The oesophagus gullet is a muscular tube. On this page. What is the oesophagus? The oesophagus has four layers: The mucosa is the inner layer. It is moist to help food pass smoothly into the stomach. The submucosa contains glands that produce mucus secretions. This keeps the oesophagus moist. The muscularis is the muscle layer. It pushes food down into the stomach. The area where the oesophagus and stomach join is called the gastro oesophageal junction GOJ. Cancers that start here are called gastro oesophageal junction cancers.
It can sometimes be difficult to tell the difference between oesophageal, stomach and GOJ cancers. But we know from research that GOJ cancers are a separate type of cancer.
They can behave differently to cancers of the oesophagus and stomach. Around 9, people are diagnosed with oesophageal cancer in the UK each year. It's more common in older people. It's very rare in people younger than Read Tony's story. Lifestyle changes could prevent 4 in 10 cases of cancer. Donate to oesophageal cancer research.
Factors that increase the risk of oesophageal cancer include being older or overweight, smoking and drinking alcohol, and gastro-oesophageal reflux disease. There is no national screening programme for oesophageal cancer in the UK. Read more about this. If the tumour continues to grow, even liquids may become difficult to swallow.
The exact cause of oesophageal cancer is unknown, but certain things can increase the risk of it developing. Gastro-oesophageal reflux disease GORD is a condition in which a weakness in the muscles above the stomach means stomach acid can travel up into the oesophagus. In around 1 in 10 people with GORD, repeated damage from stomach acid over many years can eventually cause changes in the cells lining the oesophagus.
This is called Barrett's oesophagus. These abnormal cells are at an increased risk of becoming cancerous in the future, although the risk is still small. It's estimated that one in every people with Barrett's oesophagus will develop cancer within years. If the cells in the lining of your gullet become inflamed, they're more likely to become cancerous. Read more about alcohol and drinking , including tips on cutting down. Tobacco smoke contains many harmful toxins and chemicals.
These substances irritate the cells that make up the lining of the oesophagus, which increases the likelihood that they will become cancerous. Read more about getting help to stop smoking. If you're overweight or obese , your risk of developing cancer of the oesophagus is higher than people of a healthy weight.
The more overweight you are, the higher the risk. This may be partly because obese people are more at risk of developing GORD and Barrett's oesophagus see above.
Read more information and advice about losing weight. Read more about having a healthy diet. Certain rare medical conditions can also increase your chances of developing cancer of the oesophagus, including:. See your GP if you experience symptoms of oesophageal cancer. They will carry out an initial assessment and decide whether you need to have any further tests.
If your GP thinks you need to have some tests, they can refer you to a hospital specialist. This will usually be a gastroenterologist specialist in conditions affecting the digestive system.
An endoscopy is a procedure that allows your doctor to see inside your oesophagus so they can check for cancer. A thin, flexible tube with a light and camera at the end an endoscope is passed into your mouth and down towards your stomach. Small samples of tissue are also removed from your oesophagus so they can be checked for cancer under a microscope. This is called a biopsy. You'll be awake while an endoscopy is carried out.
It shouldn't be painful, but may be a bit uncomfortable. You'll normally be given local anaesthetic to numb your throat and possibly a sedative to help you relax. A barium swallow or barium meal involves drinking a harmless white liquid called barium before several X-rays are taken. The barium coats the lining of your oesophagus so it shows up on the X-ray. This can show whether there's anything blocking your oesophagus, which may be a sign of cancer.
This test isn't used to diagnose oesophageal cancer very often nowadays because the best way to confirm a diagnosis is to use tissue samples taken during an endoscopy. If you have oesophageal cancer, further tests will be recommended to determine how far the cancer has spread — known as called the "stage". See below for more information about this. The most widely used system for staging oesophageal cancer is the TNM system. This involves scoring the cancer in three categories:. Scores for each category are then often used in a simpler number system, ranging from stage 1 early cancer to stage 4 advanced cancer.
Read more about treatments for oesophageal cancer. You'll be cared for by a group of different healthcare professionals and your team will recommend a treatment plan they feel is most suitable for you see below , although final treatment decisions will be yours. Read more about the stages of oesophageal cancer. During the procedure, your surgeon will remove the section of your oesophagus that contains the tumour and, if necessary, the nearby lymph nodes.
A small portion of your stomach may also need to be removed. To access your oesophagus, your surgeon will either make incisions cuts in your tummy and chest, or in your tummy and neck. A procedure called endoscopic mucosal resection EMR may sometimes be an option instead of an oesophagectomy if oesophageal cancer is diagnosed very early on.
It involves cutting out the tumour using a loop of wire at the end of a thin flexible tube endoscope. The endoscope is passed down your throat so no incisions are made in your skin. There are various ways a surgeon can get to the oesophagus and various types of operation. If the lower part of the oesophagus is removed, it may be possible to sew the stomach back on to the remaining section of oesophagus if the stomach is brought up into the chest area. If all of the oesophagus is removed, the surgeon may use a section of your gut intestine to create a new artificial oesophagus.
Some lymph glands around the oesophagus are also removed at the same time of the operation to see if any cancer has spread to them. Even if the cancer is advanced and it is not possible to remove it, some surgical techniques may still have a place to ease symptoms. For example, a blockage may be eased by:.
Chemotherapy is a treatment of cancer by using anti-cancer medicines which kill cancer cells, or stop them from multiplying. See separate leaflet called Chemotherapy for more details. Chemotherapy may be used in addition to surgery or radiotherapy.
For example, following surgery you may be given a course of chemotherapy. This aims to kill any cancer cells which may have spread away from the primary tumour. When chemotherapy is used after surgery it is called adjuvant chemotherapy. In some cases, chemotherapy is given before surgery, to shrink a large tumour so that surgery is more likely to be successful. This is called neoadjuvant chemotherapy. Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on cancerous tissue.
This kills cancer cells, or stops cancer cells from multiplying. See separate leaflet called Radiotherapy for more details. When radiotherapy is used to treat cancer of the oesophagus it is commonly used in addition to either surgery or chemotherapy. The exact combination of treatments advised depends on various factors. A newer treatment called photodynamic therapy PDT uses low-powered lasers combined with a light-sensitive medicine to destroy cancer cells.
In the UK it is still only carried out in a few specialist hospitals. It is more commonly used as a treatment to relieve the difficulty in swallowing caused by cancer of the oesophagus. PDT is being used in trials for the treatment of early oesophageal cancer, instead of surgery.
Without treatment, cancer of the gullet oesophagus is likely to get larger, and spread to other parts of the body. If it is diagnosed and treated at an early stage, there is a chance of a cure with treatment. An 'early stage' would be before the cancer has grown through the wall of the oesophagus or spread to lymph nodes or other areas of the body.
Unfortunately, most cases in the UK are not diagnosed at an early stage. This is because symptoms do not tend to develop until the cancer is already fairly large. If the cancer is diagnosed when it has grown through the wall of the oesophagus, or spread to other parts of the body, a cure is less likely.
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