- The oesophagus is the tube that transports food from your throat to your stomach to be digested. There are three layers of the oesophageal wall, which include the mucosa (made up of squamous cells), submucosa and muscle layer (muscularis propria), in addition to the outer covering (adventitia)
- Most oesophageal cancers begin in the lower section of the oesophagus
- Each year more than 1,600 people in Australia are diagnosed with oesophageal cancer
- Oesophageal cancer is the 14th most common cancer in Australian men and is more common in people over the age of 60
Oesophageal cancer occurs when uncontrolled abnormal cells develop in layers of the oesophageal wall.
The two most common types of oesophageal cancer are:
Cancer that develops in the glandular cells which line the oesophagus. This type of cancer typically forms in the lower section of the oesophagus.
Oesophageal squamous cell carcinoma
Cancer that begins in squamous cells that line the oesophagus. This often develops in the middle and upper part of the oesophagus
Other types of oesophageal cancer include small cell carcinoma, lymphoma, neuroendocrine tumours and gastrointestinal stromal tumours.
As signs and symptoms for oesophageal cancer can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive an oesophageal cancer diagnosis.
Oesophageal cancer can be difficult to detect as there are often no symptoms during the early stages. However, as the disease progresses symptoms may include:
Pain or difficulty swallowing such as a feeling of choking when swallowing
Black or bloody stools
Discomfort in the upper abdomen particularly when eating
Coughing or hoarseness
The TNM system is used to stage oesophageal cancer, and it helps doctors understand what your cancer looks like. The TNM stands for:
- Tumour – The extent to which the tumour infiltrates into surrounding tissue
- Node – Is a measure of surrounding lymph nodes involvement
- Metastasis – Describes whether or not the cancer has spread to other parts of the body
The TNM information, along with other tests, helps determine the stage of your oesophageal cancer using the guidelines below:
The cancer is only in the top layer of the oesophageal lining (epithelium) and has not spread to deeper layers of the oesophagus.
The cancer has grown into the mucosa, submucosa or muscle layer (muscularis propria).
The cancer has spread to the muscularis propria or outer layer of the oesophagus (adventitia). Alternatively, the cancer has grown into the mucosa or submucosa and has spread to one or two nearby lymph nodes.
The cancer has spread to the mucosa, submucosa, adventitia or muscularis propria and no more than six nearby lymph nodes. Alternatively, the cancer has grown into the pleura, pericardium or diaphragm and no more than two nearby lymph nodes.
The cancer has spread beyond the oesophageal wall to nearby lymph nodes and parts of the body such as the pleura, pericardium, diaphragm, trachea, aorta and spine, or throughout the body to distant lymph nodes and/or organs such as the liver or lungs.
For most oesophageal cancer cases, genetic mutations are somatic (meaning they happen in cells only specific to that individual and are not inherited). In rare cases, genetics can play a role in the development of oesophageal cancer, particularly for people who have inherited gene mutations such as the RHBDF2 gene. However, the known risk factors of oesophageal cancer are high alcohol consumption and cigarette smoking.
The cause of oesophageal cancer is not fully known, however there are a number of modifiable and non-modifiable factors which increase your risk of oesophageal cancer.
Oesophageal adenocarcinoma risk factors
- Age – The risk for oesophageal cancer increases for people over 60 years
- Certain lifestyle-related factors – Such as being overweight or obese, drinking alcohol or smoking
- Family history – Including oesophageal cancer, pre-existing medical conditions such as gastroesophageal reflux disease (GERD), or inherited genetic conditions such as Peutz-Jeghers syndrome (PJS) or Cowden syndrome
Oesophageal squamous cell carcinoma risk factors
- Age – The risk for oesophageal cancer increases for people over 60 years
- Certain lifestyle-related factors – Such as drinking alcohol, smoking and drinking very hot liquids (above 65°C) frequently
Oesophageal cancer is an uncommon cancer in Australia, affecting more than 1,600 people every year. It affects both men and women, young and old, however is more common in people older than 60. Oesophageal cancer is also more common in men than women, with men nearly three times more likely to be diagnosed.
There are many different tests that are used to diagnose oesophageal cancer. This may include an endoscopy, which uses an endoscope to investigate the digestive tract and remove tissue (biopsy), or an endoscopic ultrasound which can indicate if the cancer has spread into the oesophageal wall or lymph nodes. Further tests may include CT/PET scans or laparoscopy to detect if the cancer has spread.
There are a number of lifestyle-related factors you can consider to reduce your risk of developing oesophageal cancer, like:
- Quit smoking – Cigarette smoking carries a significantly higher risk of developing oesophageal cancer
- Get regular exercise – Cancer Australia recommends at least 30 minutes of moderate-intensity exercise each day
- Reduce your alcohol intake – If you choose to drink, try to limit your alcohol intake to no more than two standard drinks a day. Alcohol consumption has a dose-response relationship with cancer (meaning the more you drink the higher the risk of developing cancer). Drinking alcohol has been related to cancers of the oesophagus
- Eat a healthy, balanced diet – Eat a fibre-rich diet from grain and legume sources, as well as enjoy a variety of fruit (2 serves) and vegetables (5 serves) per day, limit your intake of salt and saturated fats, and avoid all processed meat
Icon offers clinical trials across a wide range of cancer types and treatments. If you would like more information on participating in a clinical trial, please speak with your doctor who will be able to find a trial that might be right for you and your cancer.
- Cancer Australia. (2021). Oesophageal cancer.Retrieved on 15 November 2021 from https://www.canceraustralia.gov.au/cancer-types/oesophageal-cancer/overview
- Cancer Council. (2021). Understanding Stomach and Oesophageal cancers.Retrieved on 15 November 2021 from https://www.cancercouncil.com.au/wp-content/uploads/2021/11/Understanding-Stomach-and-Oesophageal-Cancers-2021.pdf
- Cancer Australia. (2021). Oesophageal cancer in Australia.Retrieved on 15 November 2021 from https://www.canceraustralia.gov.au/cancer-types/oesophageal-cancer/statistics
- American Cancer Society. (2021). Esophageal Cancer Stages. Retrieved on 15 November 2021 from https://www.cancer.org/cancer/esophagus-cancer/detection-diagnosis-staging/staging.html
- Cancer Council Victoria (2021). Stomach and oesophageal cancer. Retrieved on 23 November 2021 from https://www.cancervic.org.au/cancer-information/types-of-cancer/stomach_and_oesophageal_cancer/stomach-oesophageal-cancer-overview.html
- American Cancer Society (2020). Causes of esophagus cancer. Retrieved 23 November 2021 from https://www.cancer.org/cancer/esophagus-cancer/causes-risks-prevention/what-causes.html
- Australian Government: Cancer Australia. (2020). Lifestyle risk factors and the primary prevention of cancer.Retrieved on 15 November 2021 from https://www.canceraustralia.gov.au/resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer
- Australian Institute of Health and Welfare 2019. Cancer in Australia 2019. Cancer series no.119. Cat. no. CAN 123. Canberra: AIHW.
Helpful linksBecoming a patient
What you need to know about cancer research and clinical trials
View a Facebook Live with Icon specialists from across Australia and Singapore
Clinical Opinion Article
Five tips for life beyond cancer treatment
Icon Medical Director and Clinical Haematologist Dr Ian Irving shares his advice on how to stay well and find your new normal once treatment ends
Become a patient
Find out how to become a patient at Icon Cancer Centre, or request more information from your nearest centre.
Icon brings together some of Australia’s most experienced medical oncologists, radiation oncologists and haematologists.
Care at Icon
At Icon, care is more than just a word. Our cancer care team are here to support you with compassion, knowledge and hope.
Our patients share their perspective and advice.