The most common
types of esophageal cancer are squamous cell
carcinoma and adenocarcinoma, which develop in the
cells that line the wall of the esophagus. These
cancers may develop anywhere in the esophagus and
may appear as a narrowing (stricture) of the
esophagus, a lump, an abnormal flat area (plaque),
or an abnormal connection (fistula) between the
esophagus and the airways that supply the lungs.
Although doctors don't know all of the causes of
esophageal cancer, certain factors greatly increase
your risk. Among these are
alcohol abuse, and acid reflux, a condition that
occurs when stomach acids back up into the lower
part of your esophagus. Even mild chronic
heartburn- the kind of acid reflux you relieve with antacids
- can make you more prone to esophageal cancer. A
diet lacking in fruits, vegetables and certain
nutrients also increases your risk.
In the past, the
outlook for most people with esophageal cancer was
poor. But survival rates have improved, in part
because close monitoring of people with
esophagus - a serious, premalignant complication of acid reflux disease - can help detect cancer early,
when it's more likely to respond to treatment. Even
more encouraging is that diet and lifestyle changes
may significantly reduce your chances of ever
developing this type of cancer.
Signs and symptoms
It's unusual to have signs and symptoms of esophageal cancer in the
early stages of the disease. When cancer is more advanced, you may
Although this is the most common symptom of esophageal cancer, it
usually doesn't appear until a tumor has grown large enough to
narrow your esophagus to about half its normal width. At this point,
meat and bread may be nearly impossible to eat, and you may
unconsciously change your eating habits, chewing more slowly and
carefully, for example, or switching to softer foods. But in time,
you may even have trouble swallowing liquids.
unintentional weight loss.
As eating becomes more difficult, you may not consume enough
calories to maintain your weight. In addition, cancer in general can
cause weight loss and muscle wasting because it changes the way your
body metabolizes nutrients.
Pain in your
throat, in your mid-chest or between your shoulder blades.
Although not common, you sometimes might have pain when you swallow
or discomfort or burning behind your breastbone.
chronic cough and sometimes coughing of blood.
These symptoms usually don't appear until cancer is quite advanced.
Although your esophagus is essentially a hollow tube, its walls are
composed of a number of highly-specialized layers, including an inner
lining made up of thin, flat cells (squamous cells), a layer below the
inner lining (submucosa) that contains mucus-secreting glands, and a
thick band of muscle tissue.
When you eat or drink, a muscle in the upper part of your esophagus
(upper esophageal sphincter) relaxes, allowing food and liquid to enter.
Smooth muscles in the esophagus wall then move the food along in a
series of rhythmic contractions a process called peristalsis. It
usually takes four to 10 seconds for food to flow through your
Another ring of muscle, the lower esophageal sphincter, sits at the
junction where your esophagus and stomach connect. It opens to allow
food into your stomach and then clamps shut so that corrosive stomach
acids and digestive enzymes don't back up into the esophagus.
Cancer can occur almost anywhere along the length of the esophagus and
is classified according to the types of cells in which it originates:
or epidermoid carcinoma.
The most common esophageal cancer in black Americans, squamous cell
carcinoma develops in the flat squamous cells that line the
This arises in the glandular tissue in the lower part of the
esophagus nearest the stomach. Adenocarcinoma is more common in
white than in black poeple.
Although squamous cell and adenocarcinoma are the primary types of
esophageal cancer, other, rare forms of the disease sometimes occur.
These include sarcoma, lymphoma, small cell carcinoma and spindle
cell carcinoma. In addition, cancer that starts in the breast or
lung can spread (metastasize) through the bloodstream or lymph
system to the esophagus.
Healthy cells grow and divide in an orderly way. This process is
controlled by DNA the genetic material that contains the instructions
for every chemical process in your body. When DNA is damaged, changes
occur in these instructions. One result is that cells may begin to grow
out of control and eventually form a tumor a mass of malignant cells.
Although researchers don't know all the causes of esophageal cancer,
they have identified several factors that can damage DNA in your
esophagus. These factors include:
cell carcinomas result from chronic alcohol abuse. Long-term heavy
drinking irritates the lining of the esophagus, leading to
inflammation that eventually may cause malignant changes in the
Using tobacco in any form, including cigarettes, cigars, pipes and
chewing tobacco, increases the likelihood of developing esophageal
squamous cell carcinoma. The risk increases with long-term use and
rises dramatically for people who both smoke and drink.
Sometimes the lower esophageal sphincter relaxes abnormally or
weakens, allowing caustic stomach acids to back up into your
esophagus (esophageal reflux). The result is
heartburn a burning
chest discomfort that in severe cases may mimic the symptoms of a
heart attack. Occasional heartburn usually isn't serious, but
chronic acid reflux can lead to Barrett's esophagus, a condition in
which cells similar to the stomach's glandular cells develop in the
lower esophagus. These new cells are resistant to stomach acid, but
they also have a high potential for malignancy.
Each year, nearly 1 million children under age 5 accidentally drink
toxic household substances. Some of these chemicals, especially
drain cleaners that contain lye, burn the lining of the esophagus
and may contribute to esophageal cancer later in life.
Eating a diet low in fruits and vegetables appears to contribute to
esophageal cancer. Especially implicated are diets lacking in
vitamins A, C, B1 (riboflavin), the mineral selenium, and
beta-carotene a substance found especially in orange and yellow
fruits and vegetables that is converted into vitamin A in your body.
Weighing 20 to 30 pounds more than your ideal weight has been linked
to an increased risk of adenocarcinoma.
Sometimes esophageal cancer is associated with certain rare medical
In this disorder, food collects at the bottom of the esophagus, both
because the esophagus lacks normal peristalsis to move food along
and because the lower esophageal sphincter doesn't relax normally.
For reasons that aren't clear, having achalasia seems to increase
your risk of esophageal cancer.
These thin protrusions of tissue can appear anywhere in the
esophagus. Some webs cause no symptoms, but others can make
swallowing difficult. When other problems including anemia and
abnormalities of the tongue, fingernails and spleen occur in
conjunction with esophageal webs, the condition is called
Plummer-Vinson or Paterson-Kelly syndrome. People with this syndrome
are at risk of developing esophageal cancer.
This rare, inherited disorder causes excess skin to form on the
soles and palms. Close to half the people with tylosis eventually
develop esophageal cancer. A genetic defect appears to be
responsible for both tylosis and the associated cancer.
Heavy drinking and smoking are the two greatest risk factors for
esophageal squamous cell carcinoma. The risk increases substantially if
you drink as well as smoke. If you drink heavily every day for several
years, your risk of esophageal cancer is 18 times greater than it is for
someone who drinks in moderation or not at all. When you also smoke,
your risk nearly doubles.
Other risk factors for esophageal cancer include:
Your risk of developing esophageal cancer increases as you grow
older. Most people with the disease are between 45 and 70. The risk
is much less if you're under 40.
Men are three times as likely to develop esophageal cancer as women
Squamous esophageal cancer affects three times as many black
Americans as whites, whereas whites have much higher rates of
esophageal adenocarcinoma than do blacks. Although the reason for
this disparity isn't known, genetic factors may play a role.
If your diet is low in fruits and vegetables, or you're very
overweight, you're at increased risk of esophageal cancer. To help
protect your health, the American Cancer Society recommends eating
five or more servings of vegetables and fruits each day, using whole
grains such as brown rice and whole wheat instead of refined or
processed grains, and limiting red meat.
heartburn or Barrett's esophagus.
Both conditions, which occur when stomach acid backs up into your
esophagus, increase your risk of esophageal cancer.
When to seek medical advice
See your doctor if you have difficulty swallowing, a chronic cough or
unintended weight loss. Having these signs and symptoms doesn't mean you
have esophageal cancer. A number of other conditions can cause similar
problems, and your doctor can perform tests to help determine the cause.
Also seek treatment if you experience chronic
heartburn, which can cause
inflammation in your esophagus and increase your risk of esophageal
cancer. In many cases, you can control mild or moderate
changing your diet and using over-the-counter antacids. When these
measures aren't enough, your doctor may recommend stronger medications.
Signs and symptoms of gastroesophageal reflux include:
A sour taste and
the sense of food re-entering your mouth (regurgitation)
pain, especially after meals or at night when lying down
swallowing, often due to a spasm or stricture in your esophagus
wheezing, asthma, hoarseness or sore throat, often resulting from
acid reflux in your throat or windpipe
Screening and diagnosis
To help find the cause of your symptoms, your doctor will take a
complete medical history and perform a physical exam. You're also likely
to have a chest X-ray and other diagnostic tests, such as:
A diagnostic test often given to people who have difficulty
swallowing, a barium swallow uses a series of X-rays to examine the
esophagus. Before the test, you'll drink a thick liquid (barium)
that temporarily coats the lining of your esophagus so that the
lining shows up clearly on the X-rays. You may also have air blown
into your esophagus, to help push the barium against the esophagus
walls. Although a barium swallow can help diagnose cancer, it may
not show whether a tumor has spread beyond the esophagus. After the
test you can eat normally and resume your daily activities, although
you'll need to drink extra water to help flush the barium from your
system and prevent constipation. A barium swallow briefly exposes
you to ionizing radiation. The danger from this exposure is small
and doesn't appear to increase even if you have a number of X-rays.
Even so, care is taken to produce the best images with the lowest
amount of radiation and the fewest possible X-rays.
During this procedure, your doctor examines the inside of your
esophagus using an endoscope a thin, lighted tube with a tiny
camera on the end that sends images to a TV monitor. Your throat
will likely be sprayed with a topical anesthetic before you're asked
to swallow the tube, and you may also receive medication through
your veins (intravenously) to keep you relaxed and comfortable. The
endoscope allows your doctor to clearly see any masses in the wall
of your esophagus as well as to take a tissue sample (biopsy) if
abnormal cells are found. The samples are then sent to a laboratory
for analysis. Risks of the procedure include a reaction to the
medication and bleeding at a biopsy site. If your doctor needs to
make a wider opening (dilate) your esophagus because of a stricture
or narrowing, there's also a small risk of creating a hole in your
esophagus (esophageal perforation).
Screening tests check for a disease in its early stages, before you
develop symptoms. If you're at high risk of esophageal cancer,
especially if you have Barrett's esophagus or tylosis, you're likely to
have regular endoscopic examinations and biopsies. Many doctors
recommend having these tests every two to three years if you don't have
cell abnormalities (dysplasia). When cell abnormalities are present,
you'll usually need tests more often.
If cancer is diagnosed, you're likely to have more tests to determine
whether and where the cancer has spread (metastasized), a process known
as staging. This step is especially important because it helps your
doctor determine the best possible treatment. Esophageal cancers are
staged using the numbers 0 through IV. In general, the higher the number
the more advanced the cancer.
(carcinoma in situ).
These cancers, also called noninvasive or in situ (in one
place) cancers or high-grade dysplasia, don't have the ability to
spread to other parts of your body. Still, it's important to have
them followed closely or removed because they eventually may become
This cancer occurs only in the top layer of cells lining your
At this stage, the cancer has invaded deeper layers of your
esophagus lining and may have also spread to nearby lymph nodes.
The cancer has spread even more deeply into the wall of your
esophagus and to nearby tissues or lymph nodes.
At this stage, the cancer has spread to other parts of your body.
To help stage esophageal cancer, you may have one or more of these
In this procedure, which is similar to esophagoscopy, your doctor
uses an endoscope to examine your windpipe (trachea) and the air
passages leading to your lungs (bronchi) to determine whether cancer
has spread to these areas.
tomography (CT) scan.
This X-ray technique produces more detailed images of your internal
organs than do conventional X-ray studies. That's because a computer
translates information from X-rays into images of thin sections
(slices) of your body at different levels. CT scans can confirm the
location of a tumor within the esophagus and whether cancer has
spread to nearby lymph nodes or other organs. A CT scan exposes you
to more ionizing radiation than plain X-rays do and usually isn't
recommended if you're pregnant.
This procedure may prove to be more accurate than either CT scans or
upper endoscopy in determining how far an esophageal cancer has
spread into nearby tissues. During the test, a tiny ultrasound probe
is passed through an endoscope into your esophagus. The probe
produces very sensitive sound waves that penetrate deep into
tissues. A computer then translates the sound waves into close-up
images of your esophagus and nearby tissues. Your doctor can also
take biopsies of lymph nodes and other tissues during the procedure.
Endoscopic ultrasound uses sound waves rather than X-rays to create
images, and the risks of the procedure, such as bleeding or
perforation of the esophagus, are slight.
emission tomography (PET) scan.
During this test, your doctor injects a small amount of a
radioactive tracer typically a form of glucose into your body.
All tissues in your body absorb some of this tracer, but tumors
absorb greater amounts and appear brighter on the scan than healthy
tissue does. A PET scan exposes you to a small amount of radiation,
but because the radioactivity is short-lived, your overall exposure
As esophageal cancer advances, the tumor may block more and more of your
esophagus, making swallowing increasingly difficult. Eventually, some
people aren't able to swallow their own saliva. To help make swallowing
easier or reduce the size of the tumor, your doctor may stretch your
esophagus with a balloon-like device, vaporize the tumor with a laser,
or insert a stainless steel or plastic tube (stent) to hold your
Other complications of esophageal cancer include:
This occurs when a tumor creates a hole between your esophagus and
windpipe, leading to coughing and gagging when you swallow. A
tracheoesophageal fistula requires surgery or the use of a stent to
prevent food or liquid from your esophagus entering your windpipe
unintended weight loss.
About half the people with esophageal cancer experience severe
weight loss and weakness, usually because of cancer-caused changes
in metabolism or because swallowing is painful and difficult.
This is the most serious complication of esophageal cancer. Because
esophageal tumors are rarely discovered in the early stages, they
often have spread to nearby lymph nodes or to other parts of your
body, such as the lungs or liver, before they're diagnosed.
Treatment for esophageal cancer depends on the type, location and stage
of cancer as well as on your age, overall health and personal
preferences. Decisions about therapy can be particularly complicated
because various combinations of surgery, chemotherapy and radiation may
be more effective than any single treatment. When cancer is advanced,
choosing a treatment plan is a major decision, and it's important to
take time to evaluate your choices.
You may also want to consider seeking a second opinion. This can provide
additional information to help you feel more certain about the option
The goal of treatment is to eliminate the cancer completely. When that
isn't possible, the focus may be on preventing the tumor from growing or
causing more harm. In some cases, an approach called palliative care may
be best. Palliative care refers to treatment aimed not at removing or
slowing the disease, but at helping relieve symptoms and making you as
comfortable as possible.
Surgery is the most common treatment for esophageal cancer, either as a
therapy for the cancer itself or as a way to relieve symptoms,
especially difficult swallowing. It's also recommended if you
consistently have very abnormal cells (high-grade dysplasia) occurring
with Barrett's esophagus.
Depending on the nature of the cancer, the operation may be performed in
one of two ways:
Doctors generally recommend this approach for early-stage esophageal
cancer that doesn't involve your stomach. During the procedure, your
surgeon removes the portion of your esophagus that contains the
tumor along with nearby lymph nodes. The remaining esophagus is
reconnected to your stomach so you can still swallow. In some cases
the stomach is pulled up to the esophagus. In others, part of your
large intestine is used to replace the missing section of your
In this procedure, which is used for more advanced cancer, your
surgeon removes part of your esophagus, nearby lymph nodes and the
upper part of your stomach. The remainder of your stomach is then
pulled up and reattached to your esophagus. If necessary, part of
your colon is used to help join the two.
Surgery for esophageal cancer is complex and carries risks that include
infection, bleeding and leakage from the area where the remaining
esophagus is reattached. Hospitals where surgeons perform a large number
of esophagectomies have significantly lower mortality rates than do
hospitals where few esophagectomies are performed. If you're considering
this surgery, look for a hospital or medical center whose surgeons are
highly experienced in the procedure.
Using drugs to kill cancer cells is another option for treating
esophageal cancer. Chemotherapy medications, which can be injected into
a vein or taken by mouth, travel throughout your body, attacking cancer
cells that have spread beyond your esophagus. You usually receive a
combination of anticancer drugs given in cycles, with periods of
recovery alternating with periods of treatment.
Chemotherapy can help in several ways before surgery to shrink the
tumor, in combination with radiation when surgery isn't an option, or to
relieve symptoms in advanced cases of esophageal cancer.
Unfortunately, anticancer drugs affect normal cells as well as malignant
ones, especially fast-growing cells in your digestive tract and bone
marrow. For that reason, side effects including nausea and vomiting,
mouth sores, an increased chance of infection due to a shortage of white
blood cells, and fatigue are common. Not everyone experiences side
effects however, and there are now better ways to control them if you
do. Be sure to discuss any questions you may have about side effects
with your treatment team.
Radiation is usually most effective against esophageal cancer when used
in combination with chemotherapy, either before surgery or as the
primary treatment. It's also used to relieve pain and improve
swallowing. Most often, the radiation comes from a machine outside your
body (external beam radiation), but sometimes thin plastic tubes
containing radioactive material are implanted near the cancer cells in
your esophagus (brachytherapy). Your doctor may insert a plastic or
metal stent to keep your esophagus open during treatment.
You commonly receive radiation therapy five days a week for five to
seven weeks. The most common side effects are fatigue which generally
becomes more noticeable later in the course of treatment skin rash or
redness in the area being treated, loss of appetite, and mouth sores or
increased problems with swallowing.
These side effects generally aren't permanent, and most can be treated
or controlled. Long-term side effects are rare, but they can be serious
when they do occur and include inflammation or scarring in the lungs,
esophagus, heart or spinal cord.
This therapy is generally used to relieve pain and obstruction in the
esophagus, but it's also being studied as a treatment for early-stage
esophageal cancer. During the procedure, you receive an injection of a
light-sensitive drug that remains in cancer cells longer than it does in
healthy ones. A laser light is then directed at your esophagus through
an endoscope. This stimulates the production of an active form of oxygen
that destroys the cancer cells while sparing healthy tissue.
Photodynamic therapy isn't without side effects. It makes your skin and
eyes sensitive to light for at least six weeks after treatment, so
you'll need to wear protective clothing and sunglasses every time you go
outdoors. It can also make swallowing even more difficult for a short
period of time.
Areas of research
Scientists are continually seeking more effective and less harmful
treatments for esophageal cancer. Some areas of research include:
Researchers have identified many of the genetic changes that cause
healthy esophageal cells to become malignant. Understanding these
changes may eventually lead to gene therapies that help repair
Scientists are studying a range of chemotherapy options, including
new anticancer drugs such as tyrosine-kinase inhibitors. Protein
tyrosine kinases are substances that help regulate signals between
cells, especially those having to do with the cell growth and
mortality. Because abnormal signals from protein tyrosine kinases
have been linked to a number of different cancers, some researchers
have focused on finding ways to selectively inhibit these signals.
Also under investigation are new combinations of existing drugs and
different combinations of radiation and chemotherapy.
This therapy stimulates your immune system to fight cancer. One
approach uses monoclonal antibodies, which are produced by fusing
antibody-forming cells and tumor cells, to treat esophageal
Although it's not possible to prevent all cases of esophageal cancer,
the following lifestyle changes can greatly reduce your risk:
This may be the single most important thing you can do to prevent
esophageal cancer and improve your overall health. Cigarette smoke
contains carcinogens that can damage the DNA that regulates cell
Nearly three-fourths of esophageal squamous cell carcinomas and many
adenocarcinomas result from heavy alcohol consumption over a period
of years. Drinking in moderation or abstaining from alcohol can
greatly reduce your risk of this type of esophageal cancer.
Get help for
Don't ignore severe or frequent heartburn. Your doctor can recommend
medications and lifestyle changes that can help prevent gastric
reflux. Sometimes drugs that inhibit acid formation may provide the
relief you need. You may also be helped by avoiding acidic, spicy or
fatty foods, by waiting at least two to three hours after eating
before lying down or exercising, and by elevating the head of your
Eat a healthy
Eating more fruits and vegetables, especially those rich in
beta-carotene, and vitamins A, C and B-1, can help protect against
esophageal cancer. Look for deep green and dark yellow or orange
fruits and vegetables, such as Swiss chard, bok choy, spinach,
cantaloupe, mango, acorn or butternut squash, and sweet potatoes.
Also try to eat vegetables from the cabbage family, including
broccoli, brussels sprouts and cauliflower. Lycopene, a nutrient
found in tomatoes and other red fruits and vegetables, such as
strawberries and red bell peppers, may be a particularly powerful
anticancer chemical. Because diets low in selenium have been linked
to esophageal cancer, try to include foods rich in this mineral,
such as milk, broccoli, cabbage, fish and whole grains. Healthy
adults should ingest at least 55 micrograms (mcg) of selenium every
day. A slice of whole-wheat bread contains 10 mcgs.
Being significantly overweight (obese) increases your risk of
esophageal cancer as well as your risk of other serious health
problems, such as diabetes, cardiovascular disease and stroke. Slow
and steady weight loss of 1 or 2 pounds a week is considered the
safest way to lose weight and keep it off. In many cases, you can
lose weight by committing to eating a healthier diet, exercising and
changing unhealthy behaviors. Other treatments for obesity include
prescription medications and surgery.
Poor appetite, difficulty swallowing, weight loss and weakness are often
problems for people with esophageal cancer. These symptoms may be
compounded by cancer treatments and by the need for a liquid diet or
intravenous feeding during the course of your treatment as well as by
the emotional toll of living with the disease.
When you're able to eat more normally, your doctor may recommend talking
to a registered dietitian. He or she can help you find ways to get the
nourishment you need. These suggestions also may help:
Try eating several
small meals throughout the day instead of two or three larger ones.
If you are nauseous or have trouble swallowing, choose foods that
are soothing and easy-to-swallow, such as soups, yogurt or
Talk to your
doctor about vitamin and mineral supplements. If you haven't been
eating as much as you normally would or if your diet is restricted,
you're likely deficient in a variety of nutrients.
snacks within easy reach. That way, you're more likely to eat. Fresh
fruit and yogurt are good choices.
Learning you have any life-threatening illness can be devastating. But
coping with a diagnosis of esophageal cancer can be especially
difficult. The more advanced the disease when it's discovered, the less
likely the chance of real recovery. As a result, you may feel especially
overwhelmed just when you need to make crucial decisions. Although there
are no easy answers for people dealing with esophageal cancer, some of
the following suggestions may help:
Learn all you can about your illness.
Learn everything you can about esophageal cancer how the disease
progresses, your prognosis and your treatment options, including both
experimental and standard treatments and their side effects. Be sure you
understand whether a particular approach is used to treat cancer or
provide palliative care. Don't be afraid to seek a second opinion and to
explore treatments available through clinical trials. You'll have many
decisions to make in the weeks and months ahead. The more you know, the
more active a role you can take in the decision-making process.
Maintain a strong support system.
Strong relationships are crucial in dealing with life-threatening
illnesses. Although family and friends can be your best allies, in some
cases they may have trouble dealing with your illness. Or you may not
have a large social network. If so, the concern and understanding of a
counselor, medical social worker, pastoral or religious counselor, or
even a formal support group can be helpful. Although support groups
aren't for everyone, they can sometimes be a good resource for practical
information about your disease. You may also find strength and
encouragement in being with people who are facing the same challenges
If you're interested in learning more about support groups, talk to a
doctor, nurse, social worker or psychologist. They may be able to put
you in touch with a group in your area. Or check your local phone book,
library or cancer organization. The National Cancer Institute also can
provide a list of support groups. After deciding to participate in a
group, try it out a few times. If it doesn't seem useful or comfortable,
you don't have to continue.
Come to terms with your illness.
Coming to terms with your illness may be the hardest thing you've ever
done. For some people, having a strong faith or a sense of something
greater than themselves makes this process easier. Others seek
counseling from someone who understands life-threatening illnesses, such
as a medical social worker, psychologist or chaplain. Many people also
take steps to ensure that their end-of-life wishes are known and
Fears shared by many people with a life-threatening illness include
being subjected to treatments they don't want, becoming a burden to
their loved ones, and spending their last weeks or months in a hospital
away from familiar surroundings. The welcome news is that many more
choices now exist for people with a terminal illness.
Hospice care, for example, provides a special course of treatment to
terminally ill people. This allows family and friends with the aid of
nurses, social workers and trained volunteers to care for and comfort
a loved one at home or in hospice residences. It also provides
emotional, social and spiritual support for people who are ill and those
closest to them. Although most people under hospice care remain in their
own homes, the program is also available in other locations including
nursing homes and assisted living centers. For those who stay in a
hospital, palliative care specialists can provide comfort, compassionate
care and dignity.
Although it can be extremely difficult, discuss end-of-life issues with
your family and medical team. Part of this discussion will likely
involve advance directives a general term for oral and written
instructions you give concerning your medical care should you become
unable to speak for yourself.
Complementary and alternative medicine
More and more people are interested in nontraditional approaches to
healing, especially when standard treatments produce intolerable side
effects or aren't able to provide a cure. In general, alternative
medicine refers to therapies that may be used instead of conventional
treatments. Complementary or integrative medicine, on the other hand,
usually means therapies used in conjunction with traditional treatments.
Rather than simply addressing a problem with the body, complementary and
alternative treatments often focus on the entire person body, mind and
spirit. As a result, they can be especially effective at reducing
stress, alleviating the side effects of conventional treatments such as
chemotherapy and improving quality of life.
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