Oesophageal cancer is a type of cancer affecting the oesophagus (gullet) – the long tube that carries food from the throat to the stomach.
It mainly affects people in their 60s and 70s and is more common in men than women.
Symptoms
Oesophageal cancer doesn’t usually cause any symptoms in the early stages. It’s only when it gets bigger that symptoms tend to develop.
Symptoms of oesophageal cancer can include:
Difficulty swallowing
Persistent indigestion or heartburn
Regurgitation of food soon after eating
Loss of appetite and weight loss
Pain or discomfort in your upper abdomen chest or back
Causes of oesophageal cancer
The exact cause of oesophageal cancer is unknown, but the following things can increase your risk:
Oesophageal cancer doesn’t usually cause any symptoms in the early stages. It’s only when it gets bigger that symptoms tend to develop.
Symptoms of oesophageal cancer can include:
Persistent gastro-oesophageal reflux disease (GORD)
Smoking
Drinking too much alcohol over a long period of time
Being overweight or obese
Treatments for oesophageal cancer
If oesophageal cancer is diagnosed at an early stage, it may be possible to cure it with:
Surgery to remove the affected section of oesophagus
Chemotherapy, with or without radiotherapy (chemoradiation), to kill the cancerous cells and shrink the tumour
If oesophageal cancer is diagnosed at a later stage, a cure may not be achievable.
Oesophagectomy
You have been diagnosed as having cancer of the oesophagus, which usually causes a blockage and makes it hard to swallow. The results of tests and investigations will show that an operation is possible to remove the tumour. This will make it easier for you to eat and drink, with the hope the procedure cures your cancer.
The Oesophagectomy procedure is the surgical removal of all or part of the oesophagus. This is usually replaced with stomach but can also be replaced with colon or small bowel depending on how much oesophagus is removed. This is performed through two or three large incisions, one in the abdomen, one in the chest and sometimes one in the neck depending on how much oesophagus needs to be removed. Once the affected tissue has been removed with an adequate margin around the cancer, the remaining healthy stomach is fashioned into a tube which is then joined back together with the remaining part of the oesophagus. This procedure can also be performed using laparoscopic keyhole surgery or robotic surgery.
Oesophagectomy surgery risks include:
A leak from the anastomosis
Bile or acid reflux
Bleeding
Cardiac problems
Cough
Death
Respiratory complications
Voice changes
Infection
Nause, vomiting and diarrhoea
Deep vein thrombosis
Dysphagia (Swallowing difficulties)
At your consultation we will explain in more detail some of the aims, benefits, risks and alternatives to this procedure (operation/treatment). We want you to be informed about your choices to help you to be fully involved in making any decisions.
We will discuss which technique and approach we feel is best for you based on your medical history. Please ask about anything you do not fully understand or wish to have explained in more detail.
After your Procedure
After the Procedure
- After your operation your anaesthetist continues to monitor your condition carefully.
- You will probably be transferred to a recovery ward where specially trained nurses, under the direction of anaesthetists, will look after you.
- Your anaesthetist and the recovery nurses will ensure that all the anaesthetic effects are reversed and that you are closely monitored as you return to full consciousness.
- You may be given some oxygen to breathe in the recovery area, and may find that intravenous drips have been inserted whilst you are unconscious in theatre and that these will be replacing fluids that you might require.
- You will be given medication for any pain that you might feel, and systems, such as Patient Controlled Anaesthesia (PCA) may be set up to continue pain control on the ward.
- You are likely to feel drowsy and sleepy at this stage. Some patients feel sick, others may have a sore throat related to the insertion of the breathing tube during surgery.
- During this time it is important that you relax as much as you can, breathe deeply, do not be afraid to cough, and do not hesitate to ask the nursing staff for any pain relief, and about any queries you may have.
- You are likely to have hazy memories of this time and some patients experience vivid dreams.
- The length of your hospital stay will depend on a number of factors including how complex your procedure was and how your body recover’s from the operation.
- Your doctor and their team will discuss your specific recovery and what you should do once you leave hospital.