Oesophageal cancer

There are two types of cancer of the oesophagus; Squamous Cell Carcinoma (SCC) and Oesophageal Adenocarcinoma (OAC).

Squamous Cell Carcinomas are more prevalent in Asian countries whilst Oesophagel Adenocarcinomas are more prevalent in UK, Europe and America.

SCC is more likely to be found in the upper oesophagus and is heavily linked to drinking and smoking. Rates of SCC are remaining static.

OAC is more likely to be found in the lower oesophagus and is heavily linked to acid reflux and Barrett's Oesophagus. Rates of OAC are rising rapidly.

In UK, OAC is the 13th most commonly identified cancer, more common in men in whom it's the 8th most common cancer.

Deaths from oesophageal cancer in UK, however, are disproportionately higher with it being the fifth most common cancer killer amongst men and 7th amongst women accounting for one person an hour on average with mortality rates having increased by 65% in the last 40 years.

Treatment for Oesophageal cancer depends upon its stage at discovery.

Staging of Oesophageal Cancer.

Cross section of the Oesophagus showing cancer stages T1, T2, T3

(image courtesy of Cancer Research UK)

Cancers are staged using TNM codes as described below. T refers to the stage of the primary Tumour, N refers to Lymph Nodes and M to metastasis (ie whether it's spread to other organs).

Primary Tumour (T)

Carcinoma in situ / High Grade Dysplasia

("High grade dysplasia" includes all noninvasive neoplastic epithelia that was formerly called "carcinoma in situ", a diagnosis that is no longer used for columnar mucosae in the gastrointestinal tract.)

N.B. Carcinoma in Situ is not cancer but has a high risk of becoming cancerous.

Regional Lymph Nodes (N) Distant metastasis (M)