipe).
  • Laparoscopy, to determine if cancer has spread into the abdominal cavity before an extensive resection is undertaken.

We encourage all of our patients and prospective patients to empower themselves with knowledge from reputable sources. For more information on screening and diagnosis of stomach and esophageal cancer, we recommend the American Cancer Society (stomach and esophageal) and the National Cancer Institute (stomach and esophageal).

To learn more about stomach and esophageal cancer treatment options,  schedule a consultation with one of our specialists.

Why do stomach and esophageal cancers occur?

While the factors that lead to the development of stomach and esophageal cancer vary from person to person, certain lifestyle choices and genetics remain key factors. Smoking, heavy alcohol consumption, and diets rich in fats and salt and lacking in fresh fruits and vegetables can lead to these cancers. Age, gender (men are three times more likely to develop these cancers than women), obesity and lack of physical activity are also potential culprits.

How are stomach and esophageal cancers treated?

In larger part, treatment for stomach and esophageal cancers depends on the size and location of the tumor and whether the cancer has spread to other parts of the body. Each treatment plan may include one or more of the following:

For more information on the specific treatments we’ve developed for stomach and esophageal cancers, we invite you to contact us and schedule an appointment.

Surgery:

A process known as “endoscopic mucosal resection” removes the cancerous area through an endoscope.

Subtotal gastrectomy, removal of part of the stomach, is used for cancer located in the upper part of the stomach. If the cancer has spread throughout the stomach, a total gastrectomy will remove the stomach and rework the digestive tract to allow some food to be eaten.

For esophageal cancer, surgery may remove some or most of the esophagus through an esophagectomy. Sometimes the cancer has spread to the upper part of the stomach, and that must be removed as well. There are new minimally invasive forms of esophagectomy surgery now being performed.

Chemotherapy:

Chemotherapy uses drugs to attack cancerous cells, and is often used in conjunction with surgery. It may also be recommended prior to surgery to shrink the tumor.

Targeted Therapy:

New drugs called targeted therapies also attack cancerous cells but have fewer side effects.

Radiation:

Radiation delivers high-energy rays from a machine outside of the body to attack cancerous cells without the side effects of drugs.

Clinical Trials:

New treatment options are continually being developed. As the region’s only participant in the National Cancer Institute’s Community Clinical Oncology Program, we conduct national-level clinical trials here in our communities and help to identify new ways to detect, diagnose, and treat stomach and esophageal cancers.

Types of treatment by stage of stomach cancer

stage 1

Stage 1A stomach cancer is found in the lining of the stomach, but not in the muscular layer or the lymph nodes; in stage 1B, the cancer has spread to one or two nearby lymph nodes.

Surgery is recommended and generally is successful at this stage.

stage 2

Stage 2A stomach cancer has spread through the muscular layer of the stomach and is found in one or two lymph nodes; in stage 2B, the cancer has spread to the outermost layers of the stomach and/or may be in three to six lymph nodes.

Treatment is surgery followed by chemo-radiation, or chemotherapy before and after surgery.

stage 3
Stage 3A stomach cancer has spread to the outermost layer of the stomach and is in seven or more lymph nodes; in stages 3B and 3C, the cancer has spread to nearby organs.
Treatment can include surgery followed by chemo-radiation or chemotherapy before and after surgery.
stage 4

In stage 4, the cancer has spread to distant areas of the body.

With treatment difficult at this point, patients in this stage may be good candidates for clinical trials that offer access to drugs and procedures in the research phase.

Types of treatment by stage of esophageal cancer

Staging indicates the severity of a person’s cancer and is integral in determining the appropriate treatment.

stage 1
Stage 1 esophageal cancer is in the lining of the esophagus but not into the lymph nodes.
Surgery is recommended.
stage 2
Stage 2A/2B esophageal cancer has grown into the muscle wall of the esophagus and may have spread to the lymph nodes.
Treatment may include surgery and/or chemotherapy and radiation.
stage 3
Stage 3 esophageal cancer has spread to surrounding structures.
Treatment usually consists of a combination of chemotherapy with radiation therapy and surgery. Chemo-radiation is often given prior to surgery to help shrink the cancerous area.
stage 4
Stage 4 esophageal cancer has spread to other organs or distant parts of the body.
Treatment typically consists of chemotherapy and/or radiation therapy. Treatment is intended to prolong the quality of life. Patients in this stage may also seek out clinical trials to have access to treatments in the research phase.

MORE STOMACH AND ESOPHAGEAL RESOURCES:

For more information on stomach and esophageal cancer and related treatment options, we recommend the following resources: