Oesophageal Cancer

Oesophageal cancer is a malignant tumour arising from the oesophagus, the tube that transports food from the mouth to the stomach.

• Squamous cell carcinoma (common in the upper/middle oesophagus).
• Adenocarcinoma (common in the lower oesophagus).

• Tobacco and alcohol use.
• Gastroesophageal reflux disease (GORD).
• Barrett’s oesophagus (pre-malignant condition).
• Achalasia.
• Diet low in fruits and vegetables.
• History of head and neck cancers.

• Progressive dysphagia (initially to solids then to liquids).
• Unintentional weight loss.
• Epigastric or retrosternal pain.
• Regurgitation of food.
• Hoarseness (due to recurrent laryngeal nerve involvement).
• Respiratory symptoms (e.g., cough) if there’s a tracheoesophageal fistula.

• Endoscopy with biopsy: Primary diagnostic tool.
• Barium swallow: Might show an ‘apple core’ lesion or stricture.
• CT and PET scans: For staging and to detect metastasis.
• Endoscopic ultrasound (EUS): To evaluate depth of tumour invasion and involvement of regional lymph nodes.

• Early stage:
• • Endoscopic resection.
  • Radiotherapy and/or chemotherapy.
• Advanced disease:
  • Surgical resection (oesophagectomy) combined with neoadjuvant therapy.
  • Palliative care (stenting, radiation, chemotherapy) for symptom relief in unresectable tumours.

• Depends on the stage at diagnosis and overall health of the patient.
• Generally, the 5-year survival rate is low, especially if diagnosed at advanced stages.

• Metastasis to regional lymph nodes or distant organs.
• Tracheoesophageal fistula formation.
• Bleeding and anaemia.
• Stricture or obstruction of the oesophagus.