Surgery to remove as much of the tumour as possible. This is most appropriate if the cancer has not yet spread. Part or most of the oesophagus may need to be removed, or, if the cancer has begun to spread, part of nearby organs such as the top of the stomach.
Oesophageal cancer - everything you need to know
16th September 2022
Oesophageal cancer is the 8th most common cancer worldwide, and the 6th most common cause of cancer death around the world. Despite being so common, it is not as well-known as many other cancer types. So, what are the symptoms of oesophageal cancer? What different types of oesophageal cancer are there, and what increases your risk? Is there a cure for oesophageal cancer?
What is oesophageal cancer?
Oesophageal cancer is cancer that starts in the oesophagus, also called the gullet or food pipe, which connects the throat to the stomach. There are two main types of oesophageal cancer:
- Squamous cell carcinoma, which starts in the cells lining the oesophagus. Cancer in the upper or middle oesophagus is usually this type of cancer.
- Adenocarcinoma, which starts in glandular cells. It is linked to a pre-cancerous condition called Barrett’s oesophagus, and normally starts in the lower oesophagus where it joins the stomach.
Rarer types of oesophageal cancer include neuroendocrine cancer, small cell cancer, and soft tissue carcinoma. The seriousness of oesophageal cancer, regardless of where it is found, depends on how much the cancer has spread by the time it is found.
Over 600,000 people worldwide were diagnosed with oesophageal cancer in 2020
Over 540,000 people worldwide died from oesophageal cancer in 2020
Are oesophageal cancer and throat cancer the same?
Oesophageal cancer is a specific type of cancer, whereas throat cancer is a general term for cancers that start in the neck and throat area. Throat cancer does not refer to a specific list of different cancer types (it isn’t precise on what is meant by the ‘throat’) so it is not typically used by medical staff.
Cancers that may be referred to as throat cancer could include thyroid cancer, tracheal cancer (also called the wind pipe), cancers that start behind the nose or mouth, in the voicebox (larynx), and oesophageal cancer.
What are the early signs of oesophageal cancer?
Someone with oesophageal cancer may not notice any signs of a problem at first, but when symptoms first appear they are most likely to experience:
- Difficulty swallowing – This is the main symptom, and can relate to hard/solid foods at first, but softer foods too later on. This is also called dysphagia.
- Feeling & being sick
- Heartburn or acid reflux
- Symptoms similar to indigestion, such as burping a lot
Less common symptoms might include:
- A persistent cough
- Losing your voice
- Loss of appetite
- Unexpected weight loss
- Pain in your throat or chest, especially when swallowing
The symptoms can be similar to other conditions like acid reflux, so it’s important to speak to a doctor if your symptoms change or worsen.
Spotting cancer early is the best way to improve the chances of successful treatment. If any of the symptoms above are concerning you, speak to your GP.
What causes oesophageal cancer? What increases your risk?
There are several factors that we know can increase the likelihood of someone developing oesophageal cancer. These include:
- Smoking – It’s well known that smoking causes lung cancer, but according to recent data more than 203,000 risk-attributable oesophageal cancer deaths worldwide (i.e., deaths that were associated with a specific risk factor) were linked to smoking in 2019.
- Alcohol – Globally, approximately 114,000 oesophageal cancer deaths were linked to alcohol use, according to the same study.
- Obesity – A high BMI is another major risk factor, and was associated with almost 90,000 oesophageal cancer deaths worldwide in 2019.
- Age, especially for people aged over 75 years old.
- Sex – it is more common in males than females.
- Certain medical conditions, such as long term, severe acid reflux, and Barratt’s oesophagus.
There is some evidence that very hot drinks can increase your risk – if it feels too hot, better to let it cool down before drinking your tea or coffee
Does acid reflux cause oesophageal cancer?
Acid reflux in itself does not cause oesophageal cancer, and most people experience acid reflux and never develop oesophageal cancer.
However, long-term and severe acid reflux has been linked to the disease, as has a pre-cancerous condition called Barratt’s oesophagus.
How is oesophageal cancer detected?
The most commonly used method for testing for oesophageal cancer is a gastroscopy, where a camera is used to look inside the oesophagus and stomach.
Doctors may also collect a biopsy at this stage to test for cancer, or they may need to perform a small operation to look inside the stomach and oesophagus.
Where does oesophageal cancer spread to?
If undiagnosed or left untreated too long, oesophageal cancer can spread to other parts of the body. This can include nearby lymph nodes, the lungs, and (most commonly) the liver.
How advanced the cancer is will determine which treatment approach is most effective, and how likely it will be to stop or slow further spread of the cancer. Where it has spread will also affect the symptoms it may cause, and what can be done to relieve those symptoms.
Can oesophageal cancer be cured?
It is often possible to treat oesophageal cancer, but chances of a cure depend on how advanced the cancer is when it is diagnosed.
In the UK, 16% of people with oesophageal cancer survive at least 5 years after their diagnosis – this is quite low compared to some other cancer types, and is due in part to difficulty diagnosing and treating the disease.
If oesophageal cancer is diagnosed when it is still localised to one place, 62% of people will survive at least three years, but this drops to only 4.4% if it has already spread to other parts of the body.
That’s why it’s so important to speak to your doctor if you notice any of the signs or symptoms of oesophageal cancer – the sooner you are diagnosed, the better your chances of successful treatment.
How do you treat oesophageal cancer?
Chemotherapy, where different medicines are used to kill the cancer cells throughout the body. It may also be used before surgery, to reduce the size of the tumour, or after surgery to help prevent the cancer coming back. Chemotherapy can also be used to treat the symptoms of oesophageal cancer, or slow its growth or spread.
Radiotherapy, where focused radiation is used to kill cancer cells in one area. This is usually used if oesophageal cancer is caught early, often with chemotherapy (chemoradiotherapy).
Immunotherapy and other targeted medicines, that have been developed more recently, may be used to treat oesophageal cancer where appropriate. They may be able to prevent the cancer developing further, and may be options for patients who have not had success with other more common approaches like surgery or chemotherapy.
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How is Worldwide Cancer Research helping to find new cures for oesophageal cancer?
Your donations have helped Worldwide Cancer Research to fund projects like this on oesophageal cancer as far back as 1993, and we continue to support pioneering, cutting-edge research that seeks to discover new cancer cures.
In fact, we’ve funded over £1.6 million in research on oesophageal cancer and conditions like Barratt’s oesophagus, which can lead to oesophageal cancer.
Dr Denes Hnisz, at the Max Planck Institute for Molecular Genetics in Germany, is currently studying the 3D structure of the genome (the complete set of genes present in a cell) in cancer cells compared to healthy cells.
This will help them find new genes involved in the development of oesophageal cancer that we didn’t know about before.
Denes and his team hope that this might reveal new ways to target and treat oesophageal cancer, which will offer new hope to patients in the future.
The information contained in this article was accurate at the time of publication.