Oesophageal cancer

Oesophageal cancer refers to cancer of the oesophagus, or gullet or food pipe, the organ through which food is transferred from the mouth to the stomach.

According to the Cancer Association of South Africa (CANSA), oesophageal cancer is the sixth most common cancer among men and eighth most common among women in South Africa. It is one of the fastest growing forms of cancer in the developed world, including Sub-Saharan Africa. This rise is largely blamed on the increase in obesity. This puts South Africans especially at risk where more than 61 percent of the population is overweight, obese, or severely obese, according to the South African Medical Research Council.

There are two oesophageal cancer types: squamous cell carcinoma occurs in the epithelial cells that line the oesophagus, and adenocarcinoma that occurs in the mucous glands.

Most cancer occurs in the lower third of the oesophagus.

Oesophageal cancer causes are linked to the following risk factors:

What are its symptoms?

Oesophageal cancer symptoms may not be that obvious at first, and often present once the disease has advanced. Symptoms include:

  • Difficulty swallowing
  • Throat pain
  • Chronic (persistent) cough
  • Weight loss
  • Central chest pain
  • Vomiting blood

How is it diagnosed?

There are a number of tests that can be performed by your doctor or a cancer specialist to detect the presence of abnormal cells/presence of cancer.

Oesophageal cancer diagnosis involves: 

  • Endoscopic examination – an endoscope, a flexible, thin tube with a light and video camera, is passed down the throat and into the oesophagus. The camera is connected to a monitor that allows the doctor to see any abnormalities (including tumours) on the oesophageal wall. If necessary, the endoscope can be used to remove a tissue sample of the affected area (biopsy) that can be sent for testing.
  • Endoscopic ultrasound – this imaging test uses sound waves to capture images that can detect small abnormalities as well as the growth of tumours, whether lymph nodes have been affected and how nearby tissue has been affected.
  • Barium swallow – a thick, chalky liquid (Barium) is swallowed which then coats the walls of the oesophagus. X-ray images are taken of the oesophagus, which the barium outlines quite clearly. This test can detect abnormalities in the usually smooth surface of the inner lining of the oesophagus.

What are your treatment options?

Oesophageal cancer treatment will depend on how far the cancer has advanced and the general health of the patient, that is, whether there are accompanying conditions, such as heart disease.

If the cancer is localised and has not spread to underlying muscles, lymph nodes or beyond the oesophagus, surgery to remove the affected portion is usually considered the best option. Pre-operative chemotherapy and radiotherapy may be used in conjunction with surgery.

In more advanced cases of oesophageal cancer, chemotherapy and radiation may be considered, especially if the cancer has affected the underlying tissue of the oesophagus, if there is lymph node involvement, or it spreads to nearby tissue or organs.

A stent may be placed in the oesophagus to assist the passage of food and liquid, as scar tissue may narrow this passage.

Can it be prevented?

There are a number of ways you can reduce the risk factors for developing oesophageal cancer:

  • There is a link between oesophageal cancer and alcohol especially in conjunction with smoking. Reduce alcohol intake and stop smoking.
  • Maintain a healthy weight.
  • If you suffer from GORD, it is advised that you undergo endoscopic screening. (Adenocarcinoma of the oesophagus is a complication in Barrett’s oesophagus, which is found in up to 20 percent of people who show symptoms of GORD.) 

For more info
Cancer Association of South Africa

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015
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