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The prognosis for patients with carcinoma of the esophagus is dismal; by the time a patient presents with progressive dysphagia, the disease has usually advanced beyond the point where it is amenable to surgical therapy. Dysphagia and pain, with resultant poor nutritional status, cause great distress in the patient, and palliation is generally all that can be offered. Dr Bruckstein discusses the diagnosis and management of carcinoma of the esophagus.