Esophageal Cancer Treatment

The esophagus is the tube that carries food from the mouth to the stomach. Esophagectomy (with or without partial stomach resection) is mainly performed on patients with malignant tumors. The two most frequent malignancies are squamous cell carcinoma and adenocarcinoma.

There is a known link between frequent consumption of very hot beverages and the development of this disease. The incidence of squamous cell cancer is almost 100 times higher among individuals who have suffered chemical burns to the esophagus. An increased risk is also noted in patients with achalasia — a benign esophageal condition characterized by impaired emptying and peristalsis.

Unlike squamous cell carcinoma, esophageal adenocarcinoma is more common in Western countries. In recent decades, the incidence of this form of esophageal cancer in Israel and globally has been rising steadily compared to other types.

Adenocarcinoma frequently occurs in patients with chronic gastroesophageal reflux (GERD), where stomach contents move backward into the esophagus. This can lead to a condition known as Barrett’s esophagus.

Barrett’s esophagus is a state where abnormal (precancerous) cells develop in the lower lining of the esophagus. These cells may undergo dysplastic changes, which are not yet cancerous but can progress to esophageal cancer in approximately 1 out of 100 patients over time.

• Chemical injuries to the esophagus
• Severe achalasia with significant dilation
• Long strictures unresponsive to conservative therapy
• Benign precancerous tumors

At the Tel Aviv Sourasky Medical Center (Ichilov), esophageal oncology treatment in Israel involves a comprehensive protocol that includes chemotherapy, radiation therapy, and surgery — for patients who are suitable candidates.

Patients with esophageal tumors who are eligible for surgery are offered a complex procedure involving removal of the esophagus and part of the stomach, followed by reconstruction of the gastrointestinal tract.

Recovery after surgery is prolonged. Patients remain under observation in a specialized unit until full recovery.

It’s important to note that esophagectomy is a complex operation that requires extended hospitalization and carries a high risk of complications.

However, recent studies show that complication rates are significantly lower in hospitals that specialize in esophageal oncology in Israel and perform these surgeries regularly.

Surgery is the only proven curative method for esophageal cancer treatment in Israel. If surgery is not an option due to serious comorbidities or poor physiological condition, an alternative protocol is followed — usually involving chemotherapy with or without radiation.

The success of the operation greatly depends on the stage of the disease at diagnosis and how quickly treatment is initiated.

When the condition is detected early and surgery is performed by qualified specialists, survival rates are significantly higher.

However, due to the nature of the disease, most diagnoses are made at an advanced stage. Therefore, the overall survival rate remains around 20–30% based on statistics from leading medical centers.

Esophagectomy is carried out under general anesthesia. The patient remains in a deep sleep throughout the procedure. Sedatives are administered via IV shortly before surgery to reduce anxiety.

There are several surgical approaches:

• Through the chest and abdomen
• Through the abdomen and neck
• Or a combination of chest, abdominal, and cervical incisions

The choice depends on the tumor’s location (upper, middle, or lower esophagus), whether lymph node removal is necessary, and which organ will be used for reconstruction (stomach or intestine).

The area and type of anastomosis (connection) between the remaining parts of the digestive tract depends on the segment removed. In most cases, the esophagus is reconstructed using part of the stomach or colon.

At the end of surgery, drainage tubes are placed in the chest and abdomen. Incisions are sutured and covered with sterile dressings.

General anesthesia.

The duration depends on the chosen surgical method, usually lasting 3 to 5 hours.

After the procedure, the patient spends about two hours in a post-operative recovery room before being transferred to intensive care. Once stabilized, they will begin sitting up with assistance.

For the first week, the patient will not be able to eat or drink. Nutrition will be delivered through a feeding tube inserted through the nose into the stomach or small intestine. In some cases, a jejunostomy may be created.

During hospitalization, the patient gradually transitions to soft foods. If a jejunal feeding tube is placed, it will be removed later during outpatient follow-up.

Patients are typically discharged 2–3 weeks after surgery.

Patients must adapt their eating habits to the new digestive anatomy. Small, frequent meals are recommended over large ones due to reduced stomach volume.

Most patients lose about 10 kg following surgery, which is considered normal. Weight stabilizes as the patient resumes regular eating.

Some patients may require additional treatment — radiation and/or chemotherapy.

If you wish to treat esophageal cancer without queues or delays, contact the international department at Ichilov Medical Center:

• Email: medtour@tlvmc.gov.il
• Submit a request on this page

Your case will be reviewed within 24–48 hours, and you’ll receive a response with a preliminary treatment plan and cost estimate. This allows patients to treat esophageal cancer without waiting, avoid unnecessary testing, and begin treatment as soon as they arrive.