COMPASSIONATE ALLOWANCE INFORMATION

ESOPHAGEAL CANCER

DESCRIPTION

Esophageal cancer originates from the lining of the esophagus and presents as either squamous cell carcinoma (cancer that begins in flat cells lining the esophagus) or adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). Esophageal cancer spreads extensively through the esophagus and often extends far beyond the edges of the primary tumor (distant metastases). The cancer generally presents as an obstruction to swallowing with complaints of difficulty swallowing.

ALTERNATE NAMES

Adenocarcinoma of the Esophagus, Squamous cell carcinoma of the Esophagus

DIAGNOSTIC TESTING AND CODING

The definitive test for esophageal cancer is esophagoscopy with visualization of the cancer and biopsy. Testing used to determine the causes of symptoms include a barium swallow (esophagram) generally done with a series of x-rays of the esophagus, esophagoscopy (also called endoscopy) testing that examines the inside of the esophagus using a thin lighted tube called an endoscope and a biopsy. Testing used to determine whether the cancer has spread includes a CT (CAT) scan of the chest, abdomen and pelvis, a PET scan, a bone scan and a bronchoscopy.

TREATMENT

Historically, treatment of esophageal cancer has been surgery. Recent multimodality therapy with radiation, chemotherapy and surgery has begun to play a major role in treatment.

PROGRESSION

The prognosis for esophageal cancer is not good regardless of the treatment employed. When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed. At later stages, esophageal cancer can be treated but rarely can be cured.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation: A pathology report from biopsy taken during esophagoscopy (also called esophagogastroduodenoscopy or EGD). The report will address the extent to surrounding structures, recurrence and/or metastases to, or beyond, the regional lymph nodes.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets Listing

13.16A

Esophageal Cancer meets Listing 13.16A

Medical Equals

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.

Last Updated: 9/10/08

Office of Disability Programs