Oesophageal (esophageal) cancer: symptoms, causes, tests and treatment

The NHS says there are many possible symptoms of oesophageal cancer, but they might be hard to spot. They can affect digestion:

• Problems swallowing (dysphagia).

• Feeling or being sick.

• Heartburn or acid reflux.

• Symptoms of indigestion, such as burping a lot.

The NHS lists these further symptoms. Cancer Research UK says difficulty swallowing is the most common symptom, which may feel like pain or a burning sensation when you swallow, or food sticking in the throat or chest.

• A cough that is not getting better, or one that happens when you try to eat.

• A hoarse voice.

• Loss of appetite, or losing weight without trying to.

• Feeling tired or having no energy.

• Pain in the throat or the middle of the chest, especially when swallowing.

• Black poo or coughing up blood (although these are uncommon).

The NHS says these symptoms are very common and can be caused by many different conditions, so having them does not definitely mean you have oesophageal cancer. But it is important to get them checked, because finding cancer early makes it more treatable.

If you have another condition such as acid reflux disease you may get symptoms regularly and get used to them. The NHS says it is important to be checked if your symptoms change, get worse or do not feel normal for you.

The NHS says the GP may feel your neck and tummy and might arrange a blood test. If the GP thinks your symptoms could be cancer, you may get an urgent referral for more tests or to see a specialist. This does not definitely mean you have cancer.

The main test is a gastroscopy. A long, thin, flexible tube with a small camera is put into your mouth and down your oesophagus. A small sample of cells (a biopsy) may be taken and sent to a laboratory. The NHS says it should take around 10 to 15 minutes, and that you will probably be in hospital for several hours.

You may be offered a throat spray, sedation or, in some cases, a general anaesthetic. The NHS says you should get your results within 2 weeks.

If cancer is found, more tests find the size and how far it has spread (the stage). The NHS says you may need an ultrasound scan (sometimes from inside the body using an endoscope), a CT scan, a PET-CT scan, or a small operation to look inside the tummy called a laparoscopy.

The NHS says oesophageal cancer is often treatable but can be difficult to treat. Treatment depends on the size and type of cancer, where it is, whether it has spread, and your general health. Cancer Research UK says you might have one or more treatments.

The NHS says a specialist care team will explain the treatments, benefits and side effects, create a plan with you and help you manage side effects, including changes to your diet.

Cancer Research UK says swallowing can be difficult for some people with cancer in the oesophagus, and that there are treatments that can make swallowing easier. It also describes prehabilitation, things you can do to feel more in control before treatment.

The NHS says it is not always clear what causes oesophageal cancer. Anyone can get it, but you might be more at risk if you are over 75 (it is not very common under 45), are a man, or have long-term, severe acid reflux (gastro-oesophageal reflux disease) or Barrett's oesophagus.

Many oesophageal cancers are linked to lifestyle: you are more likely to get it if you are overweight, smoke or drink too much alcohol.

The NHS says Barrett's oesophagus is a condition where some cells in the oesophagus grow abnormally. If you have it, you are slightly more likely to get oesophageal cancer, but this is not common.

Cancer Research UK says there are two main cell types lining the oesophagus, so two main types of cancer. The type affects the plan, along with the stage and grade.

The NHS says you cannot always prevent it, but healthy changes can lower your chances.

• Try to lose weight if you are overweight.

• Let hot drinks cool down a bit before drinking, so they do not damage your oesophagus.

• Try to cut down on alcohol; the NHS says avoid drinking more than 14 units a week.

• Try to quit smoking.

On the NHS, suspected oesophageal cancer is usually investigated through an urgent GP referral and gastroscopy, followed by treatment planned by a specialist team with a clinical nurse specialist as your main point of contact.

Private gastroscopy and consultations are available, but confirmed cancers are normally treated by specialist multidisciplinary teams, and any private results should be shared with your GP so the NHS team has the full picture.