Patients with Barrett's esophagus are at increased risk of developing adenocarcinoma, a type of esophageal cancer.

Adenocarcinoma in Barrett's esophagus typically develops in a sequence of changes, from non-dysplastic (metaplastic) columnar epithelium, through low-grade and then high-grade dysplasia (precancerous change detected under the microscope), and finally invasive cancer. Very superficial esophageal cancers can be treated endoscopically in some cases. However, more advanced cases that have invaded deeper into the wall of the esophagus or spread to lymph nodes or other parts of the body may require surgery, chemotherapy, and/or radiation. Johns Hopkins offers treatment for esophageal cancer using a multidisciplinary team approach.

Esophageal cancer

What does esophageal cancer look like when it is removed surgically?

This specimen depicts a cancer at the area of the junction between the esophagus and stomach. It is a large, irregular mass. The objective of endoscopic surveillance in Barrett's esophagus is to detect these processes early on when there is a high probability for cure.

Adenocarcinoma 3

What does esophageal cancer look like under the microscope?

This is an example of esophageal adenocarcinoma, showing disorganized, atypical glands that are invading the wall of the esophagus. The muscle of the esophageal wall can be seen on the right side of the image.

How is esophageal cancer graded and staged?

"Grade" in esophageal adenocarcinoma refers to the degree to which the cancer forms recognizable glands. Low-grade (well differentiated) cancers have more recognizable gland formation compared to high-grade (poorly differentiated) cancers. High-grade cancers tend to behave more aggressively.

"Stage" refers to how far a cancer has spread, and this is subdivided into T, N, and M stages.

  • T Stage - refers to how far the cancer has spread into the wall of the esophagus and whether or not it has invaded any other surrounding structures. Higher T stage indicates greater local spread of the cancer.
  • N Stage - refers to lymph node involvement by the cancer. N0 indicates that no lymph nodes are involved. N1-N3 designations refer to how many lymph nodes are involved by cancer.
  • M Stage - M stage refers to spread of the cancer to distant sites (not in direct contact with the esophagus).

For more information on staging of esophageal cancer, click the button below.

Treatment of Esophageal Cancer

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