Cancer of the Oesophagus

Symptoms

The oesophagus is a muscular tube which connects the throat to the stomach. The first symptom of oesophageal cancer is difficulty in swallowing and usually the patient experiences food sticking somewhere behind the breast bone. It is solid food, particularly meat, which mostly causes this sticking sensation. If pain occurs it is generally felt as a burning sensation when food is swallowed and it also comes from behind the breast bone.

Diagnosis

The diagnosis is established reasonably simply with the help of X-rays and a barium swallow, which outlines the abnormality in the oesophagus. It can be confirmed by oesophagoscopy, during which a slim instrument is passed through the mouth and throat into the oesophagus and through which the tumour can be directly viewed and a sample of tissue taken for examination under a microscope. It is sometimes helpful to wash the suspected area with a solution which is removed through the oesophagoscope. This solution is again examined for the existence of malignant cells which would have been shed by a small and so far invisible tumour.

Treatment

The treatment of cancer of the oesophagus is either by surgery or radiotherapy. Surgery is usually preferred when the cancer is limited to the lower part of the oesophagus. Radiotherapy can be used in conjunction with surgery or on its own. its purpose is to shrink the cancer thereby relieving the difficulty in swallowing and easing the pain. After surgical removal of part of the oesophagus the remaining oesophageal stump is rejoined to the stomach. This usually means pulling up the stomach which in consequence reduces its capacity and may lead to bouts of indigestion after large meals. Total removal of the oesophagus which is a major surgical procedure is now only rarely performed.