Oesophageal cancer treatment and diagnosis

Oesophageal cancer is cancer that begins in any part of the oesophagus (lower, middle or upper).

There are two main types:

• Oesophageal adenocarcinoma – starts in the mucus glands of the oesophagus. It usually develops in the lower part of the oesophagusat the junction with the stomach
• Oesophageal squamous cell carcinoma – starts in the inner lining of the oesophagus. It often develops in the upper and middle part of the oesophagus

It isn’t clear what causes oesophageal cancer. But some things can increase your risk. These include:

• A high-fat diet low in fruit and vegetables
• Being exposed to certain chemicals over a long period
• Being overweight or obese
• Having another oesophagus condition such as Barrett’s oesophagus which usually causes lower oesophageal cancer
• Heavy drinking
• Smoking

It can be difficult to spot the first signs of oesophageal cancer. They may include:

• Feeling tired, or shortness of breath
• Indigestion or heart burn that doesn’t go away
• Nausea and vomiting related to eating
• Pain or difficulty swallowing
• Unexplained weight loss and losing your appetite

Having these symptoms doesn’t mean you have oesophageal cancer, but it’s best to get them checked by a doctor. The sooner your cancer is detected, the better the chances of treating it successfully.

After discussing your symptoms, your doctor will usually examine your abdomen. They may look for small swellings or signs of oesophageal cancer. You may be referred to a specialist for some of the following tests:

• Endoscopy – a camera test which looks at the oesophageal wall and enables biopsies to be taken
• EUS endoscopic ultrasound which looks at the oesophageal wall in more detail
• Scans including CT, MRI or PET-CT
• Blood tests, including nutritional elements (vitamins and minerals)

Treatment of oesophageal cancer depends on its location (upper, middle, lower) and how advanced the cancer is. Your specialist doctor will discuss options with you which may include surgery, radiotherapy and chemotherapy.

Radiotherapy kills cancer cells. It’s used in the early stages of cancer treatment or after it has started to spread. It can also be used to relieve pain and discomfort from cancer that has spread.

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Chemotherapy is medication that treats your cancer. The drugs kill cancer cells, preventing them from dividing and spreading further.

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