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  • Oesophageal cancer

Introduction

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Oesophageal cancer

Learn more about the types of oesophageal cancer and potential treatment options.

What is oesophageal cancer?

What is oesophageal cancer?

The oesophagus is part of the digestive system. It carries food from the mouth to the stomach.1 Oesophageal cancer is not common.1 

In developed countries like Australia, the majority of oesophageal cancers start in the lower part of the oesophagus, where it meets the stomach.2 

Oesophageal cancer occurs when abnormal cells in the oesophagus grow in an uncontrolled way.1,2

There are two main types of oesophageal cancer:1,2

  1. Adenocarcinoma of the oesophagus - Usually starts in the lower part of the oesophagus or near where your oesophagus joins up with your stomach. Doctors refer to this as the gastro-esophageal junction, and most tumours in this area are adenocarcinomas.
  2. Squamous cell carcinoma of the oesophagus - Mostly found in the upper or middle part of the oesophagus and starts in cells that line the oesophagus.

Oesophageal cancer may not cause symptoms in the early stages.2 Symptoms may include:1,2

  • Difficulty swallowing
  • Feeling like you are choking when swallowing food or drink
  • Heartburn or reflux that won’t go away
  • Unexplained weight loss
  • Unexplained fatigue
  • Black or bloody stools
  • Vomit with blood in it
  • Discomfort in the upper abdomen, mainly when eating

The above symptoms may be related to other conditions and don’t mean you have oesophageal cancer. It’s recommended to speak with your GP or specialist for further information.1,2

There is no clear reason for oesophageal cancer.1 However, some factors appear to increase the risk. These may include:1,2

  • Smoking
  • Drinking alcohol or frequently drinking very hot liquids
  • Exposure to certain chemical fumes
  • Obesity
  • Certain medical conditions such as Barrett’s oesophagitis (a severe form of reflux)
  • Family history of gastro-oesophageal disorders
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Diagnosis

Diagnosing oesophageal cancer

Your GP may refer you to a specialist if they are concerned about your symptoms and risk factors for oesophageal cancer.1 Tests to diagnose oesophageal cancer may include:1,2
  • Endoscopy – An endoscope is passed into your mouth, down your throat and into your oesophagus to help enable your doctor to look inside. You may be given intravenous sedation, with the aim that you have no memory of the procedure afterwards.
  • Biopsy – If any unusual tissue is detected during the endoscopy, a small amount of tissue will be removed so it can be examined under the microscope. This is called a biopsy and may be done at the same time as the endoscopy.
  • Endoscopic ultrasound – An endoscope with an ultrasound probe may be passed through your mouth into your oesophagus. It uses soundwaves to create detailed images of the lining and walls of the oesophagus. It is often used after a diagnosis to determine if the cancer may have spread.
  • Laparoscopy – This is a surgical procedure that helps enable doctors to determine if the cancer may have spread from the oesophagus to the abdomen.
  • Imaging tests – These might include a PET-CT scan to help determine if there are any other tumours or if the cancer has spread to the lymph nodes.

If you are diagnosed with oesophageal cancer, your doctor should explain how far your cancer has progressed and will be able to help you with any further questions. This is known as staging. Oesophageal cancer is commonly staged with the TNM system.1 This abbreviation refers to:1

  • Tumour: Your doctors will measure the size of the tumour and how far it has grown into the oesophagus wall
  • Nodes: Refers to whether cancer has spread to lymph nodes
  • Metastasis: Refers to whether cancer has spread to other parts of the body
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Treatment options

Treatment options for oesophageal cancer

The treatment for oesophageal cancer will depend on how advanced it is. Treatment options offered may include:1,2

Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.3

 

Chemotherapy

Radiation therapy may be offered in the early stages of cancer treatment, or after it has started to spread. There are different radiation therapy techniques which may be suitable for different cancer types at different stages.4

Radiation Therapy

There are two types of surgery for oesophageal cancer:1,2

  • Endoscopic resection – May be used in the very early stages of the disease. It involves using an endoscope (a long flexible tube) to remove the abnormal cells
  • Oesophagectomy – Removes part or all of the oesophagus, depending on where the cancer is and how it has spread. If part of the oesophagus is removed, the remaining portion is joined to the stomach. If the whole oesophagus is removed, the stomach or part of your bowel may be used to replace it.
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All treatment options for oesophageal cancer may cause side effects. Most are temporary.1 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.

  • Aim to maintain a healthy diet -  you can speak with your clinician about designing a suitable eating plan during your treatment
  • Reach out to support groups and others who have are going through treatment
  • It may help to have a daily diary or journal to record things like side effects
  • Speak to your doctor about ways you may be able to incorporate gentle exercise into your weekly routine
  • Rest where needed - it is important to acknowledge when you are fatigued and have rest days when needed
  • Ask for and accept help from family, friends and neighbours
  • Be open with employers about your treatment and discuss flexible working options if you need them

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Support services

Support services

Cancer Council Australia

Australia's leading cancer charity, Cancer Council aims to lead a cohesive approach to reduce the impact of cancer.

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Australian Cancer Research Foundation

ACRF funds cutting-edge cancer research by providing scientists with advanced technology and infrastructure.

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GI Cancer Institute

GI Cancer Institute is the community-facing brand of the Australasian Gastro-Intestinal Trials Group, raising awareness and providing patient resources.

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  1. Cancer Council. Understanding stomach and oesophageal cancers. Available from: https://www.cancercouncil.com.au/oesophageal-cancer/ (accessed October 2023).
  2. Cancer Australia. Oesophageal cancer. Available from: https://www.canceraustralia.gov.au/oesophagealcancer (accessed October 2023).
  3. National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘chemotherapy’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/chemotherapy (accessed May 2023).
  4. National Cancer Institute, ‘Radiation therapy’. Available from: https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy (accessed May 2023).
  5. Cancer Council. Understanding chemotherapy. Available from: https://www.cancercouncil.com.au/cancer-information/cancer-treatment/chemotherapy/ (accessed October 2023).

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Disclaimer:

This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.

This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.
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