Esophageal cancer is a type of cancer that originates in the esophagus, which is the muscular tube that connects the throat to the stomach. The esophagus is responsible for transporting food and liquids from the mouth to the stomach for digestion. In Singapore, there are various treatment options available for esophageal cancer.
The actual treatment plan for esophageal cancer will depend on various factors including the stage of the cancer, the patient’s overall health, and individual preferences.
Surgery is the most common treatment option for localised esophageal cancer, ie for tumours that haven’t spread to distant parts of the body. The type of surgery performed depends on the location of the tumour, its size, and the stage of the cancer. Here are some surgical approaches used in the treatment of esophageal cancer:
Surgery for esophageal cancer is a major procedure that requires careful evaluation of the patient’s overall health and the extent of the cancer. Often, pre-surgery treatment, also known as neoadjuvant treatment, can be utilized to down-stage the cancer, decrease the size, and improve the outcomes of surgery. Neoadjuvant treatment involves the use of radiotherapy and/or chemotherapy.
Radiotherapy, also known as radiation therapy employs high doses of radiation to target and eliminate cancer cells. Here’s an overview of how radiation therapy is utilized in the treatment of esophageal cancer:
Radiation therapy for esophageal cancer is a highly targeted procedure, aiming to maximize the impact on cancer cells while minimizing harm to healthy surrounding tissue. The treatment plan is customized to the patient’s specific condition, including factors like the stage and location of the cancer, as well as the individual’s overall health.
Chemotherapy is a significant treatment approach for esophageal cancer, particularly in cases where the cancer has spread beyond its original site or when it’s part of a multimodal treatment plan. Chemotherapy involves using anti-cancer drugs to target and destroy cancer cells throughout the body. Here’s an overview of how chemotherapy is utilized in the treatment of esophageal cancer:
The specific chemotherapy drugs used and the treatment schedule depend on various factors, such as the cancer’s stage, the patient’s overall health, and any previous treatments received.
Targeted therapy is a significant advancement in the treatment of esophageal cancer, particularly for cases that involve specific genetic mutations or molecular characteristics. This approach involves using drugs that specifically target certain molecules or pathways involved in the growth and spread of cancer cells. Here’s an overview of how targeted therapy is employed in the treatment of esophageal cancer:
It’s important to note that targeted therapy is not suitable for all esophageal cancer cases. The decision to use targeted therapy depends on the results of molecular testing and the presence of relevant targets in the cancer cells.
Immunotherapy is an approved treatment of esophageal cancer, claimable under the Ministry of Health Cancer Drug List. It is approved for use in the adjuvant setting, following completion of neoadjuvant chemotherapy and radiation and surgery, or for the use in advanced esophageal cancer, that has spread to other organs.. This approach harnesses the body’s own immune system to recognize and fight cancer cells. Here’s an overview of how immunotherapy is employed in the treatment of esophageal cancer:
It’s important to note that not all patients with esophageal cancer will be candidates for immunotherapy, and its use often depends on factors such as the cancer’s molecular characteristics and the overall health of the patient.
Undergoing surgery for esophageal cancer can lead to several potential side effects. These side effects can vary depending on the extent of the surgery, the patient’s overall health, and individual factors. Here are some common side effects associated with esophageal cancer surgery:
Radiation therapy for esophageal cancer can lead to a range of side effects, as the treatment aims to target cancer cells while affecting some healthy tissue in the area. These side effects can vary in intensity and duration depending on factors such as the radiation dose, the treatment area, and the patient’s overall health. Here are some common side effects associated with radiation therapy for esophageal cancer:
Chemotherapy for esophageal cancer can lead to a variety of side effects, as the treatment involves using powerful drugs to target and destroy cancer cells. These side effects can vary in severity and duration depending on the specific chemotherapy drugs used, the treatment regimen, and the patient’s overall health. Here are some common side effects associated with chemotherapy for esophageal cancer:
Targeted therapy for esophageal cancer can bring about specific side effects, as this treatment approach focuses on targeting particular molecules involved in cancer growth. The severity and occurrence of these side effects can vary based on the specific targeted therapy drug used, the patient’s individual response, and their overall health. Here are some common side effects associated with targeted therapy for esophageal cancer:
Immunotherapy for esophageal cancer can lead to various side effects, as this treatment approach harnesses the immune system to target cancer cells. The occurrence and intensity of these side effects can differ based on the specific immunotherapy drug used, the patient’s individual response, and their overall health. Here are some common side effects associated with immunotherapy for esophageal cancer:
It is important to remember that esophageal cancer can be treated successfully if caught early. If you have any concerns about your esophagus health or notice any changes, do not hesitate to see a healthcare professional for evaluation.
If you suspect that you or your loved one have esophageal cancer, it is advisable to get the support you need. Early detection and diagnosis of esophageal cancer is key to treating the disease.
Regardless of what stage your esophageal cancer may be at, you should schedule an appointment to see an oncologist specialising in esophageal cancer as soon as possible. With the speed of developments in esophageal cancer diagnosis and treatment, novel emerging treatment options could be explored by your medical oncologist.
Our cancer specialists at OncoCare specialise in treating late stage and advanced stages of esophageal cancer, as well as earlier stages of the disease.
Senior Consultant, Medical Oncologist
MBBS (Singapore) – MRCP (United Kingdom)
Dr Thomas Soh is a Senior Consultant Medical Oncologist at OncoCare Cancer Centre. He is also an accredited medical practitioner by the Office of the Public Guardian, to assist patients with making a Lasting Power of Attorney (LPA).
He was previously Consultant at the Department of Haematology Oncology at National University Hospital(NUH) and Visiting Consultant at Ng Teng Fong General Hospital.
He graduated from National University of Singapore in 2003 and received his Membership of the Royal College of Physician (United Kingdom) in 2007. He later completed his advance specialist training in Medical Oncology in 2012.
He was heavily involved in both undergraduate and postgraduate education, and was core faculty for the both the Internal Medicine Residency program and the Oncology Senior Residency program in the National University Hospital from 2012 to 2016. He was recognised for his mentorship and a good teacher to junior doctors and medical students, with the Teaching Excellence Award in 2014, from National University Cancer Institute (NCIS), as well as the Best Tutor Award in 2015 for undergraduate teaching by the University Medical Cluster, NUH.
Dr Soh believes in the delivery of quality healthcare, and was the lead and co-lead in several healthcare improvement projects. He had received multiple awards for his involvement in the Clinical Practice Improvement Programmes that he had implemented in NUH. From 2013-2015, he contributed a leading role being the Honorary Secretary of the Executive Committee, Singapore Society of Oncology.
Dr Soh is actively involved in both research and education in cancer medicine. He had received funding for his work from the National Medical Research Council, Singapore, being awarded the Clinical Investigator Salary Support Program (CISSP) award 3 times. He had researched on drug response and toxicity in treating cancer, understanding how chemotherapy and targeted medications is absorbed and cleared in the body in relation to the pharmacokinetics and pharmacodynamics. He had published on genetic variants affecting chemotherapy in Asian breast cancer patients. His research publication in colorectal cancer involves working with cell free DNA, chemotherapy drugs Regorafenib, FOLFIRI regimen (irinotecan, 5-fluorouracil and folinic acid).
He was the principal investigator in several multi-centre gastrointestinal cancer clinical trials and his research work has lead to more than 10 publications in high impact medical and oncology journals. He was the Principal Investigator for studies of circulating tumour cells, and was also doing trials in hepatocellular cancer (hepatoma) with drugs such as Sorafenib, Lenvatinib, Carbozantinib. The colorectal cancer trials involved drugs such as Cetuximab (Erbitux) with FOLFOX (Oxaliplatin, 5-fluorouracil and folinic acid), FOLFIRI regimens, Aflibercept and Y90 (Therasphere). In advanced pancreatic cancer, he was principal investigator for studies using Gemcitabine, Masitinib, and Abraxane. These experiences stand him in good stead to care for cancer patients and he is recognised for his dedication and expertise in these areas.
Dr Soh’s subspecialty interest is in Gastrointestinal (oesophageal, gastric, colon and rectal cancer) and Hepatobiliary Cancer (liver, pancreas, bile duct and gallbladder cancers). He is also a cancer specialist who looks after patients with neuroendocrine cancers. He speaks fluent English, Mandarin, Malay, Bahasa as well as Hokkien and has looked after many Indonesian and Malay patients. He has looked after many international patients, including Vietnamese, Myanmar, Banglahdeshi and Cambodian patients as well, with the help of interpreters.
Senior Consultant, Medical Oncologist
MBBS (S’pore), Grad Dip (GRM), MRCP (UK), M Med (Internal Med)
Dr Angela Pang is a Senior Medical Oncologist at OncoCare Cancer Centre and also a visiting consultant at the National University Cancer Institute of Singapore (NCIS).
Prior to this, she was a Consultant with the Haematology-Oncology Department of National University Cancer Institute of Singapore (NCIS), National University Hospital (NUH) and Visiting Consultant at Ng Teng Fong General Hospital (NTFGH).
She had obtained her undergraduate degree from the School of Medicine, National University of Singapore (NUS). Thereafter, she obtained her postgraduate qualifications – Masters in Medicine (Internal Medicine) from NUS, and her Membership of the Royal College of Physicians (UK). Subsequently, she went on to complete her advanced specialist training in Medical Oncology in the National University Hospital (NUH), Singapore and was awarded the NCIS research scholarship for her Sarcoma research fellowship with Professor Robert G Maki in the Tisch Cancer Institute, Mount Sinai Hospital, New York.
With a specific interest in the optimisation of care in elderly cancer patients, Dr Pang further pursued a Graduate Diploma in Geriatric Medicine with the Yong Loo Lin School of Medicine (YLLSOM). In order to integrate her expertise in both geriatrics and oncology, she also trained in Geriatric Oncology with Dr Beatriz Korc and Dr Stuart Lichtman in the Memorial Sloan Kettering Cancer Center, New York.
Dr Pang’s main clinical interests are in breast cancer, bone/soft tissue sarcomas, gastrointestinal cancers and geriatric oncology. She was the co-lead for the Musculoskeletal oncology service in NCIS, and had set up of the multi-disciplinary Geriatric Oncology service in NCIS and NTFGH.
She was also a principal investigator for several international multi-centre cancer clinical trials and also a recipient of several grants. Her research work has been published in peer reviewed journals including the Journal of Clinical Oncology (JCO), Journal of American Society of Medicine (JAMA) Oncology, Nature Communications, Clinical Cancer Research, British Medical Journal (BMJ) GUT, Oncogene, Oncotarget and others.
She is a member of several professional bodies, including the American Society of Clinical Oncology (ASCO), European Society of Medical Oncology (ESMO), International Society of Geriatric Oncology (SIOG) and the Connective Tissue Oncology Society (CTOS).
Dr Pang was also actively involved in both undergraduate and post graduate educations at the YLLSOM and NUH respectively. She has been awarded for teaching excellence and was previously appointed as Assistant Professor for Faculty of Medicine, YLLSOM and had served as core faculty of the undergraduate education (Medical Oncology) and Senior Residency (Medical Oncology) of NUH.
Dr Pang is fluent in English, Mandarin and Hokkien. She is able to converse in simple Malay/Bahasa. She has taken care of patients from many regional and overseas regions including Malaysia, Indonesia, Vietnam, Myanmar, China, Bangladesh, Sri Lanka, India, Canada and Mongolia.
Sub-specialty oncology interest in breast cancer, bone/soft tissue sarcomas, gastrointestinal cancers and geriatric oncology.
Senior Consultant, Medical Oncologist
MBBCH, BAO (Ireland) – MRCP (United Kingdom) – FRCP (Edinburgh) – FRCP (Medical Oncology)
Dr Benjamin Chuah, Senior Consultant Medical Oncologist at OncoCare Cancer Centre, was previously Consultant in the Department of Haematology-Oncology, National Cancer Institute Singapore, National University Hospital.
Graduating in medicine from Trinity College Dublin in 1998 where he was awarded the Professor Prize in Physic (Surgery) and the Arthur Ball Prize (2nd Place), Dr Chuah returned to Singapore and obtained his Membership of the Royal College of Physicians of the United Kingdom in 2002.
Prior to entering private practice, Dr Benjamin Chuah (patients often address him as Dr Ben Chuah) was actively involved in both post-graduate teaching and research. He was the Director for Postgraduate Medical Education (Medical Oncology) and was a Core Faculty for the Residency Program (Internal Medicine). For his efforts, he was awarded the National University Hospital Postgraduate Teaching Excellence Award in 2011. He was also involved in clinical and translational research for many years and was the principal or co-investigator in international trials involving the use of novel and targeted therapy drugs for colorectal and pancreatic cancer. He was awarded the NUH Innovative Grant for research in warfarin pharmacogenomics and was also honoured with the inaugural Kobayashi Foundation Award for work done on serial changes in the expression of breast cancer-related proteins in response to neoadjuvant chemotherapy. His research work has lead to several 1st author publications in high impact medical and oncology journals including Gastroenterology, GUT and Annals of Oncology.
Dr Ben Chuah’s subspecialty interest is in Gastrointestinal Cancers including oesophageal, gastric, biliary tract, pancreatic, liver (hepatocellular carcinoma), neuroendocrine cancers and colorectal cancers. As a clinical cancer specialist and researcher, his research work includes small cell gallbladder cancer with paraneoplastic hyponatremia, exploring the lack of somatic mutations in VEGFR-2 tyrosine kinase domain in hepatocellular carcinoma, renal cell carcinoma (kidney cancer) with bony metastases and use of the chemotherapy drug, docetaxel (Taxotere) with or without ketoconazole in breast cancer. He has published on screening in colorectal cancer and was involved in a randomized, phase 2 study of ganitumab or conatumumab in combination with FOLFIRI (5-FU, leucovorin, irinotecan) for second-line treatment of mutant KRAS metastatic colorectal cancer.
He was the Director of Post Graduate Medical Education (Medical Oncology) and Core Faculty for the Residency Program (internal Medicine) at National University Hospital.
Senior Consultant, Medical Oncologist
MBBS (Singapore) – M.Med (Singapore) – MRCP (United Kingdom) – FAMS (Medical Oncology) – MHsc (Duke, USA)
Dr Wong Nan Soon is a Senior Consultant Medical Oncologist with more than 15 years of experience in the diagnosis and management of a wide range of cancers.
His subspecialty interests are in the field of breast cancer and gastrointestinal cancers (which include colon cancer, rectal cancer, anal cancer, biliary cancer, pancreatic cancer, liver cancer, GI stromal cancers (GIST) and neuroendocrine cancers.
In addition, he is also well versed in the treatment of a wide variety of cancers which include uterine cancer, cervical cancer and ovarian cancers.
He graduated from the Faculty of Medicine, National University of Singapore in 1994 and obtained the degrees of Master’s in Internal Medicine and Membership of the Royal College of Physicians of the United Kingdom in 2000.
In 2003, he completed advanced specialty training in general medical oncology.
This was followed by a 1 year clinical fellowship sub-specializing in breast medical oncology in Sunnybrook and Women’s Health Science Centre, Toronto, Canada where he trained under world renowned breast oncologists including Professor Kathleen Pritchard.
He was promoted to the position of consultant in 2006 and subsequently rose to the position of senior consultant and chief of breast team in the department of medical oncology, National Cancer Centre Singapore in 2009.
In 2009, he was awarded the prestigious Singapore National Medical Research Council overseas research fellowship to develop expertise in phase I clinical trials at Duke University, North Carolina, USA. During this year, he broadened his subspecialty interest to encompass gastrointestinal cancers, training under Professor Herbert Hurwitz. He also underwent further training in biostatistics and clinical research methodology, graduating with a master’s degree in health science research.
With this knowledge and experience in novel drug combinations, he is able to offer cutting edge medical treatment for both early stage cancers and also drug resistant difficult to treat advanced cancers.
Faculty and lecturer at numerous national and international oncology conferences
Senior Consultant, Medical Oncologist
MBBS (Delhi) – American Board Certified (Int Med) – American Board Certified (Hematology) –
American Board Certified (Med Oncology)
Before joining OncoCare Cancer Centre at Mount Elizabeth Hospital, Singapore, Dr Akhil Chopra was a Senior Consultant in Medical Oncology at Johns Hopkins Singapore, Tan Tock Seng Hospital and Adjunct Associate Professor at Lee Kong Chian School of Medicine.
Dr Chopra completed his medical school training from Delhi University, India in 2001. He is American Board Certified in Internal Medicine, Hematology and Medical Oncology. He completed his fellowship training in Hematology and Medical Oncology from Hahnemann University Hospital/Drexel University College of Medicine in Philadelphia, USA.
As a result of his comprehensive training in the USA in Internal Medicine, Hematology and Medical Oncology and his most professional appointment as a Senior Consultant in Johns Hopkins Singapore and Tan Tock Seng Hospital, Dr Chopra is vastly experienced in treating multiple cancer types including lung cancer, breast cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and the bladder, gynaecological cancers such as ovarian and uterine/cervical cancers; as well as lymphomas and chronic leukaemia’s/multiple myeloma. He also has experience in treating more rare cancers like sarcoma and neuroendocrine tumors. However, Dr Chopra does not manage patients suffering from acute leukaemias or perform bone marrow transplants and would refer these patients to his colleagues as appropriate.
As a senior specialist in cancer medicine, he has a wide experience managing cancer patients from various countries such as India, United Arab Emirates and other middle-eastern countries, USA, European countries as well as Asian nations including Bangladesh, Vietnam, Myanmar, Cambodia, Malaysia and Indonesia with help of interpreters.
During his time at his previous institution, Dr Chopra was actively involved as principal and co-investigator in several industry sponsored as well as investigator-initiated clinical trials in different cancer types. Dr Chopra has a special interest in use of immunotherapy to treat cancers and has been a principal investigator for several clinical trials using immunotherapy agents in multiple tumour types. Dr Chopra is one of the authors in a clinical trial involving multiple regional cancer centres in liver cancer (hepatocellular cancer). This trial published in the reputable journal, Lancet, involves the early use of nivolumab, a programmed cell death protein-1 (PD-1) immune checkpoint inhibitor, in patients with advanced hepatocellular carcinoma with or without chronic viral hepatitis (CheckMate 040 trial). He is also a co-author in an important publication in Journal of Clinical Oncology examining the role of nivolumab in advanced nasopharyngeal carcinoma, a common cancer in south-east Asia. He has several other publications covering his research work in the treatment of lung, prostate and kidney cancer.
Besides his clinical and research work, he has been involved in teaching medicals students from the Lee Kong Chian School of Medicine as well as medical residents and students from Johns Hopkins University, Baltimore in USA. Dr Chopra was the Program Director for the National Health Care Group Medical Oncology training program from its inception in 2012 till April 2017. His work as a clinician and researcher has been covered by national media including the Straits Times and Channel News Asia.
On a personal note- Dr Chopra is married with 2 young girls. His hobbies include a passion for aviation and playing golf.
Dr Chopra is fluent in English and Hindi and can understand spoken Punjabi.
Special interest in treating multiple cancer types including lung cancer, breast cancer, cancers of stomach, colon, rectum, liver, prostate, kidney, testicular and the bladder, gynaecological cancers such as ovarian and uterine/cervical cancers; as well as lymphomas and chronic leukaemia’s/multiple myeloma.
Esophageal cancer is a type of cancer that originates in the esophagus, which is a muscular tube that connects the throat (pharynx) to the stomach. The esophagus plays a crucial role in the process of swallowing, by transporting food and liquids from the mouth to the stomach for digestion.
Esophageal cancer typically develops from the cells that line the inner surface of the esophagus. There are two main types of esophageal cancer:
Early detection and timely treatment are important for improving the prognosis and outcomes for individuals with esophageal cancer. It’s advisable for individuals at risk or experiencing symptoms to seek medical attention for proper evaluation and diagnosis.
Esophageal cancer is the eighth most common cancer worldwide. The two main histological types of esophageal cancer, adenocarcinoma and squamous cell carcinoma, have different prevalence patterns. Adenocarcinoma is more common in Western countries, while squamous cell carcinoma is more prevalent in areas with high rates of tobacco and alcohol consumption.
In Singapore, esophageal cancer is less common compared to some other parts of the world. The National Registry of Diseases Office (NRDO) in Singapore reported that esophageal cancer accounted for about 2% of all cancer cases in Singapore in 2018.
Esophageal cancer is often diagnosed at an advanced stage in Singapore, which can impact treatment options and outcomes. The incidence rate and mortality rate for esophageal cancer in Singapore might be influenced by factors such as lifestyle and genetics.
Signs and symptoms of esophageal cancer can vary, and some individuals may not experience any symptoms in the early stages.
It’s important to note that these symptoms can also be caused by other conditions, and experiencing one or more of these symptoms doesn’t necessarily mean a person has esophageal cancer. However, if you or someone you know is experiencing persistent or worsening symptoms, especially difficulty swallowing or unintended weight loss, it’s important to consult a healthcare professional for proper evaluation and diagnosis. Early detection and treatment can significantly impact outcomes for esophageal cancer.
Screening for esophageal cancer is typically recommended for individuals who are at a higher risk due to certain risk factors, such as a family history of the disease or certain medical conditions.
It’s important to emphasize that decisions about screening should be made in consultation with a healthcare provider. They can assess your individual risk factors, medical history, and symptoms to determine whether screening is appropriate for you.
Esophageal cancer is diagnosed through a combination of medical history assessment, physical examination, imaging tests, and tissue sampling. The diagnostic process is aimed at confirming the presence of cancer, determining the stage of the disease, and guiding treatment decisions. Here’s an overview of how esophageal cancer is diagnosed:
Diagnosing esophageal cancer involves a multidisciplinary approach, with input from various healthcare professionals such as gastroenterologists, oncologists, radiologists, and pathologists. It’s important to have open and thorough discussions with the medical team throughout the diagnostic process to ensure you understand your diagnosis, its stage, and the recommended treatment options.
The development of esophageal cancer is influenced by a combination of genetic, lifestyle, and environmental factors. While the exact causes of esophageal cancer are not always fully understood, certain risk factors have been identified that increase the likelihood of developing the disease. Here are some common causes and risk factors associated with esophageal cancer:
It’s important to note that having one or more risk factors doesn’t guarantee the development of esophageal cancer, and some individuals without these risk factors might still develop the disease. Reducing modifiable risk factors like tobacco use, excessive alcohol consumption, and maintaining a healthy diet can help lower the risk.
Esophageal cancer can be categorized into two main types based on the specific cells that become cancerous within the esophagus. These types are defined by their histological characteristics and can have different risk factors, locations within the esophagus, and treatment approaches. The two primary types of esophageal cancer are:
Less common types of esophageal cancer include:
The distinction between adenocarcinoma and squamous cell carcinoma is important because they have different risk factors, presentations, and potential treatment approaches. Proper diagnosis and determination of the specific type of esophageal cancer are crucial for guiding the most effective treatment plan.
Esophageal cancer staging is a system used to describe the extent of the cancer’s spread within the body. Staging helps determine the best treatment approach and provides insight into the prognosis. The most used staging system for esophageal cancer is the TNM system, which stands for Tumour, Node, and Metastasis. This system classifies the cancer based on the size of the tumour, the involvement of nearby lymph nodes, and whether the cancer has spread to distant parts of the body. The stages are typically numbered from 0 to IV, with subcategories indicating the extent of each factor. Here’s an overview of the general stages:
Abnormal cells are found only in the innermost layer of the esophagus lining and have not invaded deeper layers.
The cancer is limited to the inner layers of the esophagus and might involve nearby lymph nodes. It has not spread to distant parts of the body.
The cancer has grown into deeper layers of the esophagus or nearby tissues, and lymph nodes may be involved. It still hasn’t spread to distant parts of the body.
The cancer has invaded nearby structures, such as the trachea, bronchi, aorta, or heart. It may have spread to nearby lymph nodes.
The cancer has spread to distant parts of the body, such as the lungs, liver, bones, or other organs. Stage IV is further divided into IVA and IVB, based on the extent of the spread.
Staging might also include additional factors such as the location of lymph node involvement, the number of affected lymph nodes, and specific characteristics of the tumour.
Site Map | PDPA | Terms of Use | Disclaimer |
Contact Us | Career | Media Contact
