Oesophageal cancer symptoms and risk factors

What are the symptoms?

Oesophageal cancer may not cause any symptoms in the early stages. If there are symptoms, these can include:

• difficulty swallowing
• heartburn or reflux that is new
• reflux that doesn’t go away
• food or fluids “catching” in the throat, or episodes of bringing food back up (regurgitation)
• pain when swallowing
• unexplained weight loss or loss of appetite
• feeling uncomfortable in the upper abdomen, especially when eating
• unexplained tiredness that won’t go away
• vomit that has blood in it
• black or bloody stools (poo).

Not everyone with these symptoms has oesophageal cancer. If you have symptoms that do not improve, see your general practitioner (GP).

What are the risk factors?

The exact causes of oesophageal cancer are not known. However, certain factors can increase the risk. Many people with these risk factors do not develop oesophageal cancer. The risk factors are different for oesophageal adenocarcinoma and oesophageal squamous cell carcinoma.

For oesophageal adenocarcinoma:

• being overweight or obese
• medical conditions, including gastro-oesophageal reflux disease (GORD) and Barretts oesophagus
• smoking tobacco
• being over 60.

For oesophageal squamous cell carcinoma:

• drinking alcohol
• smoking tobacco
• being over 60
• damage to the oesophagus from swallowing very hot liquids or corrosive substances (e.g. acid).

GORD and Barretts oesophagus

Reflux occurs when stomach acid flows up into the oesophagus. When reflux happens over a long time, it can lead to gastro-oesophageal reflux disease (GORD).

Over time, acid and bile can damage the oesophagus lining, causing inflammation or ulcers (oesophagitis). This can lead to Barretts oesophagus, which affects about 1 in 10 people with GORD.

Rarely, Barretts oesophagus can develop into oesophageal adenocarcinoma. If you have Barretts oesophagus, your doctor may recommend regular endoscopies.