Overview
Esophageal cancer begins in the food pipe that carries food from the throat to the stomach. Difficulty swallowing is the most common first symptom, and because it develops gradually, many patients reach a doctor only when swallowing solids has already become difficult.
Treatment depends on the location in the food pipe, the tumour type (squamous cell carcinoma or adenocarcinoma), the stage and how well nutrition is maintained. Chemotherapy or chemoradiation is often given before surgery, and immunotherapy is used in selected cases where testing supports it.
Keeping weight and nutrition stable is part of the treatment plan, not an afterthought — a dietitian-guided plan, and where needed a feeding tube or stent, allows treatment to continue on schedule.
Symptoms to watch for
- Difficulty or discomfort while swallowing, first with solids
- Food sticking in the chest or regurgitation
- Persistent heartburn or chest discomfort
- Unexplained weight loss
- Hoarseness or a long-standing cough
How we treat it
- Endoscopy and biopsy review, with CT and PET-CT staging
- Neoadjuvant chemotherapy or chemoradiation before surgery
- Definitive chemoradiation when surgery is not suitable
- Immunotherapy in selected cases based on PD-L1 or MSI testing
- HER2 testing for adenocarcinoma to guide targeted therapy
- Nutrition support, stenting and swallowing care during treatment
Frequently asked questions
Why has swallowing become difficult?+
A tumour narrows the food pipe, so solids pass with difficulty before liquids do. This is why any swallowing difficulty lasting more than two to three weeks deserves an endoscopy.
Is surgery always needed?+
No. Some tumours are treated with chemoradiation alone, particularly in the upper food pipe. The decision is made jointly with a surgical oncologist after staging.
Can I eat normally during treatment?+
Most patients need a modified diet — softer, higher-calorie, smaller and more frequent meals. If intake stays poor, a temporary feeding tube or stent can be considered.
This page is for information only and does not replace a medical consultation. Please speak to a qualified doctor for advice specific to your condition.