Symptoms and causes

What is it?

The oesophagus is a part of the digestive system that begins at the top end of the pharynx of the throat cavity and ends at the other end, by the stomach. At the bottom end of the oesophagus there is a sphincter that closes to prevent the stomach contents from coming up into the oesphagus (reflux).

Oesophageal cancer is a type of cancer of the oesophagus. It is usually an adenocarcinoma or squamous cell carcinoma of the oesophageal mucosa.

Possible causes

Smoking and excesive alcohol consumption remain one of the most common causes of oesophageal cancer. Other possible risk factors include:

Symptoms

Typical symptoms are trouble swallowing and pain. Trouble swallowing is recognisable because drinking is no problem, but hard and dry food are difficult to swallow when eating. If food cannot pass, it is often regurgitated or vomited back up

Other symptoms may include hoarseness and a chronic cough, weight loss, pain in the chest and vomiting blood.

Diagnosis and treatment

How is the diagnosis made?

Staging

Once the diagnosis of oesophageal cancer has been made, it is important to gain the best possible insight into the extent of the disease, particularly by determining the stage of the illness as correctly as possible. This information determines the choice of treatment and the prognosis.

Usually, there is a gradual growth with damage to part of the oesophageal wall and then the entire wall. When cancer cells become detached from the original tumour and penetrate deep enough to reach the blood and lymph vessels, they can escape and colonise glands. If a detached clump of cancer cells nest within another part of the body, the cancer is said to have spread or ‘metastasised’. Oesophageal cancer cells sometimes end up in other organs.

The stage is determined based on a globally used classification, the TNM classification (Tumor Nodus Metastasis classification), which looks at the degree to which the tumour has passed through the pancreas wall (T), whether or not the lymph nodes are affected (N) and whether or not it has metastasised (M).

Treatment

The treatment of oesophageal cancer is complex and entails a specialised team. The most commonly used treatments are oncological surgery, radiotherapy and chemotherapy. Clinical trials sometimes offer a solution and provide access to the very latest treatments.

Treatment centres and specialisations

Latest publication date: 21/01/2021