Oesophageal Cancer

Question 1

Oesophageal Cancer: Types

Answer 1

Adenocarcinoma (most common in UK/US)
Lower third - near the gastroesophageal junction
smoking
obesity
GORD
Barrett’s oesophagus

Squamous cell cancer (Most common in the developing world)
Upper two-thirds of the oesophagus
smoking
alcohol
achalasia
Plummer-Vinson syndrome
diets rich in nitrosamines

Question 2

Oesophageal Cancer: Symptoms

Answer 2

dysphagia: the most common presenting symptom
anorexia and weight loss
vomiting
other possible features include: odynophagia, hoarseness, melaena, cough

Question 3

Oesophageal Cancer: Investigations

Answer 3

Upper GI endoscopy with biopsy is used for diagnosis
Endoscopic ultrasound is the preferred method for locoregional staging
CT scanning of the chest, abdomen and pelvis is used for initial staging