- Oesophageal cancer
What is oesophageal cancer?
Oesophageal cancer begins when abnormal cells develop in the innermost layer (mucosa) of the oesophagus. A tumour can start at any point along the length of the oesophagus.
Learn more about:
- Types of oesophageal cancer
- The oesophagus and stomach
- Who gets oesophageal cancer?
- What causes oesophageal cancer?
There are two main subtypes:
Oesophageal adenocarcinoma – often starts near the gastro-oesophageal junction and is linked with a condition called Barrett’s oesophagus. Adenocarcinomas are the most common form of oesophageal cancer in Australia.
Oesophageal squamous cell carcinoma – starts in the thin, flat cells in the lining of the oesophagus, which are called squamous cells. It often begins in the middle and upper part of the oesophagus. In Australia, squamous cell carcinomas are less common than adenocarcinomas.
If it is not found and treated early, oesophageal cancer can spread through the lymphatic system to nearby lymph nodes or through the bloodstream to other parts of the body, most commonly the liver and lungs. It can also grow through the oesophageal wall and invade nearby structures.
Rare types of oesophageal cancer
Some less common types of cancer can affect the oesophagus. These include small cell carcinomas, lymphomas, neuroendocrine tumours and gastrointestinal stromal tumours. These types of cancer aren’t discussed here and treatment may be different. For more information, call Cancer Council 13 11 20.
|Some cancers start at the point where the stomach meets the oesophagus (the gastro-oesophageal junction). Depending on the type of gastro-oesophageal cancer, it may be treated similarly to stomach cancer. For more information about your situation, talk to your treatment team.|
The oesophagus and stomach
The oesophagus and stomach are part of the upper gastrointestinal (GI) tract, which is part of the digestive system. The digestive system helps the body break down food and turn it into energy.
The oesophagus (food pipe or gullet) is a long, muscular tube. It moves food, fluid and saliva from the mouth and throat to the stomach. A valve (sphincter) at the end of the oesophagus stops acid and food moving from the stomach back into the oesophagus.
The stomach is a hollow, muscular sac, located between the end of the oesophagus and the beginning of the small bowel. The stomach expands to store and help digest food that has been swallowed. It also helps the body absorb some vitamins and minerals.
Juices in the stomach break down food into a thick fluid, which then moves into the small bowel. In the small bowel, nutrients from the broken-down food are absorbed into the bloodstream. The waste matter moves into the large bowel, where fluids are absorbed into the body. The solid waste matter is passed out of the body as a bowel movement.
The oesophageal wall has three layers of tissue and an outer covering known as the adventitia. The stomach wall has four layers of tissue.
The stomach and the oesophagus
The oesophageal wall is made up of the:
|1. Mucosa (moist innermost layer)||made up of squamous cells|
|2. Submucosa (supports the mucosa)||glands in the submucosa produce fluid (mucus)this fluid helps to move food through the oesophagus|
|3. Muscle layer||known as the muscularis propriaproduces contractions to help push food down the oesophagus and into the stomach|
|4. Outer covering||known as the adventitiaconnective tissue supporting the oesophagus|
Who gets oesophageal cancer?
This is an uncommon cancer. In Australia, about 1500 people are diagnosed with oesophageal cancer each year. Men are much more likely than women to be diagnosed with this cancer. It is more common in people over 60, but can occur in younger people. About one in 160 men and one in 580 women are likely to develop oesophageal cancer before the age of 75.
What causes oesophageal cancer?
The exact causes of oesophageal cancer are unknown, but the factors listed below may increase your risk. Having one or more of these risk factors does not mean you will develop cancer.
Known risk factors for oesophageal cancer
|Squamous cell carcinoma|
GORD and Barrett’s oesophagusReflux is when stomach acid flows up into the oesophagus. Some people with reflux are diagnosed with gastro-oesophageal reflux disease (GORD).Over time, stomach acid can damage the lining of the oesophagus, causing inflammation or ulceration (oesophagitis). This may cause the squamous cells lining the oesophagus to be replaced by column-shaped cells, which look like the cells lining the stomach. This condition is called Barrett’s oesophagus and it can lead to oesophageal adenocarcinoma.If you have Barrett’s oesophagus, your doctor may recommend you have regular endoscopies to look for early cell changes that may lead to cancer. Most people with Barrett’s oesophagus will not develop oesophageal cancer.
Prof David Watson, Senior Consultant Surgeon, Oesophago-gastric Surgery Unit, Flinders Medical Centre, and Matthew Flinders Distinguished Professor of Surgery, Flinders University, SA; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Katie Benton, Advanced Dietitian, Cancer Care, Sunshine Coast Hospital and Health Service, QLD; Alana Fitzgibbon, Clinical Nurse Consultant, Gastrointestinal Cancers, Royal Hobart Hospital, TAS; Christine Froude, Consumer; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Gold Coast University Hospital, QLD; Dr Spiro Raftopoulos, Interventional Endoscopist and Consultant Gastroenterologist, Sir Charles Gairdner Hospital, WA; Grant Wilson, Consumer; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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