Oesophageal Cancer Treatment in Hyderabad

Overview

Understanding Oesophageal Cancer

Oesophageal cancer arises from the lining of the oesophagus (food pipe) and is primarily of two histological types: squamous cell carcinoma (SCC), which predominates in the mid and upper oesophagus and is strongly linked to tobacco and alcohol; and adenocarcinoma, which arises at the gastro-oesophageal junction (GOJ) or lower oesophagus and is associated with Barrett’s oesophagus and GERD. In India, SCC remains more common; adenocarcinoma rates are rising.

Oesophagectomy — surgical removal of the oesophagus — is the cornerstone of curative treatment for early to locally advanced oesophageal cancer. It is one of the most technically demanding operations in surgery, requiring expertise across chest and abdominal compartments. Modern minimally invasive approaches (thoracoscopic + laparoscopic) have reduced major complications and shortened recovery compared to open surgery.

Multimodal treatment is the standard: neoadjuvant chemoradiotherapy (carboplatin/paclitaxel + 41.4 Gy radiation — the CROSS protocol) improves R0 resection rates and survival, and is now routine for locally advanced SCC and adenocarcinoma. I work closely with oncology and radiation oncology teams to sequence treatment optimally.

At a Glance

Histological types: SCC (upper/mid) and adenocarcinoma (lower/GOJ)
Risk factors: SCC: tobacco, alcohol; Adenocarcinoma: GERD, Barrett’s, obesity
Key surgical procedure: Oesophagectomy — McKeown (3-hole), Ivor Lewis, transhiatal
Neoadjuvant therapy: CROSS protocol chemoradiotherapy — standard for T2+ disease
5-year survival (resected T2N0): ~55%; Stage III: 20–30%

Warning Signs

Recognising Oesophageal Cancer

Progressive dysphagia is the cardinal symptom — any difficulty swallowing that persists beyond 2–3 weeks must be investigated with endoscopy.

🍽️
Progressive Dysphagia

Difficulty swallowing solids first, then liquids — the hallmark symptom of oesophageal cancer.

⚖️
Weight Loss

Significant unintentional weight loss due to difficulty eating and tumour metabolism.

🔥
Heartburn / Regurgitation

Longstanding GERD symptoms that change in character or worsen should prompt endoscopy.

🩸
Haematemesis / Melaena

Bleeding from tumour ulceration — vomiting blood or black tarry stools.

😮
Hoarseness / Cough

Involvement of recurrent laryngeal nerve or tracheo-oesophageal involvement.

😣
Chest Pain

Retrosternal chest pain or discomfort, often misattributed to cardiac disease.

Our Approach

Surgical Treatment of Oesophageal Cancer

Oesophagectomy for cancer requires removal of the tumour-bearing oesophagus with adequate proximal and distal margins, along with regional lymphadenectomy. The stomach is used as the conduit to reconstruct continuity, fashioned into a gastric tube pulled up into the chest or neck. The choice of approach (McKeown 3-hole, Ivor Lewis, or transhiatal) depends on tumour location and surgeon preference.

Minimally invasive oesophagectomy (MIO) — using thoracoscopy and laparoscopy — has been shown in the TIME trial to reduce pulmonary complications, blood loss, and ICU stay compared to open surgery, while achieving equivalent oncological outcomes. I offer MIO as the preferred approach for eligible patients.

After the CROSS trial, neoadjuvant chemoradiotherapy (CRT) for all T2+ oesophageal cancers has become standard — approximately 30% of patients achieve a pathological complete response (pCR), with excellent long-term outcomes. For GOJ adenocarcinoma, perioperative chemotherapy (FLOT) is an alternative. My multidisciplinary team discusses every case to determine the optimal sequence.

Surgical Procedure
Minimally Invasive Oesophagectomy

Thoracoscopic and laparoscopic oesophagectomy — reducing complications while maintaining oncological rigour.

Learn more →

Why Choose Us

Expertise You Can Trust

Dr. Mohammed Imaduddin brings internationally trained surgical skills and a patient-first philosophy to every case.

500+
Complex Oncological Surgeries Performed
15+
Years in Surgical Oncology
3
International Training Centres (Hannover, Charité, AIIMS)
FACS
Fellow of the American College of Surgeons

Common Questions

Frequently Asked Questions

Questions I commonly hear from patients and families facing an oesophageal cancer diagnosis.

Is oesophagectomy a very risky operation?
Oesophagectomy is a major operation and was historically associated with high mortality. However, in high-volume specialist centres, mortality is now below 2–3%, and major complication rates have fallen substantially with minimally invasive techniques and enhanced recovery protocols. The most important complication is anastomotic leak (10–15%) — manageable with modern endoscopic and radiological techniques in most cases. Volume matters: outcomes at high-volume centres are significantly better than at low-volume centres.
Will I be able to eat normally after oesophagectomy?
Eating returns gradually. In the early post-operative period, a feeding jejunostomy provides nutrition. Oral liquids typically start on day 3–4 and soft solids by week 2–3. The main long-term dietary adjustment is eating small, frequent meals (6 times daily) due to the smaller gastric tube conduit. Most patients achieve a satisfactory quality of eating within 3–6 months, though they rarely return to pre-diagnosis meal sizes.
What is Barrett’s oesophagus and does it mean I will get cancer?
Barrett’s oesophagus is a condition where chronic acid reflux damages the lower oesophageal lining, replacing it with intestinal-type mucosa. It is a pre-malignant condition — the risk of progression to adenocarcinoma is about 0.5–1% per year. Not everyone with Barrett’s develops cancer, but regular endoscopic surveillance is essential. High-grade dysplasia can be treated endoscopically (radiofrequency ablation, endoscopic mucosal resection) before cancer develops.
What is the CROSS protocol?
The CROSS protocol (Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study) established neoadjuvant chemoradiotherapy (weekly carboplatin/paclitaxel for 5 weeks concurrent with 41.4 Gy radiotherapy) as the standard pre-operative treatment for locally advanced oesophageal and GOJ cancers. It demonstrated significantly improved R0 resection rates and overall survival compared to surgery alone — and approximately 30% of patients achieve a pathological complete response (the tumour is destroyed by CRT alone).
Can early oesophageal cancer be treated without surgery?
Early-stage oesophageal cancer (T1a — confined to the mucosa) can often be treated endoscopically with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), avoiding surgery entirely. T1b tumours (into the submucosa) carry a higher nodal risk and usually require surgical evaluation. It is important to have staging by endoscopic ultrasound (EUS) and CT to accurately determine depth of invasion before deciding on endoscopic vs surgical treatment.

Ready to Discuss Your Case?

Every cancer journey is different. I offer a detailed, unhurried consultation to help you understand your options and make informed decisions.

Book via WhatsApp
View Clinic Locations