Symptoms which indicate there may be cancer in the oesophagus are often vague and fairly common symptoms and therefore can be overlooked. However, as with any other area of your body, any changes, however subtle, if persistent should not be ignored.
If you have any of the following symptoms you should see your local doctor and discuss them further
- Swallowing difficulties or a sensation of food sticking in your chest
- Pain or discomfort as food passes down the oesophagus
- Persistent heartburn/acid reflux (persistent would be 2 to 3 weeks without passing off)
- Persistent cough or hoarseness
- Persistent hiccups
- Regurgitation of food on a regular basis
- Persistent nausea/retching/heaving
- Unexpected weight loss/unusual tiredness
Your GP may initially give you a medication to see if that can solve your symptoms. If after two to three weeks your symptoms have not gone away, he/she may refer you for an endoscopy. This is a camera which is passed down your oesophagus (with sedation if you prefer) where the endoscopist can have a look at the lining of the oesophagus and the stomach. They may take biopsies if they are unhappy about anything they see. This does not necessarily mean you have cancer; it may be that they have seen some ulceration or other changes in the normal linings.
Having tests then ultimately receiving a diagnosis of cancer is a frightening and often shocking experience. The waiting for test results and the fears generated whilst you are agonising over what could be wrong with you can be very wearing on both the patient and their loved ones.
When the results of the tests are all finally done and assessed you will be called to see your consultant for the results. If the consultant tells you that you have cancer, you may hear nothing past that point in the consultation we are often told that the rest of the appointment is a blur. It is a form of shock and quite understandable; that is why it is so important for you to take someone with you to important appointments. They will often hear things that you don't. It is at this point that we like patients to hear about us. It is important to know that you are not alone and that we are there to support and help.
Role of specialist nurses
It is also about this stage when an upper gastrointestinal clinical nurse specialist (Upper GI CNS) may take over co-ordination of your individual case. Most centres will have such a nurse and if you are not automatically assigned one then ask. He/she will oversee the continuity of your treatments, appointments and your best interests during the journey you are facing. They will also be able to interpret any jargon, explain what will happen to you in more detail and help you and your family find your way through the complex process of various medical departments and different skills areas you will be experiencing.
MDTs (Multi-disciplinary Team Meetings)
Following your diagnosis, there may be further tests to establish the true nature of the tumour, including size, depth and what it is doing, i.e. whether it is confined to the oesophagus/stomach or has started to spread. Once these tests are finished, a plan of your treatment needs to be made. Thankfully, this is no longer a single persons decision the treatment plan is decided by drawing opinion and expertise from every available and relevant medical discipline. Medical experts from radiology, surgery, pathology, oncology and your specialist nurse will meet to discuss your particular case and the best plan for you. You will then have an appointment when the plan can be discussed with you.