In 2015, around 9,200 people were diagnosed with oesophageal cancer in the UK and it’s the 13th most common cancer in adults.
The condition is more common in older people, with 40% of new cases occurring in people aged 75 or over and it’s very rare in people younger than 40 years old, it’s also more common in men than women.
Oesophageal cancer is a cancer affecting the long tube that carries food to the stomach and it can occur in any part of the oesophagus, including where it joins the stomach. It often manifests in tumours appearing in the oesophagus, which can begin to block the tube as they grow.
There are different types of oesophageal cancer and they are usually linked to where the cancer begins.
Cancers in the upper and middle part tend to be squamous cell carcinomas, which develop from cells that make up the inner lining of the oesophagus.
Cells in the lower part tend to be a type called adenocarcinoma, and these often start in gland cells. If it’s lower still, it is classified as a gastro oesophageal junction cancer.
Oesophageal cancer doesn’t typically have any symptoms at first, but as the cancer grows it can cause swallowing problems as it narrows the oesophagus, which can make it feel as though food is getting stuck, swallowing might also become uncomfortable or painful. You may also develop a persistent cough, loss of appetite and persistent vomiting, as well as stomach aches and heartburn.
It’s best to seek medical advice if you experience swallowing difficulties, heartburn on most days for three weeks or more, or any other unusual or persistent symptoms. Many of these symptoms can be caused by a variety of conditions so in many cases it won’t be cancer, but it is always good to get checked.
Oesophageal cancer is often caused through obesity, with 1 in 4 men and 1 in 10 women diagnosed with the disease having their diagnosis linked to obesity.
Smoking, excessive drinking and a diet lacking in fruit and vegetables are also preventable causes. However, age is also a major factor, whilst between 1 and 5 percent of people with Barett’s oesophagus will develop the cancer.
When you visit a GP with the symptoms you should be referred to a specialist for an endoscopy. This is a procedure which allows the specialist to examine your food pipe by inserting an endoscope, which is a long tube that lets the specialist see into your food pipe, down the throat so that they can diagnose the issue. The procedure will usually take between 15 minutes and an hour, and you may be given a local anaesthetic and a sedative for the duration.
If the doctors need to find out exactly where the cancer is so they can diagnose the stage your cancer has reached they may perform a CT scan, MRI or PET-CT scan or a Laparoscopy to pinpoint the location and whether it has spread.
A laparoscopy is a small operation that lasts about half an hour. The surgeon will make 2 or 3 small cuts around your abdomen and belly button and will insert a laparoscope, which is similar to an endoscope, into your tummy to see if they can find signs of the cancer on the lining of your abdomen or the surface layer of the organs in the abdomen.
Depending on where in the oesophagus the cancer is, you will be presented with different options for treatment.
If the cancer is caught at ‘stage 0’ then you will most likely be recommended an endoscopy to remove your oesophageal lining, unlike your diagnostic endoscopy, you’ll be asleep for this.
For other patients they will have surgery to remove the affected sections of the oesophagus. Chemotherapy or chemoradiotherapy, which is a combination of chemotherapy and radiotherapy, may also be used to help make the surgery more effective.