Esophageal Cancer

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People with esophageal cancer travel to Duke from all over the U.S. for our expertise, comprehensive treatment options, and breakthrough research. We offer the most advanced treatments available today -- from radiation and chemotherapy to esophagectomy, including minimally invasive and robotic surgery options. Because of the high number of esophageal cancer patients we treat each year, our experience allows us to offer care to patients who may have been considered inoperable elsewhere.

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The Best Care for Esophageal Cancer

Physicians and surgeons in our nationally ranked cancer center -- a National Cancer Institute-designated Comprehensive Cancer Center -- specialize in treatment with esophageal cancer patients. Your surgeon, radiation oncologist, and medical oncologist have a detailed and thorough understanding of your particular tumor, how it behaves, and how it should be treated. Our team approach to your care means that all three specialists evaluate your esophageal cancer and use their expertise to develop the most thorough and targeted treatment plan possible for you.

We also understand how esophageal cancer can make it difficult to eat and affect your quality of life. That’s why we also offer palliative procedures, such as dilatation and stenting, that help relieve your pain and improve your ability to eat.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

Chemotherapy

Drugs to kill cancer cells or stop them from growing are often combined with radiation therapy before surgery. Sometimes chemotherapy combined with radiation therapy may be used as your primary treatment. The type of chemotherapy used depends on the stage and type of esophageal tumor you have.

Immunotherapy

Activates your immune system against cancer or reverses immune suppression caused by cancer. Our medical oncologists will determine if immunotherapy should be added to chemotherapy or given by itself for esophageal cancers that have spread to other organs, or if immunotherapy should be given after the cancer has been removed.

Radiation Therapy

High-energy beams target cancer cells to halt or slow their growth. Radiation therapy may be combined with chemotherapy to shrink tumors before surgery, or as your primary treatment. Radiation may also be used to treat advanced esophageal cancers to relieve pain and make it easier for you to swallow. The techniques and types of radiation that target your tumor and minimize exposure of surrounding healthy tissues include:

Intensity-Modulated Radiation Therapy: Administers radiation in small beamlets that conform to the size and shape of your tumor.
Image-Guided Radiation Therapy: Uses PET, MRI, or CT scan technology to ensure we avoid healthy tissue.

Esophagectomy

Surgically removes part of the esophagus and reconnects the remaining portion to your stomach. Our surgical expertise with esophagectomies is unmatched in the Southeast. We offer advanced options, including minimally invasive surgery (which requires only small incisions) and robot-assisted surgery (which uses tiny instruments guided under 3D imaging for greater precision). These techniques can lead to faster recoveries, less pain, and fewer complications.

Endoscopic Mucosal Resection (EMR)

Removes abnormal cells or very small tumors through a small tube called an endoscope. The endoscope is inserted into your esophagus through your mouth.

Radiofrequency Ablation

Uses electrodes to administer high-energy radio waves that destroy cancerous cells lining your esophagus. An endoscope is used to insert a thin tube called a catheter down your throat and into your esophagus. A balloon attached to the catheter contains electrodes on its surface. When inflated, these electrodes come in contact with and destroy the cancerous cells.

Photodynamic Therapy

Combines a photo-sensitive drug with a type of light energy to shrink advanced tumors to improve swallowing.

Stenting

Inserts a simple device through an endoscope. The device functions like scaffolding to keep your esophagus open and improve swallowing.

Dilatation

A balloon inserted through an endoscope dilates or expands the esophagus to improve swallowing and reduce pain in patients with advanced esophageal cancer.

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Tests

Upper Endoscopy/Biopsy

An endoscope is inserted down your throat and into your esophagus to look for cancer and take a tissue sample that will be evaluated for the presence of cancer.

Endoscopic Ultrasound (EUS)

Sound-wave technology takes pictures of the lining of your esophagus. This test involves inserting an endoscope, with an ultrasound device at the end, down your throat and into your esophagus.

PET/CT Scan

Imaging test that combines PET and CT scan technology to take detailed, 3D pictures of your esophagus.

Barium Swallow

X-rays that detect abnormalities in the cells lining your esophagus by tracking how a substance called barium moves through your body.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Leaders in Esophageal Cancer

High Patient Volume
We treat hundreds of patients with esophageal cancer every year, significantly more than most medical centers around the country. Our high patient volume is a key reason why our specialists are among the most experienced esophageal cancer experts in the nation.

National Reputation
We are a part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.

Fast Access to Our Treatment Experts
When you learn you have esophageal cancer, you want treatment as soon as possible. Our patients are able to meet with a radiation oncologist, medical oncologist, and surgeon all on the same day. You will leave your visit understanding your treatment options, and you'll have a comprehensive treatment plan in place.

Surgical Excellence
Each year, our surgeons perform more than 60 esophagectomies. At most hospitals, performing 20 of these surgeries annually is considered high volume. We have experience with esophagectomy on a wide range of patients, from those needing basic procedures to complex cases that may be deemed inoperable elsewhere. Our experience with minimally invasive esophagectomy is unmatched in the Southeast. And we are among the top five hospitals in the country for robot-assisted esophagectomy.

Highly Specialized Care
Our thoracic surgeons and medical and radiation oncologists focus specifically on treating gastrointestinal cancers. Their training and experience gives them expertise in effective, targeted treatments for esophageal cancer. Our patients also have access to nutritionists, pharmacists, and other specialists who work with our team to ensure you experience the best possible outcome.

Support for You
Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. View our cancer support groups in our event calendar.

Clinical Trial Access
You may be eligible to participate in clinical trials, which offer access to new therapies for esophageal cancer before they are available elsewhere. Our research includes studying patient resistance to chemotherapy and radiation and exploring new ways to improve how tumors respond to radiation. The studies help us understand how different patients respond so we can develop more personalized and targeted treatments for you.

Patient Resources

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This page was medically reviewed on 07/03/2024 by

Nicholas C. DeVito, MD | Medical Oncologist