GP Alice Fitzgibbon, looks at the different types of this illness and what can be done
Oesophageal Cancer
This month’s column will discuss oesophageal cancer. The oesophagus is the ‘food pipe’ that connects the mouth to the stomach – it is also often known as the gullet. Oesophageal cancer is the 14th most common cancer in adults, with approximately 9,300 people diagnosed each year according to Cancer Research UK. Although it is not the most common type of cancer, knowing the signs and symptoms is very important as the earlier it is diagnosed, the more treatment options there may be.
Oesophageal cancer affects more men than women and becomes more common with age – many people are over age 75 when diagnosed. It can happen to anyone, however, if you have severe acid reflux or a condition called Barrett’s Oesophagus then the risk of developing cancer is also higher. Barrett’s Oesophagus is a condition where there are abnormal cells growing in the oesophagus. It is thought that this may result from severe acid reflux coming up from the stomach and causing damage. The abnormal cells may be more likely to turn cancerous than normal cells.
Although oesophageal cancer cannot always be prevented, there are lifestyle changes that can help lower your chances of getting it. As with many cancers, reducing alcohol intake to the recommended limits of no more than 14 units (6 pints of lager, 6 medium glasses of wine or 7 double spirit measures per week) will reduce the risk. Stopping smoking, losing weight if overweight and drinking hot beverages at cooler temperatures may also lower the risk.
So, what are the symptoms of oesophageal cancer? The most common symptoms of this cancer are:
- Difficulty swallowing (called dysphagia)
- Indigestion or heartburn that does not go away
- Weight loss that you cannot explain
- Pain in the throat or behind the breastbone
Other symptoms can include starting to regurgitate food or coughing when eating. As a GP, I see far many more people with simple indigestion than I do with oesophageal cancer. It is very important to see your GP if you have the above symptoms so they can be investigated quickly.
The best test for oesophageal cancer is a camera test (endoscopy). This is where a small tube with a camera is passed through the mouth, down the oesophagus and into the stomach. This allows a direct look at the oesophagus and to see if there is any suspicious areas in the lining. If there is an area where a growth is identified, or the lining of the oesophagus looks different, a sample can be taken there and then. This sample, a biopsy, is sent to be examined under a microscope to look for cancer cells. If cancer is found, often other investigations are needed to see if it has spread.
The treatment for oesophageal cancer depends on where in the gullet it is, the type of cancer cells, if there is any spread and the general health of the person who has it. Treatment might include surgery, chemotherapy and radiotherapy. Cases of cancer that are found early may be offered surgery. If the cancer has spread already when it is found, surgical treatment is not an option. Surgery for oesophageal cancer is a major operation; often parts of organs around the gullet are also removed such as part of the pancreas and the top of the stomach.
The statistics are clear that catching and treating oesophageal cancer early gives the best chance of surviving it. So please, if you experience any persistent symptoms of heartburn, especially with any other signs like weight loss or difficulty with swallowing, then please visit your GP as soon as possible.
