At least 50 percent of those cases are considered too advanced to cure, and treatment emphasis is placed on alleviating symptoms and improving quality of life. Dysphagia, or difficulty in swallowing, has proven to be the most important symptom affecting the quality of life in patients with esophageal cancer. Since these patients have a median survival of about six months, it is important to minimize time spent in treatments and to maximize quality time at home. This study will help us evaluate treatment options based on issues most important to the patients. Radiation therapy has been used for decades and in standard doses has shown to relieve dysphagia in 50-70 percent of patients.
Higher doses give better palliation but require prolonged treatment.
Potential side-effects include inflammation of the esophagus and lung, and stricture formation of the esophagus. Stents devices placed through the mouth at endoscopy to support the esophagus and hold back the malignancy have been used with some success for several years. However, the early non-expandable plastic or rubber stents did not gain wide acceptance as they are difficult to place and result in a high rate of complications. Due to these factors and the high rate of efficacy, expandable stents are becoming the preferred method for endoscopic palliation of esophageal cancer in the United States. The study will be coordinated by the Clinical Innovation Group of the MUSC's Foundation for Research Development.