Specialist in esophageal cancer - Dr. Klaus Emmanuel

Your specialist for esophageal cancer

Because I have set myself the goal of ensuring the best possible quality of life for my patients suffering from esophageal cancer, I dedicate a large part of my energy and expertise to this topic. ll members of our highly trained and experienced interdisciplinary team deliver outstanding work. Personally, I. am one of the most internationally recognized specialists in esophageal cancer.

Our individual treatment concept for esophageal cancer.

The esophagus is a 30–40 cm long organ that runs through the neck, chest, and abdominal cavity, with a close positional relationship to the large blood vessels of the aorta, lungs, and heart. As the oesophagus and trachea are located directly next to each other, the trachea is closed by the epiglottis for safety when swallowing.

Due to its complex anatomy, the treatment of esophageal diseases is reserved for esophageal specialists and specialized centers, as it requires an interdisciplinary team of experts and state-of-the-art treatment methods. The treatment concept must be individually tailored to the patient’s life situation, tumor biology, and personal wishes.

Types of esophageal cancer

In the esophagus, esophageal specialists distinguish between three different types of malignant cancer (esophageal cancer).

Squamous cell carcinoma can affect all sections of the esophagus. It is usually caused by smoking, often in combination with alcohol, but can also be associated with viruses and therefore occur even in younger individuals.

Adenocarcinoma (AEG ) of the esophagogastric junction is often caused by tissue changes in the junction between the esophagus and stomach triggered by heartburn.

Esophageal specialists differentiate between:

AEG I (located in the esophagus)
AEG II (at the junction between esophagus and stomach)
AEG III (at the uppermost part of the stomach).

This tumor is also known as a “prosperity tumor”, as there may be a connection with a long-standing reflux disease (heartburn).

Gastrointestinal stromal tumors of the esophagus (GIST) are extremely rare, occur more frequently in the stomach and have a fairly good prognosis. Depending on the tumor’s size, location, and activity, esophageal specialists can determine optimal treatment strategies.

Illustration eines Tumors in der Speiseröhre

Symptoms of esophageal cancer

The typical symptoms of esophageal cancer are difficulty swallowing (dysphagia) and the so-called globus sensation (“lump in the throat”). Other symptoms may include coughing, hoarseness, aversion to meat, night sweats, and loss of appetite.
It is generally advisable to have any symptoms checked out by an esophageal specialist as soon as possible to prevent the cancer from spreading.

3D Illustration des menschlichen Verdauungssystems

Diagnostics

Esophageal specialists diagnose esophageal cancer through endoscopic endoscopy (gastroscopy), combined with endosonography, a special ultrasound of the esophageal wall, which is performed from the inside during the endoscopy. As part of this examination, a sample (biopsy) can be taken using micro forceps, which is then examined for benignity or malignancy.

PET Computertomographie in einem Krankenhaus

To complete the examination, esophageal specialists arrange for a computer tomography of the abdominal and thoracic cavities and, if necessary, a PET (positron emission tomography) scan. These advanced techniques, combined with tumor markers in the blood, provide valuable insights into the presence of malignant tumors and metastases, as well as monitoring therapy outcomes. Special tumor markers in the blood are used to monitor the progress and success of the therapy.

Treatment of esophageal cancer

If esophageal cancer is diagnosed, the extent of the tumor is decisive for the therapy. If there are no metastases in other organs, surgery is the best solution.

Entfernung eines Frühkarzinoms in der Speiseröhre

Early carcinomas

In very early stages, when the tumor is limited to the mucous membrane of the esophagus, it can be removed through the mouth using endoscopic procedures without incisions. This tumor size is usually only discovered by chance, as there are usually no symptoms such as difficulty swallowing or globus sensation.

Advanced carcinomas

If the tumor (whether squamous cell carcinoma or adenocarcinoma of the esophagogastric junction) has crossed the mucosal boundary, esophageal specialists choose from the following procedures:

The surgical procedure is tailored to you and your specific diagnosis. Gentle, state-of-the-art, minimally invasive and robot-assisted removal of the esophagus is used.

If the esophagus has to be partially or completely removed, it can be reconstructed and replaced by various other organs such as the stomach, small intestine or large intestine. This decision depends on your individual situation and is customized accordingly.

From a certain tumor size, experts achieve the best healing results with a multimodal, interdisciplinary concept. In this case, additional drug-based tumor therapy and/or radiotherapy is carried out before and after the operation.

If patients cannot undergo surgery due to their general condition and the presence of metastases, drug-based tumor therapy and/or radiotherapy are available – supplemented by endoscopic therapy.

Endoscopic therapy can be a complementary measure to maintain swallowing function and thus ensure quality of life.

Zusammenhalt des interdisziplinären Teams von Chirurg Dr. EMMANUEL

Your interdisciplinary treatment team

This type of treatment requires close cooperation between a wide range of specialist disciplines, such as oncology, radiology, endoscopy, radiotherapy and surgery. It is therefore only possible at centers. We have the necessary practical experience to carry out this difficult procedure.

Life after surgery

As a rule, no special rehabilitation is required after hospitalization.

We recommend that you have a nutritional consultation at our hospital. You will be able to enjoy all types of food and drink, albeit in smaller portions. Thanks to the latest surgical techniques, a very good quality of life can be achieved even after complete removal of the esophagus.

Upon discharge, you will receive an individualized aftercare pass from us, in which a regular review of the healing success (tumor aftercare) is carried out.

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Esophageal cancer