The oesophagus is shown as a long thin tube connecting the mouth to the stomach. The lungs are shown on either side of the oesophagus, above the stomachOesophageal cancer is when a tumour grows in the oesophagus – sometimes known as the food pipe or gullet.

The oesophagus connects your mouth to your stomach. 

Oesophageal cancer is the 14th most common cancer in adults (Cancer Research UK, 2023).

About oesophageal cancer

Oesophageal cancer is caused by abnormal cells growing uncontrollably in the gullet. 

There are two main types of oesophageal cancer. Your treatment will depend on which type you have, along with other factors including the size of the cancer and whether it has spread.

The two main types of oesophageal cancer are:

  • Squamous cell carcinoma – this develops in the thin flat cells that line the oesophagus 
  • Adenocarcinoma – this develops in the glands that produce mucus in the oesophagus

Other types of oesophageal cancer include:

Anyone can develop oesophageal cancer but you may be more at risk if:

  • You are aged 75 and over
  • You are a man
  • You have certain conditions such as Barrett’s oesophagus or long-term severe acid reflux. Barrett’s oesophagus is a condition where some of the cells in the oesophagus grow abnormally
  • You smoke, drink too much alcohol or are overweight

Symptoms

The most common symptom is difficulty swallowing (dysphagia).  Other common symptoms are:

  • Feeling sick (nausea) or being sick (vomiting)
  • Heartburn or acid reflux
  • Burping a lot or indigestion

Other additional symptoms can include:

  • Cough that does not get better
  • Hoarse voice
  • Loss of appetite or losing weight without trying 
  • Feeling tired or having no energy
  • Pain in your throat or the middle of your chest, especially when swallowing
  • Black poo or coughing up blood (although these are uncommon)

It is important to see a health professional if you have symptoms, especially if they last more than a couple of weeks. It does not mean you have cancer but it is important to get checked.

You may be used to symptoms like this if you have a condition such as acid reflux.  It is really important to see a health professional if your symptoms get worse or change or if you have symptoms that are unusual for you.

Ask for an urgent GP appointment or contact 111 (call 111 or visit 111.nhs.uk) if: 

  • You're being sick for more than 2 days
  • Your poo is black or dark red
  • You have symptoms of oesophageal cancer you're worried about, but are not sure where to get help

Contact your GP if:

  • You have problems swallowing
  • You've lost a noticeable amount of weight
  • You have heartburn most days that lasts for 3 weeks or more
  • You have symptoms of oesophageal cancer that get worse
  • You have a condition that causes digestion symptoms and they’re not getting better with your usual treatments

Treatment at The Clatterbridge Cancer Centre

When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider your treatment options.  A doctor will then discuss the outcome of the MDT with you so you can decide what is right for you.

Treatment depends on a range of factors including:

  • The type of oesophageal cancer you have
  • The size and position of the cancer
  • How advanced it is (the ‘stage’ of cancer)
  • Your general health 

There are various treatment options that aim to cure the cancer. 

Sometimes when you are diagnosed, the cancer might already have spread to other parts of the body (advanced cancer). In these cases, the cancer is treatable but cannot be cured.

Treatment options can include one or more of the following:

  • Surgery – this may be before, during or after other treatments (if it might be possible to cure your cancer)
  • Drug therapies such as chemotherapy and immunotherapy. The general term for these is systemic anti-cancer therapies (SACT). These can be given as intravenous infusions or tablets
  • Radiotherapy 

Depending on the type and stage of your oesophageal cancer, you may receive a combination of these treatments.

Biomarkers are special tests that help us see if treatment can be personalised further – this means identifying which specific treatments will be more effective for you. 

We often check oesophageal and stomach cancers for proteins called MMR, PDL1 and HER 2. These tests indicate whether immunotherapy or trastuzumab might be suitable treatments. These are specialised antibodies that are given with chemotherapy.  

At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for oesophageal cancer. We also work closely with surgical teams in other hospitals to plan and coordinate your care every step of the way. 

Systemic anti-cancer therapy (SACT)

SACT is a term used to describe the different drug therapies for cancer. These include: 

  • Chemotherapy – which aims to kill cancer cells
  • Immunotherapy – which aims to train your immune system to attack cancer 
  • Targeted therapies – which aim to target the DNA and cell changes that cause cancer. 

Radiotherapy

Radiotherapy may be used depending on the size, location and stage of the cancer. It can be given by itself or with chemotherapy treatment. 

Radiotherapy is targeted x-rays that stop cancer cells dividing. It is often given every day to slow the growth of the cancer. Alternatively, an intense course of radiotherapy can be given alongside chemotherapy to cure oesophageal cancer. 

We actively recruit to available clinic trials. Research and trials of new cancer treatments are an important part of our work. 

We encourage all our patients to ask us about clinical trials during appointments. We will be happy to answer any questions you have. 

Find out more about clinical trials. 

We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes. 

We provide systemic anti-cancer therapies (e.g. chemotherapy and immunotherapy) for oesophageal cancer at the following sites:

We provide radiotherapy for oesophageal and stomach cancer at Clatterbridge Cancer Centre – Liverpool. 

Our team

The team consists of clinical oncologists, medical oncologists, clinical nurse specialists, radiographers, pharmacists, research practitioners, administrative support and a cancer support worker.  

Our operational management team makes sure the service runs smoothly.

Clinical oncologists 

  • Dr Chinnamani Eswar
  • Dr Joachim Chan
  • Dr Amy Jackson

Medical oncologists 

  • Dr Alia Alchawaf
  • Dr Shobha Silva
  • Dr Roopa Kurup

Specialty doctors 

  • Dr Nasralla Magdy 
  • Dr Michelle Mascarenhas 

Clinical Nurse Specialists

  • Lorren Sweeney
  • Sarah McKay

Cancer Support Worker 

  • Sarah Wallace 

Dietitian

  • Juliet Rhodes

Further information

Radiotherapy virtual tour video

Our Cancer Information and Support Centres  can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support include: