Esophageal cancer therapy by stage. Radiofrequency ablation can treat Stage 1 esophageal cancer. Stage 3 and stage 4 esophageal carcinoma requires extensive surgery and radiotherapy. Chemotherapy can also affect esophageal cancer treatment success rate and prognosis. Esophageal cancer treatment is one of your expertise areas. Dr. Anton Titov, MD. Esophageal cancer treatment by surgery, whenever possible, is also one of the gold standards of treatment. Now more and more elderly people could be suitable for esophageal cancer surgery. What are the criteria for esophageal cancer surgical treatment. Dr. Anton Titov, MD. How do you choose patients for treatment of esophageal cancer? Dr. Michael Lanuti, MD. Esophageal cancer is often quite aggressive. We now have more tools to treat early stage esophageal cancer. Then cancer is just in the lining of the esophagus. It's not always with cancer surgery but with things like ablation of the mucosa of the esophagus. It's called radiofrequency ablation with the technology called BARRX. There's cryoablation. There is freezing ablation. You could do it in a lung, and you can do it in the esophagus. Radiofrequency ablation are for very early stage esophageal cancer lesions that are only in the lining of esophagus. Cancer cells have not penetrated the esophageal wall. And when there's no lymph nodes involved in esophageal cancer. And probably such esophageal cancer is found on screening rather than being a symptomatic esophageal cancer. That's correct. So esophageal cancer screening, or someone has a lot of reflux who got endoscopy done. And then there are the more bulky esophageal tumors. People come in and they are having trouble swallowing. Dr. Michael Lanuti, MD. Cryoablation technology is not really appropriate for patients with advanced esophageal cancer. Those esophageal cancer patients get worked up by a CT scan of the chest and the abdomen. They get usually a PET CT scan. You assess PET CT in these advanced esophageal cancer patients. Patients get upper endoscopy. Then they get something called esophageal ultrasound. Esophageal ultrasound determines how much the tumor penetrates into the esophageal wall. Dr. Anton Titov, MD. Surgery is the mainstay of therapy for esophageal cancer. Dr. Michael Lanuti, MD. But, frankly, surgical operation cannot cure people by itself. So we pretty much have to throw everything we have at them. We have to do chemotherapy, radiotherapy, and surgery. There's a sequence of how esophageal cancer therapy is done. Different hospitals do it differently. But we think that those three modalities of esophageal cancer therapy have the best chance for cure. Sometimes you speak about patients with esophageal cancer who are young or who are old. We now have a minimally invasive esophagectomy. And we can apply minimally invasive esophageal cancer treatment. It's still a big cancer surgery with a lot of stress on the body. We can treat esophageal cancer patients who are 80 years old or older. Dr. Anton Titov, MD. But we carefully select patients for esophageal cancer treatment.