Oesophageal Cancer

Oesophagus is a muscular tube that connects the mouth to the stomach. Its also commonly called the food pipe. Oesophageal cancer is the 6th most common cancer in India and is also the 6th most common cause of cancer-related deaths in India. In 2018 there were 52,396 new cases and 46,504 deaths in India due to Oesophageal cancer.

Types and Subtypes

Oesophageal cancer may be classified based on cell type: Squamous cell carcinoma (originates from squamous cells that line the oesophagus and is found in the upper and middle part of the oesophagus) or Adenocarcinoma (originates from the glandular tissue in the lower part of the oesophagus).

Staging Of Oesophageal Cancer

If you are diagnosed with cancer, the doctors that treat cancer or the specialist of cancer, will run more tests to determine the extent (stage) of your cancer. Your cancer's stage is an important input in deciding on your treatment. The stage of a cancer describes the size of the cancer and how far it has spread. It may be described as stage 0 to stage IV, by a specialist of cancer, who takes into account: the size of the cancer, whether the lymph nodes are affected, if the cancer has spread to other parts of the body.

• Stage 0 (carcinoma in situ): The tumour involves only the uppermost layer and under the microscope.
• Stage I: The tumour invades deeper into the wall of the oesophageal with no spread of to the lymph nodes, or other parts of the body. Stage IA involves the upper and second layer of the oesophagus. Stage IB involves the third layer of the oesophagus, the muscular layer.
• Stage II: Consists of two sub-stages. Stage IIA, the tumour invades the deepest layer of the oesophageal with no spread of the tumour to lymph nodes. Stage IIB, the tumour invades the first and second layer of the oesophagus and has spread to 1 or 2 nearby lymph nodes.
• Stage III: Consists of three sub-stages. Stage IIIA, the tumour invades the sac around the lungs or heart with no spread to lymph nodes OR the tumour invades the outermost layer of the oesophagus and 1 or 2 nearby lymph nodes OR The tumour invades three of four oesophageal layers and 3 to 6 regional lymph nodes. Stage IIIB, the tumour invades the outermost layer and 3 to 6 lymph node. Stage IIIC, the tumour invades the sac around the lungs or heart and 1 to 6 lymph nodes are affected OR The tumour invades nearby tissues including bones of the spine or the airway OR has spread to 6 or more lymph nodes.
• Stage IV: The tumour has spread to other parts of the body.

Sources: Cancer India; Cancer.Net; Cancer.org; European Society of Medical Oncology (ESMO)