Esophageal Cancer

Proton therapy for esophageal cancer lowers the risk of side effects by delivering significantly less radiation to vital organs, including the heart, lungs, and spinal cord, compared to traditional radiation (x-ray/IMRT).

Proton Therapy for Esophageal Cancer Treatment

Esophageal cancer treatment depends on many things, including the stage of the cancer and the general health of the patient. Typically, a combination of modalities is used and can include radiation therapy, chemotherapy, and surgery. The precision of proton therapy allows physicians to deliver the prescribed radiation dose to the targeted area of the esophagus, while avoiding unnecessary radiation to surrounding healthy tissue and vitals organs.


Esophageal cancer occurs when cancer cells develop in the esophagus, the muscular, tube-like structure which connects the throat and the stomach.

There are two main types of esophageal cancer:

  • Squamous cell carcinoma develops within the epithelial cells making up the lining of the esophagus and can occur anywhere along its length, but is typically found in the upper and middle portions. It is commonly associated with the use of tobacco and alcohol.
  • Adenocarcinoma develops in the glandular structures within the esophagus that secrete mucus. It is associated with GERD (Gastro Esophageal Reflux Disease) and typically occurs in the lower portion of the esophagus or within a segment affected by Barrett’s Esophagus (a precancerous complication of chronic reflux). The proportion of esophageal cancer diagnoses classified as adenocarcinoma has increased in recent decades.

Esophageal cancer is far more common in men than women. Historically, it was most common in white people, but is now almost equally as common in Black people.


These are some of the most common symptoms associated with esophageal cancer. However, it’s important to note that many patients may not experience symptoms until the cancer is advanced.

  • Difficulty or pain when swallowing
  • Weight loss
  • Pain in the chest, behind the breastbone
  • Coughing
  • Hoarseness
  • Indigestion and heartburn


Imaging and other studies used for diagnosis and staging can include the following:

  • Esophagogastroduodenoscopy (EGD)
  • Endoscopic ultrasonography (EUS)
  • Computed tomography (CT) of the abdomen and chest with contrast
  • Pelvic CT scan with contrast if clinically indicated
  • Positron emission tomography (PET) scanning
  • Bronchoscopy
  • Laparoscopy and thoracoscopy
  • Barium swallow
  • Laboratory/Molecular Studies
  • Bloodwork
  • Biopsy
  • Tumor sample material tested for specific genes, proteins, and antibodies (ex – HER2 testing)


Esophageal cancer treatment options can include chemotherapy, surgery, radiation therapy, or a combination of these modalities. The stage of the cancer and general health of the patient will be factors in determining appropriate treatment.

The esophagus is located very close to many sensitive organs, like the heart, lungs, and spinal cord. This position makes it very challenging for physicians to deliver the prescribed dose of radiation needed to treat the cancerous cells, while minimizing harmful exposure to healthy tissue near the treatment site.

That’s why proton therapy can be an especially good option for treating esophageal cancer. Protons deposit the highest dose of radiation within the targeted tumor and then stop. Unlike traditional x-ray radiation therapy, this means there is no exit dose. Furthermore, Provision uses the most precise form of proton therapy available, pencil beam scanning (PBS). With PBS, physicians can conform the radiation precisely to the target area of the esophagus.

Clinical studies show that proton therapy is associated with reductions in post-operative complications and reduced hospital stays.1 Researchers also report that overall survival rates improve when esophageal cancer patients are treated with chemotherapy and radiation prior to having surgery.2

Nashville, TN

Our Cancer Care Experts are ready to help. Contact us to learn more about proton therapy for esophageal cancer treatment at our Nashville location.

Knoxville, TN

Our Cancer Care Experts are ready to help. Contact us to learn more about proton therapy for esophageal cancer treatment at our Knoxville location.

Sources & Studies

  1. Simone CB et al. Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasm: a systematic review. J Gastrointest Oncol. 2016 Aug;7(4):644-64.
  2. Shapiro J, van Lanschot J, Hulshof M, van Hagen P, van Berge Henegouwen MI, Wijnhoven BP et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for esophageal or junctional cancer (CROSS): long-term results of a randomized controlled trial. Lancet Oncol. 2015 Sep;16(9):1090-98.