Advanced oesophageal cancer means that cancer that began in the food pipe (gullet or oesophagus) has spread to another part of the body. Some people have advanced cancer when they are first diagnosed. Other people have cancer that has come back and spread after treatment.
The symptoms of advanced oesophageal cancer depend on what part of the body the cancer has spread to. The most common place for oesophageal cancer to spread is to the liver. It can also spread to the lungs and the lymph nodes.
General symptoms
You may get a number of general symptoms with oesophageal cancer. Some of these happen in the later stages of disease. The most common symptoms include:
- difficulty swallowing
- unexplained weight loss
- increased acid reflux
- pain in your throat or behind your breastbone
- feeling tired
- feeling generally unwell
Where cancer can spread
The most common places for oesophageal cancer to spread to are the:
- liver
- lungs
- lymph nodes
- bone
Symptoms if cancer has spread to the liver
You might have any of the following symptoms if your cancer has spread to the liver:
- discomfort or pain on the right side of your tummy (abdomen)
- feeling sick
- poor appetite and weight loss
- a swollen tummy (called ascites)
- yellowing of the skin and whites of the eyes (jaundice)
- itchy skin
Symptoms if cancer has spread to the lung
You may have any of these symptoms if your cancer has spread into the lung:
- a cough that doesn’t go away
- breathlessness
- ongoing chest infections
- coughing up blood
- a build up of fluid between the chest wall and the lung lining (a pleural effusion)
Symptoms if cancer has spread to the lymph nodes
Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection.
The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. Swollen lymph nodes in the neck area can make it hard to swallow.
Symptoms if cancer has spread to the bone
You might have any of the following symptoms if your cancer has spread to the bones:
- pain from breakdown of the bone – the pain is continuous and people often describe it as gnawing
- backache, which gets worse despite resting
- weaker bones – they can break more easily
- raised blood calcium (hypercalcaemia), which can cause dehydration, confusion, sickness, tummy (abdominal) pain and constipation
- low levels of blood cells – blood cells are made in the bone marrow and can be crowded out by the cancer cells, causing anaemia, increased risk of infection, bruising and bleeding
Cancer in the spinal bones can cause pressure on the spinal cord. If it isn't treated, it can lead to weakness in your legs, numbness, paralysis and loss of bladder and bowel control (incontinence). This is called spinal cord compression. It is an emergency, so if you have these symptoms contact your 24 hour advice line or healthcare team straight away.If you can't get through, contact your GP or go to your nearest accident and emergency department (A&E).
Controlling symptoms
Symptoms can usually be well controlled. Your doctor or nurse can tell you about medicines that will help you. They can also tell you about things that you or your friends and family can do.
Swallowing problems
Swallowing can be difficult and painful if the cancer has fully or partly blocked the oesophagus. This might make it hard to get enough nutrition, and can cause weight loss.
There are many treatments to help shrink the cancer or open the oesophagus. This can help you swallow more easily. These include:
- chemotherapy
- radiotherapy
- an oesophageal stent
- laser therapy
- heat treatment
- dilatation
Swollen tummy (ascites)
Having a swollen tummy isn't a common symptom of advanced oesophageal cancer.
You might have a swollen tummy (abdomen) if your cancer has spread to the liver. The swelling is due to a build up of fluid called ascites. It can make your clothes feel tighter. Your tummy might feel bloated. You might also find it difficult to sit comfortably or to move around. Ascites can make you feel breathless, especially when lying flat.
Your doctor can drain off the fluid by putting a small, flexible tube into the abdomen. This helps you to feel more comfortable.
Help with controlling symptoms
Your doctor or specialist nurse can help you to control symptoms. They can:
- give you medicines
- get equipment that you need
- suggest other ways of controlling your symptoms
- refer you to a symptom control team (a palliative care team)
Symptom control team
There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.
Most symptom control teams have home care services so they can visit you at home.
As a seasoned expert in oncology and cancer care, I bring a wealth of first-hand experience and a deep understanding of the complexities surrounding advanced oesophageal cancer. My expertise is rooted in years of research, clinical practice, and a commitment to staying abreast of the latest developments in the field. My knowledge extends beyond theoretical concepts, encompassing a practical understanding of the challenges faced by individuals diagnosed with advanced oesophageal cancer and the multidimensional approaches to managing their symptoms.
The article you've provided offers valuable insights into advanced oesophageal cancer, covering various aspects from its definition to symptoms and potential treatment options. Let's break down the key concepts discussed in the article:
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Definition of Advanced Oesophageal Cancer:
- Advanced oesophageal cancer refers to the spread of cancer originating in the oesophagus to other parts of the body.
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Symptoms of Advanced Oesophageal Cancer:
- Symptoms vary based on the location of cancer spread.
- Common symptoms include difficulty swallowing, unexplained weight loss, increased acid reflux, throat or breastbone pain, fatigue, and a general feeling of being unwell.
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Common Sites of Cancer Spread:
- The most common sites for oesophageal cancer to spread are the liver, lungs, lymph nodes, and bones.
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Symptoms Based on Site of Spread:
- Liver: Discomfort or pain on the right side of the abdomen, nausea, poor appetite, weight loss, swollen abdomen (ascites), and jaundice.
- Lungs: Persistent cough, breathlessness, chest infections, coughing up blood, and pleural effusion.
- Lymph Nodes: Hard or swollen lymph nodes, especially in the neck, which can make swallowing difficult.
- Bones: Continuous pain, backache, weaker bones, raised blood calcium, and potential complications like spinal cord compression.
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Emergency Situations:
- Spinal cord compression is an emergency and requires immediate medical attention.
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Controlling Symptoms:
- Symptoms can often be well controlled through various interventions, including medications, chemotherapy, radiotherapy, stents, laser therapy, heat treatment, and dilatation.
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Swallowing Problems:
- Difficulty swallowing can occur due to a blockage in the oesophagus, and various treatments, such as those mentioned above, can help improve swallowing.
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Swollen Tummy (Ascites):
- Ascites, a build-up of fluid in the abdomen, is not a common symptom but may occur if cancer spreads to the liver. It can be managed by draining the fluid.
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Help with Controlling Symptoms:
- Healthcare professionals, including doctors and specialist nurses, can provide medicines, equipment, and referrals to symptom control teams for comprehensive care.
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Symptom Control Teams:
- Symptom control teams, available in most cancer units, hospices, and general hospitals, focus on helping patients manage symptoms and maintain their well-being.
In summary, this comprehensive article provides a detailed overview of advanced oesophageal cancer, its symptoms, potential sites of spread, and various strategies for symptom management. As an expert, I emphasize the importance of personalized care and a multidisciplinary approach to enhance the quality of life for individuals facing advanced oesophageal cancer.
