Oesophageal cancer has very few symptoms at the onset and often the cancer is well advanced before there are any recognisable symptoms. Treatment of oesophageal cancer will depend on the size of the cancer, whether it has spread and the patient’s age and general state of health.
In recent years, endoscopy has been used as the main form of treatment for the right type of tumours. Endoscopy is preferred over surgery as it is less invasive and requires less recovery time. Surgery is used where endoscopy would not be as effective, and where there is limited spread of the cancer. But if any of the staging investigations show metastatic spread, surgery can no longer be offered, and the patients are referred to oncology for radiation and chemotherapy treatments, and in some cases to palliative care.
Endoscopy is an option if the tumour is small and confined to the mucosa. If so, an endoscopic mucosal resection will be conducted. However, if the cancer has spread through the superficial layer, then surgery would be the treatment of choice. This is why it is always good to see the doctor at the first instance of symptoms, rather than putting a doctor's visit off. If you have concerns, always ask to see a specialist for further tests.
To cut out the cancer if the tumour is small enough or in a location that is safe to do so. In cases where the cancer blocks the oesophagus, the surgeon may insert an expandable tube (called a stent) to hold open the sides of the oesophagus, or the oesophagus will be dilated and widened. Surgery for oesophageal cancer is a major operation that will need considerable post-surgery treatment and recovery time.
Radiotherapy uses radiation (high energy X-rays, gamma rays, electron beams or protons) to kill or damage cancer cells to stop them from multiplying and growing. Many people have radiotherapy as part of their treatment. Radiotherapy can be used as a cure, to control the cancer from spreading, to help other treatments such as chemotherapy and surgery and as symptom relief. Radiotherapy is usually the treatment of choice of squamous cell carcinoma.
This uses medication to kill or slow the growth of the cancer cells. The medications may be taken as a pill, by injection or intravenously.