In some cases, elderly patients (those over 70 years old) with esophageal cancer have been told that surgery is not the best option. This stems from a belief that these patients have less favorable outcomes than younger patients. However, Rebecca Araujo of DocWire News shares that this viewpoint isn’t necessarily accurate. According to a recent study, older patients actually have comparable outcomes to younger patients after undergoing esophageal surgery. Check out the full study findings in the Journal of the American College of Surgeons.
Typically, the recommended surgery for patients with either esophageal or esophagogastric cancer is called an esophagectomy. This may be performed alone or in conjunction with other treatment options, such as radiation or chemotherapy. The American Cancer Society defines an esophagectomy as:
removing the esophagus (and nearby lymph nodes)…often a small part of the stomach is removed as well. The upper part of the esophagus is then connected to the remaining part of the stomach [and] part of the stomach is pulled up into the chest or neck to become the new esophagus.
After surgery, patients may experience nausea and vomiting, blood clots, infection, pain, and voice changes. One complication that can arise from esophageal cancer is lung issues like pneumonia. For this reason, many surgeons have worried about operating on elderly patients.
In this study, researchers analyzed patient outcomes using data from 282 patients over a 16-year period. The patients all received chemotherapy before having an esophagectomy. Of those involved, 188 patients (66.6%) were under 70 years old. 94 patients (33.3%) were 70+ years old. Although older patients experience more atrial fibrillation and urinary retention following surgery, researchers discovered no significant differences in terms of complications, length of hospital stay, or mortality. After adjusting for age, 44.8% of older patients had a 5-year survival rate compared to 39% for younger patients.
Ultimately, these findings suggest that esophageal surgery can, and should, be an option for older patients with esophageal cancer.
Our esophagus is a long, hollow tube running from the throat to the stomach. This muscular tube, which is about 8 inches long, helps move food from the back of the throat to the stomach. Esophageal cancer occurs in the esophageal tissue, typically beginning in the innermost layer and spreading outward. Multiple forms of esophageal cancer exist, including esophageal sarcoma or melanoma, adenocarcinoma, and squamous cell carcinoma. While adenocarcinoma is the most common form of esophageal cancer in America, squamous cell carcinoma is the most common form throughout the world.
Each year, an estimated 4 in every 100,000 individuals develops esophageal cancer. Risk factors include smoking tobacco, gastroesophageal reflux disease, acid reflux, obesity, overuse of alcohol, and being male. In many cases, symptoms do not appear until later stages of the cancer. These include:
- Difficulty swallowing
- Unintended weight loss
- Appetite loss
- Chest pressure
- Nausea and vomiting
- Heartburn and indigestion
- Chronic cough
- Hoarse voice
- Bone and chest pain
- Esophageal obstruction
Learn more about esophageal cancer here.