Oesophageal cancer

With a percentage of around 2% of all possible cancers, oesophageal cancer is one of the rarer types of cancer. Around 600 people are diagnosed with oesophageal cancer in Switzerland every year. Men are affected by it more frequently and make up around three quarters of the illnesses.

Oesophageal cancer can occur all over the oesophagus. Depending on what type of cells the cancer originates from, medicine differentiates between squamous cell carcinoma and adenocarcinoma. Squamous cell carcinomas are often located in the upper two thirds of the oesophagus and stem from the surface mucosa cells. Adenocarcinoma are often located in the lower third of the oesophagus and originate from the rather deeper-lying mucosa gland cells.

Several factors are known to increase the risk of oesophageal cancer These include smoking, alcohol consumption as well as chronic indigestion with regurgitation (reflux) of stomach acid into the oesophagus. Years of reflux can result in mucosa changes in the oesophagus at the crossover to the stomach. These changes are called Barrett syndrome and substantially increase the risk of oesophageal cancer.

Difficulty swallowing can be the first sign of oesophageal cancer. At the beginning, the difficulty swallowing is only recognisable when swallowing solid food; later also when swallowing fluid. However, oesophageal cancer can manifest in pain when swallowing, acid reflux or hoarseness.

The earlier that oesophageal cancer is detected, the better the chances of recovery. Any swallowing difficulties should therefore be checked by a doctor. Different examinations are used to diagnose cancer of the oesophagus. They include an ultrasound examination and an oesophagoscopy. See the Gastroscopy section for information on carrying out a oesophagoscopy. During the oesophagoscopy, tissue samples can be taken from suspicious areas. Computed tomography or an x-ray of the oesophagus is often carried out as well to determine the exact spread of the cancer and to plan the treatment.

The treatment depends on the stage of the disease. Very small tumours in an early stage can be removed via an oesophagoscopy. As oesophageal cancer is often only discovered in an advanced stage, it usually requires surgery. In the process, the affected part of the oesophagus is removed and the rest is connected with the stomach again. Sometimes a part of the intestine is used as a bypass. If the oesophagus is completely removed, a replacement oesophagus is formed from the stomach. You can find out more about the surgical treatment options in the Oesophageal surgery section.

Sometimes radiotherapy or chemotherapy is carried out before and after the surgery.