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Oesophageal Cancer

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What is Oesophageal Cancer?

Oesophageal cancer is cancer that develops in the oesophagus, which is the tube leading from our mouth to our stomach; when we swallow food, it goes through the oesophagus.

Oesophageal cancer is the eighth most common cancer worldwide and the 6th leading cause of cancer death.

There are two main types of oesophageal cancer:
  • Adenocarcinoma: Cancer that starts near the gastro-oesophageal junction, where the oesophagus meets the stomach.
  • Squamous cell carcinoma: Cancer that starts in the cells lining the oesophagus.

A gastrointestinal cancer may spread or metastasize to other organs. This ability to spread is what makes cancers so deadly because as they metastasize, they start to infiltrate and destroy normal body cells, eventually resulting in death. Hence, early detection and intervention is key for cancer curability and survivability. 

What are the common causes?

There are no specific causes of oesophageal cancer; however the following increases your risk of oesophageal cancer: 

  • Smoking
  • Excessive alcohol consumption 
  • Chronic acid reflux or heartburn 
  • GERD 
  • Barrett’s oesophagus 
  • Achalasia

What are the common symptoms of Oesophageal Cancer in Singapore?

Oesophageal cancer is usually asymptomatic during the early stages. Once symptoms appear, the cancer is most likely in the advanced stages and symptoms include:

  • Difficulty swallowing
  • Unintentional weight loss
  • Painful swallowing
  • Indigestion
  • Chronic heartburn that does not respond to medication
  • Signs of blood loss such as anaemia
  • Chest pains
  • Coughing or hoarseness

Is Oesophageal Cancer painful?

Yes, advanced oesophageal cancer can be painful.

Who is at risk of Oesophageal Cancer in Singapore?

Although cancer is not entirely preventable, there are certain things that make you more susceptible to it, such as

  • Smoking: Cigarette smoke can cause our normal cells to mutate into cancer cells
  • Alcohol: Excessive consumption of alcohol increases the risk of oesophageal cancer
  • Obesity: Being obese may cause an inflammation of the oesophagus which can lead to cancer
  • Barrett’s oesophagus: Thickening or changing of the oesophageal wall from smooth, pink, skin like cells, to rough, textured, red and inflamed intestinal cells.
  • Gastroesophageal reflux disease (GERD): Also known as chronic reflux; the continuous exposure of your oesophagus to the stomach acid can eventually cause Barrett’s oesophagus which then increases your chance of getting cancer.
  • Unhealthy diets: A diet filled with processed foods and meat but limited in fruits and vegetables can make you more susceptible to oesophageal cancer.
  • Human papillomavirus (HPV): The virus that causes herpes, it can cause changes in the tissue of your mouth, genitals, vocal cords, hands, and feet. It is also linked to cervical cancer.
  • Previous history of cancer: If you have a previous history of cancer, your chance of getting oesophageal cancer is increased.
  • Other medical conditions: Certain disorders such as achalasia (having difficulty swallowing) and tylosis (where excess skin grows on your hands and feet), can make you more prone to oesophageal cancer.
  • Age and gender: Oesophageal cancer is more common in older males.

How is Oesophageal Cancer diagnosed?

The first step in the diagnosis of oesophageal cancer is a gastroscopy

  • A thin, flexible tube is inserted into your mouth and led down through your oesophagus. 
  • If there are any suspicious looking growths or lesions, they will either be removed, or some samples will be taken for a biopsy. 

The next steps depend on whether the lesions come back as malignant (cancerous) or benign (non-cancerous). If the lesions are benign, then you will be monitored on follow-up visits. If the lesions are malignant, the following tools might be used for further diagnosis:

  • Positron Emission Tomography (PET-CT)
  • Computed Tomography Scan (CT-scan)
  • Laboratory tests
  • Endoscopic ultrasound

The results of your diagnosis will be able to identify the stage of oesophageal cancer and will help decide on the best treatment option for you.

What are the treatment options for Oesophageal Cancer in Singapore?

The treatment of oesophageal cancer depends on the stage at diagnosis; these treatment options are:

  • Endoscopic mucosal resection: Removal of precancerous or early-stage tumours
  • Esophagectomy: Removal of some or all of the oesophagus and then reconstructing it using part of another organ
  • Lymphadectomy: Removal of lymph nodes to check for presence of cancer
  • Chemotherapy: Drugs used to kill rapidly dividing cells, such as cancer cells
  • Radiotherapy: Radiation used to kill rapidly dividing cells, such as cancer cells
  • Targeted drug therapy: Drugs used to target the weak parts of a cancer cell, resulting in its death
  • Immunotherapy: Drug treatment that helps your own immune system fight the cancer

These treatments can either be used by itself or in combination with each other.

Frequently asked questions

What is the life expectancy of oesophageal cancer?
The five-year survival rate for oesophageal cancer is approximately 20%. If oesophageal cancer is found early and its size is still small, the five-year survival rate is higher.
Is oesophageal cancer curable?
Like all cancers, oesophageal cancer has a better chance of recovery if found early. However, as oesophageal cancer is asymptomatic in the early stages, they are most often only discovered in the later stages – making it treatable but not curable.
Does oesophageal cancer spread quickly?
Oesophageal cancer is slow growing, meaning it may grow for several years before symptoms appear. However, once symptoms appear, it can spread quickly.

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    6A Napier Road, Annexe Block #05-35C Gleneagles Hospital
    Singapore 258500
    820 Thomson Road, #06-07 Mount Alvernia Medical Centre A Singapore 574623

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