Oesophageal cancer begins when abnormal cells develop in the innermost layer (mucosa) of the oesophagus. A tumour can start anywhere along the oesophagus.
Learn more about:
- Types of oesophageal cancer
- Rare types of oesophageal cancer
- Who gets oesophageal cancer?
- What causes oesophageal cancer?
- GORD and Barrett’s oesophagus
- The oesophagus and stomach
Types of oesophageal cancer
There are two main subtypes:
Oesophageal adenocarcinoma – This often starts near the gastro-oesophageal junction and is linked with Barrett’s oesophagus. Adenocarcinomas are the most common form of oesophageal cancer in Australia.
Oesophageal squamous cell carcinoma – This starts in the thin, flat cells of the mucosa, which are called squamous cells. It often begins in the middle and upper part of the oesophagus. In Australia, oesophageal squamous cell carcinoma is less common than oesophageal adenocarcinoma.
If it is not found and treated early, oesophageal cancer can spread to nearby lymph nodes or to other parts of the body, most commonly the liver and lungs. It can also grow through the oesophageal wall and into nearby structures.
Rare types of oesophageal cancer
Some less common types of cancer can start in the stomach and 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 (called the gastro-oesophageal junction). Depending on the type of gastro-oesophageal cancer, it may be treated similarly to stomach cancer or oesophageal cancer.
Who gets oesophageal cancer?
This is an uncommon cancer. In Australia, about 1650 people are diagnosed with oesophageal cancer each year. Men are much more likely than women to be diagnosed with this cancer
What causes oesophageal cancer?
The exact causes of oesophageal cancer are not known. Research shows that the factors listed in the table below may increase your risk. Having one or more of these risk factors does not mean you will develop cancer. Some people have these risk factors and do not develop stomach or oesophageal cancer.
Known risk factors for oesophageal cancer include:
Adenocarcinoma
- being overweight or obese
- medical conditions, including gastro-oesophageal reflux disease (GORD) and Barrett’s oesophagus
- smoking tobacco
- older age (being over 60)
- having an inherited genetic condition such as Peutz-Jeghers syndrome (PJS) or Cowden syndrome
Squamous cell carcinoma
- drinking alcohol
- smoking tobacco
- older age (being over 60)
- damage to the oesophagus from hot or corrosive liquids such as acid
GORD and Barrett’s oesophagus
Reflux is when stomach acid goes back 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 and cause inflammation or ulcers (oesophagitis). This causes the cells lining the oesophagus to change to look like the cells lining the small bowel. 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 changes to the cells that may cause cancer.
Most people who have Barrett’s oesophagus will not develop oesophageal cancer.
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) is a long, muscular tube. The stomach is a hollow, muscular sac-like organ. The top part of the stomach joins to the end of the oesophagus and the other end joins to the beginning of the small bowel.
Anatomy of the oesophagus and stomach
What the oesophagus and stomach do
The oesophagus moves food, fluid and saliva from the mouth and throat to the stomach. A valve (sphincter) at the lower end of the oesophagus stops acid and food moving from the stomach back into the oesophagus.
The stomach stores food and breaks it down (digests it). Juices and muscle contractions 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 moves into the large bowel, where fluids are absorbed into the body and the leftover matter is turned into solid waste (known as faeces, stools or poo).
This table descibes the layers that make up the oesophagus and stomach:
Layer |
In oesophagus |
In stomach |
|
1. mucosa |
|
|
|
2. submucosa |
|
|
| 3. muscle layer |
|
|
| 4. outer layer |
|
|
Key resource
Download a PDF booklet on this topic.
More resources
Dr Spiro Raftopoulos, Gastroenterologist, Sir Charles Gairdner Hospital, WA; Peter Blyth, Consumer; Jeff Bull, Upper Gastrointestinal Cancer Nurse Consultant, Cancer Services, Southern Adelaide Local Health Network, SA; Mick Daws, Consumer; Dr Steven Leibman, Upper Gastrointestinal Surgeon, Royal North Shore Hospital, NSW; Prof Michael Michael, Medical Oncologist, Lower and Upper Gastrointestinal Oncology Service, and Co-Chair Neuroendocrine Unit, Peter MacCallum Cancer Centre, VIC; Dr Andrew Oar, Radiation Oncologist, Icon Cancer Centre, Royal Brisbane Hospital, QLD; Rose Rocca, Senior Clinical Dietitian: Upper Gastrointestinal, Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, VIC; Letchemi Valautha, Consumer; Lesley Woods, 13 11 20 Consultant, Cancer Council WA.
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