Oesophagus Cancer Surgery

What is oesophagus/oesophageal cancer?

The oesophagus is the medical name for the gullet. It is part of the digestive system. The oesophagus is a long tube that carries food from the throat to the stomach. The top part of the oesophagus lies behind the windpipe (trachea). The bottom part runs through the chest between the spine and the heart. The body is made up of millions of different types of cells. Cancer happens when cells multiply in an abnormal way, causing a growth called a tumour to form. Tumours can be benign (not cancerous) or malignant (cancerous). Tumours can occur in any part of the body where the cells multiply abnormally.

There are two main types of cancer of the oesophagus:

• Squamous cell carcinoma forms in the upper part of the oesophagus when cells on the inside lining of the oesophagus multiply abnormally.
• Adenocarcinoma of the oesophagus forms in the lower part of the oesophagus when cells inside the mucous glands that line the oesophagus multiply abnormally. Mucous glands produce a slimy substance to help food slide down the oesophagus more easily. 

What are the causes of oesophagus cancer/oesophageal cancer?

The rate of oesophageal cancer is increasing rapidly in Australia and the rest of the Western world according to Cancer Victoria. The risk factors include:

• Greater risk amongst males than females
• Obesity
• Smoking
• Genetics and family history
• Reflux 

Barretts Oesophagus

This is a relatively common condition that effects the lower part of the oesophagus where the stomach joins the oesophagus. It is related to reflux disease and is often silent. It may be found on a routine endoscopy.

The lower cells of the oesophagus change from one type to another and can become unstable leading to a pre malignant condition called dysplasia which can turn to cancer.

Not everybody with Barretts will get cancer but the chances are higher than if you don’t. We therefore perform regular endoscopy on people with barretts to make sure the cells have not started to change. 

Treatment for oesophageal cancer

Treatment for oesophageal cancer will depend on the type, location and stage of your cancer. It will also depend on your age, general health and personal preferences.

The first aim of treatment for oesophageal cancer is to completely remove the tumour and any other cancerous cells in your body. If this is not possible then we will focus on preventing the tumour from getting any bigger and causing any further harm to your body.

Unfortunately, in some cases it is not always possible to eliminate the oesophageal cancer, or slow down its progression. In this case, your treatment will aim to relieve your symptoms and keep you as comfortable as possible. 

Surgery - Oesophagectomy (Trans-thoracic oesophagectomy)

This surgery is done if your cancer is only present in your oesophagus (and not the surrounding tissues or organs). Adam Skidmore will make incisions into your abdomen and chest. He will then remove the section of your oesophagus which contains the tumour. The remaining section of your oesophagus is then reconnected to your stomach. If your stomach can not be pulled up to meet your

oesophagus, a small section of your intestine may be used. In short, the cancerous section of your oesophagus will be removed, as with the upper part of your stomach and surrounding lymph nodes. (Lymph nodes are small collections of lymphatic tissue which help keep the body’s immune system working).