Oesophageal Cancer

Question 1

What is the most common type of oesophageal cancer in the UK?

Answer 1

adenocarcinoma

Question 2

What are the risk factors for adenocarcinoma and where is it located?

Answer 2

• Barret’s oesophagus
• GORD
• Smoking
• Obesity
• Located in lower third, near gastroesophageal junction

Question 3

What are the risk factors for squamous cell carcinoma and where is it located

Answer 3

• smoking
• alcohol
• achalasia
• Plummer-Vinson syndrome
  -diets rich in nitrosamines
• Located in upper two thirds

Question 4

What are the symptoms of oesophageal cancer?

Answer 4

• Dysphagia (most common symptoms)
• Anorexia and weight loss
• Vomiting
• Anaemia
• Other possible/later symptoms are: odynophagia, hoarseness, melaena, cough

Question 5

What are the differentials for dysphagia?

Answer 5

• Oesophageal CA
• Oesophageal candidiasis
• Structure
• Pharyngeal pouch
• Achalasia
• Oesophageal web
• Mediastinal mass
• Lymphoma

Question 6

How is the diagnosis of oesophageal cancer made?

Answer 6

• Upper GI endoscopy with biopsy
• CT CAP is used for staging along with CT PET, EUS (for locoregional staging)

Question 7

What is the treatment of oesophageal cancers?

Answer 7

• For T1 tumors surgical resection is the best management, can be endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD)
• For T2+ then chemo and radiation can be used.
• Palliative - Chemo/radiotherapy, immunotherapy, endoscopic therapy (stenting) and supportive care.