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Oesophageal cancer at a glance

Oesophageal cancer is the ninth most common form of cancer in the UK. There are over 7,600 new cases each year.

Oesophageal cancer develops in cells that line the oesophagus (also known as the gullet or food pipe). It is the hollow tube that connects the throat with the stomach, and is part of the digestive system.

There are two main types of oesophageal cancer:

• Squamous cell carcinoma (SCC) develops in the cells that line the oesophagus
• Adenocarcinoma develops in the glandular cells

Click on the links below to find out more about oesophageal cancer:

• Risks and causes
• Signs and symptoms
• Detection
• Treatment

If you are a patient looking for information on oesophageal cancer, please visit our patient information website, Cancerhelp UK.

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Risks and causes

The following things affect a person's chances of developing oesophageal cancer:

Oesophageal cancer is most common in people over 50.

Oesophageal cancer is nearly twice as common in men than in women.

Smoking is a major risk factor for oesophageal cancer, particularly squamous cell carcinoma. This risk increases the longer a person smokes.

Heavy drinking increases the risk of oesophageal cancer. The combination of heavy drinking and smoking results in a particularly high risk of developing this type of cancer.

Diets that are poor in fruits and vegetables as well as some vitamins and minerals may increase the risk of oesophageal cancer.

Acid refulx is where the stomach acid flows back into the oesophagus. As a result, changes can occur in the cells that line the oesophagus, and there is some evidence that this can cause a very slight increase in cancer risk. Barrett's reflux is a long-term problem with reflux. A small proportion of people with BarrettÕs oesophagus go on to develop adenocarcinoma.

Obesity roughly doubles the risk of adenocarcinoma of the oesophagus. This may be because obese people are more likely to suffer from acid reflux.

Workers in some industries who are exposed to certain chemicals over long periods, such as soot, lye and diesel exhaust, are at increased risk.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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Signs and symptoms

Symptoms of oesophageal cancer include:

• difficulty in swallowing
• unexplained weight loss
• pain in the form of pressure, or a burning sensation, as the food goes down the oesophagus
• hoarseness or a chronic cough
• vomiting

These symptoms may well be due to reasons other than oesophageal cancer. However, people who notice any of these symptoms should see their doctor, as the cancer may be easier to treat if detected early.

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Detection

Initially a doctor will:

• ask questions about any previous medical problems, including those of family members
• ask questions about current symptoms
• carry out a pelvic examination (internal).

Further tests may then be ordered as a referral to a specialist, such as:

• Barium meal
• Endoscopy
  

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Treatment

Treatments for oesophageal cancer include:

About a third of patients with oesophageal cancer are able to undergo 'radical curative' surgery. This depends upon the size of the cancer, which part of the oesophagus it is in and whether they are fit enough to have this sort of operation.

Radiotherapy is sometimes given alone to treat oesophageal cancer or the symptoms that it causes. Radiotherapy is often combined with chemotherapy which is called chemoradiation. Chemoradiation is often used to treat squamous cell carcinomas (SCCs) in the upper third of the oesophagus.

Chemotherapy is sometimes given before surgery to increase the success rate of the operation.

There are several treatments which can relieve problems associated with oesophageal cancer, particularly with swallowing. If the cancer is blocking the inside of the oesophagus, expandable wire tubes called 'stents' can be put in place to open it up and make swallowing easier. .

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