Esophageal Cancer

Background

EarlyStages keySymptoms of esophageal cancer include trouble swallowing, weight loss, indigestion and coughing. However, certain factors, such as smoking, human papillomavirus, obesity, and gastroesophageal reflux disease, might increase the risk for esophageal cancer. Age is also a risk factor.

Esophageal cancer accounts for 18,000 new cancer cases and 15,000 deaths in the United States each year. Worldwide, esophageal cancer is the eighth most common cancer, with more than 80% of cases occurring in less developed regions of the world.

Current Treatment

Surgery (open or laparoscopic) can be used to remove small tumors or remove a portion of the esophagus and upper part of the stomach. These surgeries carry a high risk of complications including bleeding and infection.

Less invasive treatments involve chemotherapy and radiation therapy which can be used alone or in combination. Both of these treatments can be used before and/or after surgery and can also relieve symptoms in people with extremely advanced cases. Two types of radiation may be used including external beam radiation (radiation comes from machine outside the body) or brachytherapy (radiation placed inside the body near the site of the cancer).

Focused Ultrasound

Because focused ultrasound directs a focused beam of acoustic energy toward a target area, such a method could provide a non-invasive way to heat and destroy esophageal tumors. However, focused ultrasound remains theoretical as a treatment for esophageal cancer. Researchers at the University of Lyon have investigated the use of magnetic resonance imaging to monitor the heating and destruction of esophageal tumors by an endoscopic ultrasound transducer inserted into the esophagus in preclinical studies. No other work has explored the use of focused ultrasound for esophageal cancer.

Notable Papers

Rata M, Salomir R, Umathum R, Jenne J, Lafon C, Cotton F, Bock M. Endoluminal ultrasound applicator with an integrated RF coil for high-resolution magnetic resonance imaging-guided high-intensity contact ultrasound thermotherapy. Phys Med Biol. 2008;53(22):6549-67.

Melodelima D, Salomir R, Chapelon JY, Theillère Y, Moonen C, Cathignol D. Intraluminal high intensity ultrasound treatment in the esophagus under fast MR temperature mapping: in vivo studies. Magn Reson Med. 2005;54(4):975-82.

Melodelima D, Salomir R, Mougenot C, Prat F, Theillère Y, Moonen C, Cathignol D. Intraluminal ultrasound applicator compatible with magnetic resonance imaging “real-time’ temperature mapping for the treatment of esophageal tumors: an ex vivo study. Med Phys. 2004;31(2):236-44.

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