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Identify the oesophagus
The oesophagus is a muscular tube about 25cm (10in) long that connects your throat to your stomach. It goes down from the neck in the middle of the thorax (chest) to your tummy(abdomen). When you swallow food, the walls of the oesophagus squeeze together (contract). This moves the food down the oesophagus to the stomach. The area where the oesophagus joins the stomach is called the gastro-oesophageal junction.
What is oesophageal cancer?
Oesophageal cancer is the sixth most common cause of cancer deaths worldwide. More men than women get oesophageal cancer. In some regions, higher rates of oesophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits. Oesophageal cancer is not usually caused by an inherited faulty gene. So it is unlikely that your children will develop oesophageal cancer if you have it.
Oesophageal cancer usually begins in the inner layer. There are two types mainly depending on the types of cells becoming cancerous: Squamous (mid and upper oesophagus) and adenomatous (lower oesophagus). Oesophageal cancer can occur anywhere along the oesophagus.
What are the risk factors of oesophageal cancer?
We do not know exactly what causes oesophageal cancer. But we know that certain things called risk factors can increase a person’s chances of developing it. Having one or more risk factors does not mean you will definitely get oesophageal cancer. Equally, if you do not have any risk factors, it does not mean you won’t get oesophageal cancer.
Long-term acid reflux (GORD)
This is when stomach acid flows back up into the oesophagus. It can happen in people with conditions such as gastro-oesophageal reflux disease (GORD). Acid reflux can damage the lining of the oesophagus and can lead to a condition called Barrett’s oesophagus. This is when abnormal cells develop in the lining of the lower oesophagus. It is not a cancer, but a small number of people (less than 1%) with Barrett’s oesophagus may go on to develop cancer. It is known as a pre-cancerous condition.
Being overweight may increase your risk of developing oesophageal cancer. This may be because long-term acid reflux is more common in people who are overweight.
Oesophageal cancer is more common in men than in women.
The risk of developing oesophageal cancer increases as you get older. It is less common in people under 45.
The longer a person smokes and the more tobacco they smoke, the more likely they are to develop oesophageal cancer. All types of smoking are harmful.
There is an increased risk of oesophageal cancer if you chew betel.
Drinking a lot of alcohol over a long period of time increases your risk of developing oesophageal cancer. People who drink alcohol and also smoke may have a greater risk. Your risk increases if you drink more than 14 units of alcohol a week.
Eating lots of red and processed meats may increase your risk of developing oesophageal cancer. Eating lots of fresh fruit and vegetables may help to reduce the risk. Some evidence suggests that drinking very hot drinks may increase the risk of developing oesophageal cancer. This is because hot drinks may damage the lining of the oesophagus.
Previous cancer treatment
Radiotherapy to the chest area can increase your risk of developing oesophageal cancer (as in cases of childhood lymphoma/thymoma). This is very rare.
Other rare medical conditions
Achalasia is a condition where the muscle that controls the opening between the oesophagus and the stomach does not relax properly. People with achalasia have a higher risk of developing oesophageal cancer.
What are the signs and symptoms?
The most common symptoms of oesophageal cancer include:
- difficulty in swallowing – feeling that your food is sticking in your throat or chest
- food coming back up before reaching the stomach (regurgitation)
- being sick (vomiting)
- pain in your throat or in the middle of your chest when swallowing
- indigestion or heartburn that does not go away
- a cough
- a hoarse voice
- dull pain or discomfort behind the breastbone or in the back, for example between the shoulder blades
- weight loss
These symptoms can be caused by other conditions, but you should always have them checked out by your doctor.