Oesophageal cancer develops when cells in the oesophagus start to grow uncontrollably. There are two main types of oesophageal cancer:

1. Squamous cell carcinoma: Occurs in the cells lining the upper part of the oesophagus.
2. Adenocarcinoma: Occurs in the gland cells of the lower part of the oesophagus, often related to long-term gastroesophageal reflux disease (GERD) and Barrett’s oesophagus.

Why Does Oesophageal Cancer Happen?

The exact cause of oesophageal cancer is not always known, but several risk factors can increase the likelihood of developing the disease:

• Age: The risk of oesophageal cancer increases with age, particularly after 60.
• Gender: Men are more likely to develop oesophageal cancer than women.
• Smoking and alcohol: Both are major risk factors, as they can damage the lining of the oesophagus.
• Obesity: Being overweight or obese is linked to an increased risk of adenocarcinoma.
• Diet: A diet low in fruits and vegetables, and high in processed meats and salt-preserved foods, can increase risk.
• Chronic GERD and Barrett’s oesophagus: Long-term exposure to stomach acid can cause changes in the cells lining the oesophagus, which can lead to cancer.
• Family history: A family history of oesophageal cancer can also increase risk.

When Does Oesophageal Cancer Occur?

Oesophageal cancer can occur at any age but is most common in people over 60 years old. The symptoms may develop gradually and become more noticeable as the cancer grows:

• Difficulty swallowing (dysphagia)
• Unintentional weight loss
• Chest pain or discomfort
• Indigestion or heartburn
• Cough or hoarseness
• Fatigue

How to Treat Oesophageal Cancer

Treatment for oesophageal cancer depends on the type, stage, location of the tumour, and the overall health of the patient. Options include:

Symptom management and support are essential for improving quality of life in patients with advanced oesophageal cancer.

Surgery:

Oesophagectomy: Removal of part or all of the oesophagus along with nearby lymph nodes. The stomach may be used to reconnect the remaining oesophagus to the stomach.

Laser therapy: Used to destroy small tumours and reduce symptoms in early-stage cancers.

Stent placement: A stent may be inserted to keep the oesophagus open if the tumour is blocking the passage of food.

Radiotherapy:

External beam radiotherapy: High-energy rays are targeted at the cancer cells to destroy or damage them.

Brachytherapy: Internal radiotherapy where radioactive seeds are placed directly in or near the tumour.

Chemotherapy:

Before surgery (neoadjuvant chemotherapy): Used to shrink the tumour before surgical removal.

After surgery (adjuvant chemotherapy): Used to kill any remaining cancer cells and reduce the risk of recurrence.

Palliative chemotherapy: To relieve symptoms and slow the progression of advanced cancer.

Targeted therapies:

Trastuzumab (for adenocarcinoma with HER2 gene mutations): Targeted drugs that interfere with cancer cell growth.

Immunotherapy:

Checkpoints inhibitors: Used to stimulate the body’s immune system to attack cancer cells, particularly in advanced cases.

Palliative care:

Symptom management and support are essential for improving quality of life in patients with advanced oesophageal cancer.

Other Resources:

• https://www.webmd.com/cancer/esophageal-cancer
• https://pubmed.ncbi.nlm.nih.gov/28748917/
• https://www.healthline.com/health/gerd/esophageal-cancer
• https://en.wikipedia.org/wiki/Esophageal_cancer