Oesophageal cancer comes in two main forms, squamous cancer which is caused by smoking and alcohol and adenocarcinoma which is caused by acid reflux. Adenocarcinoma is in the majority of cases preceded by the development of Barrett’s oesophagus and is one of the most rapidly increasing cancers in the UK. Both types tend to present with similar symptoms of weight loss and difficulty in swallowing, initially to solids but later to both liquids and solids as the tumor progresses. They are diagnosed by endoscopy, and are staged initially to detect spread by CT scanning. Very early cancers discovered on screening programmes for Barrett’s oesophagus may be treated effectively endoscopically.
Patients with either condition are discussed at a multi-disciplinary meeting with oncologists from the Marsden to decide on the best approach to treatment, which may be surgery or chemotherapy and radiotherapy or simply placing a stent to relieve swallowing problems. Often all three types of treatment are used.