How do you treat esophageal cancer in a 21 year old?

Choices: Depends on location, extent, stage and associated illnesses. If complete surgical resection is possible, that is best! sometimes preop radiation is used. If not operable, oncologists will do their best with chemo and radiation.

Aggressively: Treatment depends upon stage and often includes multi-modality therapy (chemotherapy, radiation, and surgery). The therapies and the surgery can be challenging and therefore decisions need to incorporate the patient's preferences and their ability to tolerate the various treatments. In a 21 yo who is otherwise healthy, it seem reasonable to be aggressive with treatment.