Oesophageal Cancer

Oesophageal cancer is slow growing, and most people may not feel any change in the early stages. There are a number of symptoms you can look out for, including:

• difficulty swallowing or pain when swallowing
• a feeling of choking when swallowing
• heartburn or reflux that doesn't go away
• pain in the upper belly area
• losing weight without meaning to or loss appetite
• feeling really tired
• vomiting blood
• black or bloody poo.

Having these symptoms may not mean you have cancer, but it is important to check.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. 
 

You won’t know if you have oesophageal cancer until your doctor has yarned with you, completed a physical examination and done some tests. The tests might include:

• a physical examination
• blood tests
• imaging tests like an ultrasound, a CT scan, an MRI scan or others to see what your insides look like
• an endoscopy, where a doctor put a long tube down your throat so they can look inside your oesophagus and stomach
• a biopsy, where a tiny bit of your oesophagus is removed during the endoscopy, and the doctors looks at it with a microscope.  

Most people who have these tests find out they don’t have cancer. But it’s important to check.
 

If you have oesophageal cancer, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of your body, and how far. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you. 

• Stage 1: The cancer is only in the inner lining of the oesophageal wall. 
• Stage 2-3: The cancer has spread deeper into the layers of the oesophageal wall and to nearby lymph nodes. 
• Stage 4: The cancer has spread to other parts of the body such as the liver or the lungs – this is also known as metastatic cancer. 

With all stages of oesophageal cancer, there are options of treatments that can help you. 
 

There are different ways to treat oesophageal cancer. Most people with oesophageal cancer have surgery. Some also have radiotherapy or chemotherapy, or targeted therapy. If you have oesophageal cancer, you might need one of these, or a combination of them. 

Your doctors will yarn with you about what treatments they recommend and what your options are best for you. 

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have and if you want to include traditional healing, bush medicines and/or cultural practices in your treatment plan.

Surgery

Surgery is a procedure done to remove the cancer and help to stop it from spreading to other parts of the body. Having surgery involves staying in hospital and having an anaesthetic (so that you are asleep during the operation) and an operation. 

Surgery is commonly offered in oesophageal cancers and can involve removing the affected part of the oesophagus, upper stomach and nearby lymph nodes.

Recovering from surgery is different for everyone. Some people make a quick recovery and others may need to stay in hospital for a couple weeks before going home. 

Your doctor will yarn with you beforehand about what will happen.

Yarn with your doctor, nurse, or Aboriginal and/or Torres Strait Islander Health Worker if you have any concerns or questions. If you need travel away from home for surgery, assistance is available for you and your family for travel and accommodation.

Read more about surgery. 

Radiotherapy

Radiotherapy (or radiation therapy) uses X-rays to destroy cancer cells in one part of your body. It is not used commonly in oesophageal cancer, but can be used to relieve symptoms if the cancer has grown or is not able to be removed surgically.

Most people who have radiotherapy have it 5 days a week for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks you need radiotherapy and you don’t live near a radiotherapy site, Assistance is available for you and your family for travel and accommodation.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker. 

Read more about radiotherapy.

Chemotherapy

Chemotherapy or ‘chemo’ involves you taking strong drugs to kill the cancer cells. 

Many people have chemo in cycles – such as one day every three weeks, or once a week. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.

Most chemo comes as injections into your arm or hand that drip in over a few hours and some need you to take home a small bottle home for two days then come back to take it off again. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do and take to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker. Mob who have had chemo say that traditional healing, bush medicines, Men’s Business, Women’s Business, being on Country and cultural practices help with managing the side effects of chemo.

Read more about chemotherapy and side effects.

Targeted therapies

Targeted therapies are newer drugs that try to stop the cancer growing. They are usually in the form of tablets that you can take at home.  

Targeted therapy is usually used in combination with other treatments, such as radiation therapy, chemotherapy or surgery. 

If your doctor thinks they might help, here are some questions to ask.

Read more about targeted therapy.
 

It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and where you live, and what you want. Yarn with doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or
• won’t cure you, but is meant to make you feel better or prolong your life

Your doctors will talk to you and explain this. You can yarn with them and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave Country for treatment, or don’t want any treatment. It’s your choice. You can also talk to another doctor to help you decide.
 

It can take time to decide about treatment. There are usually some options to hear about and choices to make. Read more about treatment.

It can be helpful to write things down, and have someone else come to appointments to help remember information.

Yarn with your doctor, specialist nurse or Aboriginal and/or Torres Strait Islander health worker. Other mob who have had cancer say that yarning with trusted family, friends and Elders helps.

Read more about treatment. 
 

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time.

After treatment is finished, your doctors will keep in touch with you to check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.
 

It is not possible to say what causes oesophageal cancer in a single person. We do know there are some features that are more common in people who develop oesophageal cancer. These features are called ”risk factors”. 

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for breast cancer does not mean that someone will develop this cancer. In fact, many people with oesophageal cancer have no obvious risk factors.

Some factors can even lower your risk of developing oesophageal cancer. 

Risk factors for oesophageal cancer you can change:

• tobacco smoking 
• being overweight
• drinking alcohol
• eating a diet low in fresh fruit and vegetables
• eating lots of smoked, salted or pickled food
• frequent drinking of very hot liquids.

Risk factors for oesophageal cancer you can’t change

• getting older
• medical conditions such as reflux (gastro-oesophageal reflux disease) and Barrett’s oesophagus (a change that happens to the oesophagus in someone who has reflux for a long time)

If you have any of these risk factors or you’re worried about your risk for oesophageal cancer, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.
 

Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option. Read more about clinical trials. 

Read more detail on oesophageal cancer here.