What is oesophageal cancer?

Oesophageal cancer is when abnormal cells grow in your oesophagus. Your oesophagus is a tube that carries food and drink from your mouth to your stomach.

If it's not diagnosed and treated early, oesophageal cancer can spread to other parts of your body, such as:

• nearby lymph nodes (glands)
• your liver
• your lungs

What are the types of oesophageal cancer?

The most common types of oesophageal cancer include:

• adenocarcinoma — this is the most common type of oesophageal cancer and usually occurs in the lower part of your oesophagus
• squamous cell carcinoma — this occurs in the middle and upper parts of your oesophagus

What are the symptoms of oesophageal cancer?

Oesophageal cancer does not always cause symptoms.

Common symptoms of oesophageal cancer are:

• dysphagia (difficulty swallowing)
• pain in the top of your abdomen (tummy)
• heartburn or reflux that doesn't go away
• regurgitation (food getting stuck in your oesophagus and coming back up)
• pain when swallowing
• a hoarse voice or a cough that doesn't go away

You may have general symptoms of cancer, such as:

• unexplained weight loss
• poor appetite
• fatigue

You may have symptoms caused by bleeding in your oesophagus, including:

• coughing or vomiting up blood
• black or bloody bowel movements (poo)

These symptoms can also occur for other reasons, so having these symptoms doesn't always mean you have cancer.

If you are worried, see your doctor. Your doctor can examine you and refer you for tests to better understand your symptoms.

What causes oesophageal cancer?

The cause of oesophageal cancer is not always known.

Some medical conditions, such as Barrett's oesophagus (abnormal cells in your lower oesophagus) and gastro-oesophageal reflux disease (GORD) can increase your chance of getting oesophageal cancer.

Other risk factors that can increase your risk of having oesophageal cancer include:

• smoking
• drinking too much alcohol
• not eating enough fresh fruit and vegetables
• being overweight or obese
• breathing in chemical fumes
• regularly drinking very hot drinks

When should I see my doctor?

If you have any symptoms of oesophageal cancer, you should see your doctor. It's important to diagnose and treat cancer early, to prevent it from spreading to other parts of your body.

How is oesophageal cancer diagnosed?

Your doctor will ask about your symptoms and examine you.

Your doctor may refer you for tests, such as:

• CT scan — a scan that creates images of the inside of your body
• PET scan — a type of imaging that shows anything unusual in your organs and tissues
• endoscopy — a flexible tube with a camera at one end that is used to look into your oesophagus
• biopsy — a small surgery that involves removing a piece of tissue from your oesophagus to check it for signs of cancer
• endoscopic ultrasound — a flexible tube that is passed into your oesophagus to help detect a tumour

Sometimes laparoscopy (keyhole surgery) is used to look inside your abdomen. This allows your doctor to check if the cancer has spread.

How is oesophageal cancer treated?

Treatment for oesophageal cancer will depend on:

• the type of cancer
• what stage the cancer is (if the cancer has spread)
• the location of the cancer
• how severe your symptoms are

Treatments for oesophageal cancer include:

• endoscopic resection — this is a surgical procedure that can be used to remove very small tumours
• surgery — this can remove the cancerous part of your oesophagus. If the cancer has spread, part of your stomach may be removed as well.
• chemotherapy — this uses medicines to destroy cancer cells. It can be used as the main treatment, or before surgery to help shrink the tumour.
• radiotherapy — this uses radiation to destroy cancer cells. It can be used as the main treatment, or after surgery to remove any remaining cancer cells.
• immunotherapy — this uses medicines to help boost your immune system.

You may need an oesophageal stent, which is a small tube placed in your oesophagus to keep it open. This helps food and liquids pass through while the cancer is being treated.

Living with oesophageal cancer

Surgery for oesophageal cancer can make it hard to swallow for a while. It's important to eat and drink, so you don't lose too much weight or become unwell. Your doctor or a dietitian will help plan your meals to make sure that you are eating enough.

After your treatment has finished, you will need check-ups with a specialist every 3 to 6 months. This is to check:

• if the cancer has returned
• if you have any side effects from your treatment

After you have been treated for cancer, it's normal to feel afraid that the cancer will return. If you are struggling, you can seek support from:

• your doctor
• a therapist
• other people who have been through cancer

What are the complications of oesophageal cancer?

Oesophageal cancer can cause various complications.

Metastasis

Oesophageal cancer can spread to other parts of your body and cause complications. The earlier oesophageal cancer is diagnosed, the lower your chance of it spreading to other parts of your body.

Complications of treatment

Oesophageal cancer treatment can cause complications, such as:

• fatigue
• difficulty swallowing
• pneumonia
• reflux

Can oesophageal cancer be prevented?

Oesophageal cancer can't be prevented. You can lower your risk of having oesophageal cancer by:

• avoiding smoking
• limiting how much alcohol you drink
• having a diet with plenty of fruits and vegetables
• maintaining a healthy body weight
• avoiding very hot food or drinks

If you have gastro-oesophageal reflux disease (GORD), it's important to get treatment to help prevent oesophageal cancer. Talk to your doctor about how the best treatment options for you.

Resources and support

For more information and support, try these resources:

• Cancer Council Australia provides services and support to all people affected by cancer. Call 13 11 20.
• The Pancare Foundation provides information and support for people affected by oesophageal cancer. Call 1300 881 698.
• Beyond Blue provides support to people with depression and anxiety.
• General information about cancer is available on the Cancer Institute NSW website in multiple languages.
• Read about cancer for Aboriginal and/or Torres Strait Islander peoples on the Cancer Council website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.