Emerging Roles of Phytochemicals in the Pathobiology and Management of Esophageal Cancer

Esophageal cancer demonstrates varying epidemiology across the globe. Over the last 30 years, esophageal adenocarcinoma has overtaken esophageal squamous cell cancer as the most common histologic variety in the Western hemisphere. However, esophageal squamous cell cancer remains the predominant type in Asia. Despite an increase in our understanding of its pathophysiology, varying chemotherapeutic regimens have not made any significant impact on the survival of patients with this disease. These chemotherapeutic agents have potentially severe adverse effects which affect the patient adherence to the given treatment. As an alternative modality of the disease treatment, various phytochemicals have been studied as therapeutic and prophylactic entities for esophageal cancer. Most of these agents exert their effect using antioxidant and anti-inflammatory pathways. In this chapter, we discuss the roles of curcumin, flavonoids, and other agents in terms of the available data. As we move towards preventative care among the high-risk patients with conditions such as Barrett’s esophagus, supplementation of these phytochemicals may lead to halting and decrease in the progression towards malignancy. More robust studies are needed prior to recommending their widespread application; however, in the era of cost-effective medicine, introducing such options in the care of patients will have a significant impact in the long run. We also briefly discuss the current state of chemotherapeutic and immune therapeutic options for patients with esophageal cancer.