After an individual is diagnosed with esophageal cancer, doctors will try to figure out the stage and also if the cancer has spread to other parts of the body and to what extent.
The stage of the cancer helps to evaluate how serious the cancer is and helps to determine the best treatment plan.
While staging, lower the number, the less the cancer has spread. A higher number, such as Stage IV means cancer is at an advanced stage and has spread aggressively.
Most esophageal cancers start in the innermost lining of the esophagus and then gradually grow into deeper layers over time.
For Esophageal cancer, TNM staging system or the Tumor Node Metastasis system is a common and universal tool used to describe the stage of cancer for each individual.
- Tumor (T): It describes how deep the primary tumor has grown into the wall of esophagus and the surrounding tissue.
- Node (N): This helps to determine if the cancer has spread to lymph nodes. If yes, then where and how many?
- Metastasis (M): This specifies whether the cancer has spread to other parts of the body. If so, then to what extent and what part of the body.
Here’s a simplified version of the staging system for squamous cell carcinoma and adenocarcinoma.
- Stage 0: This is the onset stage, where cancer cells are located anywhere in the top lining of the esophagus. Thus, cancer at this stage has not started growing into the deeper layers yet.
- Stage I (stage 1 esophageal cancer): During esophageal cancer stage 1, the tumor is small, ~ around 7 cm or less, and is present in the top layers of the esophagus.
- Stage II (stage 2 esophageal cancer): Tumor is slightly big in size and has spread to the third layer of esophagus or outer layer of any part of esophagus. The cancer has also spread to 1 or 2 lymph nodes near the tumor.
- Stage III (stage 3 esophageal cancer): At this stage, cancer has spread beyond the esophagus and tumors may have spread to 3 to 6 lymph nodes. It has not spread to the distant organs, though.
- Stage IV (stage 4 esophageal cancer): During this advanced stage, the tumors may have any size and would have grown beyond esophagus. Also, at this stage, lymph nodes along with the distant organs like liver and abdomen are badly affected.
For the purpose of treatment, esophageal cancer is further classified into two types –
- Resectable (that can be removed by surgery)
- Unresectable (that cannot be operated)
Based on where the tumor is located and how far it has spread, it could be either removed surgically, or is considered unresectable.
As a rule, Stage 0, I, and II, esophageal cancers are potentially resectable. Most Stage III cancers, unless spread to windpipe or aorta are potentially resectable too, even when they have spread to the nearby lymph nodes.
But despite this staging, there are cases where performing surgery is impossible owing to the patient’s overall health parameters.
Esophageal cancer stage 4 life expectancy
For any esophageal cancer patient, survival depends on different factors. So no one, but only a cancer specialist can tell you exactly how long you will live.
However, various factors that affect the survival of patients with esophageal cancer depend on: type of cancer, how much it has spread and level of fitness as it helps to cope with the treatment.