Condition Guide

Esophageal cancer surgery
Minimally invasive esophagectomy — Canada’s first published series

Esophageal cancer starts in the esophagus, the tube that carries food from your throat to your stomach. Dr. Irshad treats it with minimally invasive esophagectomy — keyhole surgery to remove the cancer — and published Canada’s first series of this operation. Keyhole techniques can mean less pain and a smoother recovery than traditional open surgery.

Esophagectomy

Procedure

7–10 days

Hospital stay

Keyhole

Minimally invasive

First in Canada

Published series

What is esophageal cancer?

It develops when cells in the lining of the esophagus grow out of control, which can make swallowing harder over time. Treatment often combines surgery with chemotherapy, and sometimes radiation, planned together by a team of specialists.

Signs & symptoms

Trouble or pain when swallowing
A feeling that food is stuck
Unplanned weight loss
Ongoing heartburn or reflux
Hoarseness or a lasting cough
Tiredness caused by low blood counts

See your doctor if swallowing is getting harder, food feels stuck, or you’re losing weight without trying — these should always be checked promptly.

How it’s diagnosed

Upper endoscopy with biopsy to confirm the diagnosis
CT and PET scans to check for spread
Endoscopic ultrasound to judge how deep it goes
Sometimes a staging laparoscopy

Treatment options

Chemotherapy (and sometimes radiation) before surgery for many stage II–III cancers
Minimally invasive esophagectomy to remove the cancer
Reshaping the stomach into a tube to replace the esophagus
Coordinated oncology follow-up

Know your risk

Long-term reflux and Barrett’s esophagus

Years of acid reflux (GERD) can change the lining of the lower esophagus into a condition called Barrett’s esophagus, which slightly raises the risk of esophageal cancer over time. Other risk factors include smoking, heavy alcohol use, and being overweight. If you have frequent, long-standing reflux, ask your doctor whether you should have an endoscopy — finding changes early makes them much easier to treat.

Dr. Irshad’s approach

Minimally invasive esophagectomy

Removing the esophagus is one of the most complex operations in surgery. Dr. Irshad performs it using laparoscopic and thoracoscopic keyhole techniques — he published Canada’s first series in 2009 — to achieve strong cancer outcomes while easing the toll of open surgery.

The stomach is gently reshaped into a tube and brought up into the chest to restore swallowing. Most patients adapt well and eat near-normally within a few months.

Your recovery, step by step

Before surgery

Prehab matters: good nutrition, stopping smoking, and daily breathing exercises help you come through this big operation and recover faster.

Hospital

Usually 7–10 days — an overnight in intensive care, then the step-down ward.

Weeks 1–3

Liquid diet moving to soft foods, with nutrition support as needed.

Weeks 4–6

Gradual return to normal foods; fatigue keeps improving.

3 months

Most patients eat near-normally and resume light activities.

Download recovery guide (PDF)A printable guide to take home.

Common questions

What are the stages of esophageal cancer?

Staging describes how deep the cancer is and how far it has spread, which guides treatment. In simple terms: Stage 1 — only in the inner layers of the esophagus wall; very early cancers can sometimes be removed through an endoscope, others with surgery. Stage 2 — deeper into the wall or into a nearby lymph node; usually chemotherapy (sometimes with radiation) followed by surgery. Stage 3 — through the wall and/or into more lymph nodes; usually chemotherapy or chemo-radiation before surgery. Stage 4 — spread to distant parts of the body; treated mainly with medicines and radiation. Your exact stage is confirmed with endoscopy and biopsy, endoscopic ultrasound, and CT/PET scans.

Will I need chemotherapy or radiation before surgery?

For most stage II–III esophageal cancers, chemotherapy before surgery is standard and has been shown to improve survival. Dr. Irshad works closely with oncology teams to coordinate your care.

How will I eat after an esophagectomy?

Your stomach is reshaped into a tube and brought up into the chest to replace the esophagus. Most patients adapt well and eat near-normally within a few months, though small, frequent meals are often best long term.

Is William Osler equipped for this level of surgery?

Yes. Brampton Civic Hospital has the specialized nursing, intensive care and support teams needed for complex esophageal surgery. Dr. Irshad has performed this operation here since publishing Canada’s first series in 2009.

Preparing for your surgery at William Osler

Your operation takes place at William Osler Health System (Brampton Civic Hospital). These are the hospital’s general instructions for getting ready, the day itself, and afterwards — always follow any specific advice Dr. Irshad gives you. Full details are on the Osler Surgical Services page.

Before your surgery

Do not eat anything (including gum) after midnight the night before. Unless told otherwise, you may have clear fluids — water, pulp-free juice, black coffee or tea — up to 2 hours before.
No alcohol, smoking, or marijuana for 24 hours before surgery.
Shower the evening before and the morning of surgery (with chlorhexidine soap if you have it). Skip lotion, perfume, makeup and nail polish.
Bring your OHIP card and photo ID, all your medications in their original containers (inhalers, insulin, supplements), and your CPAP machine if you use one.
Arrange a responsible adult to drive you home — a taxi, Uber or Lyft does not count, and surgery may be cancelled without one.
Leave jewellery, money and valuables at home.

The day of your surgery

Arrive about 2 hours before your scheduled time. Register at the central registration desk in the main lobby at Brampton Civic Hospital (2100 Bovaird Drive East), then go to the Day Surgery area. Staff will help you change, check your vitals, confirm the details from your pre-anaesthesia visit, and start an IV before you go to the operating room. Your family member can wait in the surgery waiting area.

After your surgery

You’ll wake up in the Post-Anaesthesia Care Unit, then move to Day Surgery or an inpatient room (or the Intensive Care Unit if you need closer monitoring). For the first 24 hours after the anaesthetic, have an adult with you, do not drive or operate machinery, avoid alcohol, and hold off on big decisions. A follow-up appointment is booked before you leave. Learn more about discharge and pain management.

The pre-anaesthesia clinic

Before your operation you’ll get a call from the pre-anaesthesia clinic for an education call or an in-person visit, where the team reviews your health, your medications and your anaesthetic plan.

Medically reviewed by Dr. Kashif Irshad, MD, MSc, FRCSC · Last updated July 2026

A referral from your family doctor or specialist is all that’s needed to be seen by Dr. Irshad. Find the referral forms and clinic details below.

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Esophageal cancer surgeryMinimally invasive esophagectomy — Canada’s first published series