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An Overview of Stage IV of Esophageal Cancer

written by: Vikas Vij • edited by: Diana Cooper • updated: 12/8/2010

Stage IV of esophageal cancer should be addressed with an optimal combination of treatments. The latest clinical trials have shown improvements in the number of patients where the cancer goes into a remission.

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    Esophageal Cancer in an Advanced Stage

    Stage IV of esophageal cancer constitutes a condition of metastasis in which the cancer has spread out to unrelated sites. There are several challenges in treating the cancer at this stage and the possible benefits of the treatment should be weighed against the potential risks to the patient. Each patient’s condition may be unique, and the treatment will depend upon the specific prognosis of a particular case. To address the cancer at such advanced stage, most of the latest treatments are in different stages of clinical trials. If the patient agrees to participate in the clinical trials, it may provide him with better access to advanced treatment.

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    Problems with Stage IV of Esophageal Cancer

    The key challenge faced at this stage is that there is no standardized curative treatment available to the patient. The primary difficulty faced by the patient at this stage is dysphagia. In simple terms, it means that the patient experiences problems in swallowing any kind of food or even liquids. Therefore, the nutrition levels of the patient may get affected due to this hurdle. There are a few therapies that may provide short-term relief and temporary improvement in nutrition of the patient.

    The primary aim of the treatment at this stage is to reduce the symptoms of cancer or at least prevent them from worsening in order to prolong the patient’s survival. The optimal treatment approach at this stage is to try different options, or a few options in combination with each other. The best care to the patient can be provided at a medical institution that is equipped with multi-modality treatments. For optimal care, the patient needs attention from a team which should include a surgeon, medical oncologist, radiation specialist, gastroenterologist and a nutrition expert.

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    Survival Rates at Stage IV

    Long-term survival is rare at this stage under the current treatment options available. Surgical treatment is primarily palliative in nature and not curative because the cancer has already spread to distant sites within the body. Surgery can help to improve the patient’s condition to swallow food and liquids. However, some patients who undergo surgery with curative intent may experience recurrence of the cancer within a year or two after the surgery.

    Chemotherapy is also widely used to treat patients suffering from an advanced stage of esophageal cancer. Chemotherapy may help the cancer to go in clinical remission for some time. About 40 percent of all patients respond positively to chemotherapy. The average length of survival of patients at this stage may range between 8 months to a year. However, the latest clinical trials have been reporting a greater percentage of patients responding to new drugs for metastatic esophageal cancer. In about 20 percent of the patients the cancer may go into a remission with the latest drugs.