Oesophageal cancer can result from reflux disease. The continual escape of stomach acid into the oesophagus leads to inflammation, bleeding and ulceration of the skin-like lining of the oesophagus. This damage can cause changes in the cells, which may lead to cancer (Barrett’s oesophagus). Smoking can also cause oesophageal cancer, and being overweight has more recently been identified.
- Sensation of food sticking in the food pipe
- Less reflux and heartburn
- Chest pain
- Loss of weight
- Change in the pattern of reflux
- Barrett’s Oesophagus can predispose the patient to cancer of the oesophagus. It is an increasingly common illness.
Early diagnosis will lead to better prospects of cure.
A combination of surgery with other techniques seems to offer the best prospect of cure. Treatment without surgery predominately relieves symptoms but does not often result in lengthy survival. Some patients are not suitable for surgery. We have found removal of lymph nodes has markedly improved survival compared with other groups.
A high concentration of experience and high volume of cases performed by the surgeon is essential to increase thecancer cure rate and reduce the complication rate of what is a very large operation. As only diseases of the upper gastrointestinal tract are treated within this clinic a large number of patients are treated.
Management through a multi-disciplinary approach including radiotherapy, oncology, gastroenterology, dietetics and anesthetics is vital. Cardiology and respiratory medicine are also often utilised.
Some patients are suitable for keyhole surgery.
Treatment when surgery is not possible
The clinic treats many patients where surgery is for one reason or another is not advisable. Standard techniques are all available, however a number of alternatives can be targeted to individuals for different effect. Laser rebore is utilised in many cases , and internal radiotherapy can be done in other cases and can offer quite good control of disease (brachytherapy). Standard radiation and chemotherapy is often recommended.
For an excellent review of management see: http://cancerhelp.cancerresearchuk.org/