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Definition of oesophageal cancer:

Cancer that forms in tissues lining the esophagus (the muscular tube through which food passes from the throat to the stomach). Two types of oesophageal cancer are squamous cell carcinoma (cancer that begins in flat cells lining the oesophagus) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). 

Oesophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the oesophagus.

The oesophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue. Oesophageal cancer starts at the inside lining of the oesophagus and spreads outward through the other layers as it grows.

Gastrointestinal (digestive) system anatomy; shows esophagus, liver, stomach, large intestine, and small intestine.

The stomach and oesophagus are part of the upper digestive system.

The two most common forms of oesophageal cancer are named for the type of cells that become malignant (cancerous):

  • Squamous cell carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the oesophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
  • Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the oesophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the oesophagus, near the stomach.

Smoking, heavy alcohol use, and Barrett oesophagus can increase the risk of developing oesophageal cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:

  • Tobacco use.
  • Heavy alcohol use.
  • Barrett oesophagus: A condition in which the cells lining the lower part of the oesophagus have changed or been replaced with abnormal cells that could lead to cancer of the oesophagus. Gastric reflux (the backing up of stomach contents into the lower section of the esophagus) may irritate the oesophagus and, over time, cause Barrett oesophagus.
  • Older age.
  • Being male.
  • Being African-American.

Signs and symptoms of oesophageal cancer are weight loss and painful or difficult swallowing.

These and other signs and symptoms may be caused by oesophageal cancer or by other conditions. Check with your doctor if you have any of the following:

  • Painful or difficult swallowing.
  • Weight loss.
  • Pain behind the breastbone.
  • Hoarseness and cough.
  • Indigestion and heartburn.

Tests that examine the oesophagus are used to detect (find) and diagnose oesophageal cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Barium swallow: A series of x-rays of the oesophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the oesophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series.

Barium swallow; shows barium liquid flowing through the esophagus and into the stomach.

Barium swallow. The patient swallows barium liquid and it flows through the oesophagus and into the stomach. X-rays are taken to look for abnormal areas.

  • Oesophagoscopy: A procedure to look inside the oesophagus to check for abnormal areas. An oesophagoscope is inserted through the mouth or nose and down the throat into the esophagus. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. When the esophagus and stomach are looked at, it is called an upper endoscopy.

Esophagoscopy; shows endoscope inserted through the mouth and into the esophagus. Inset shows patient on table having an esophagoscopy.

Oesophagoscopy. A thin, lighted tube is inserted through the mouth and into the esophagus to look for abnormal areas.

  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy is usually done during an oesophagoscopy. Sometimes a biopsy shows changes in the oesophagus that are not cancer but may lead to cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether it affects part of the oesophagus, involves the whole oesophagus, or has spread to other places in the body).
  • The size of the tumor.
  • The patient’s general health.

When oesophageal cancer is found very early, there is a better chance of recovery. Oesophageal cancer is often in an advanced stage when it is diagnosed. At later stages, oesophageal cancer can be treated but rarely can be cured.

For more information on Oesophageal Cancer click here

This link is to the National Cancer Institute (NCI) cancer website in the United States. There may be references to drugs and clinical trials that are not available here in Australia.