What is the oesophagus?
The oesophagus is the muscular tube that passes from the back of the mouth to the stomach. It starts in the neck, passes through the chest and into the abdomen to meet the stomach. It job is to transport food, liquids and saliva to the stomach for digestion.
What is oesophageal cancer?
Oesophageal cancer is when the cells of the oesophagus become abnormal and start to grow in an uncontrolled fashion. There are 2 main types of oesophageal cancer;
- Squamous cell - from the cells of the upper part of the oesophagus. This type of oesophageal cancer is treated with a combination of chemotherapy and radiotherapy.
- Adenocarcinoma - from the cells of the lower oesophagus. In western countries, this type of oesophageal cancer is most common. Treatment usually includes surgery.
What are the symptoms of oesophageal cancer?
- Vomiting of coughing up blood
- Difficulty swallowing food or food getting stuck
- Weight loss
- Worsening acid reflux
- Black sticky stools
These symptoms can also be caused by conditions that are not oesophageal cancer. But if you have these symptoms, tell your doctor or nurse about them.
What are the tests for oesophageal cancer?
- Upper GI endoscopy - is an essential test to rule out oesophageal cancer and may be used to biopsy any abnormal lumps.
- CT scan - to assess the extent of any spread to the liver lungs or structures around the oesophagus
- PT scan - to see if there is any spread not detected on other tests
- Endoscopic ultrasound - sometimes used for small tumours to assess the depth and whether non-surgical endoscopic treatment is appropriate.
- Laparoscopy - used for some tumours to look for spread to the lining of the abdomen
What are the options to treat oesophageal cancer?
Treatment options depend on whether the tumour has spread, how many layers of the oesophagus it extends through, your fitness for radical surgery and chemotherapy and your own wishes.
Very early small tumours confined to the first layer of the oesophagus – these can be removed with an endoscopy or endoscopic mucosal resection)
Small shallow tumours which have not spread - surgery to remove the affected portion of oesophagus and re-join the oesophagus to the stomach.
Deeper tumours that have not spread - A combination of chemotherapy and radiotherapy, prior to surgery to remove the affected portion of the oesophagus.
Tumours which cannot be removed or those which have spread – chemotherapy and radiotherapy are used increase survival
What are the outcomes of treatment for oesophageal cancer (adenocarcinoma)?
Around 40% of people with oesophageal adenocarcinoma can undergo ‘curative’ treatment. Around 50% survive 3 years after surgery and 40% survive 5 years. In those who cancer has spread only 4% survive 5 years.