Answers
What are the warning signs of food pipe (oesophageal) cancer?
Short answer
Cancer of the food pipe usually shows up as difficulty swallowing that slowly gets worse, first with solid food and then with liquids, along with weight loss. It is more common in parts of India such as the North-East and Kashmir, and is strongly linked to tobacco, alcohol and very hot drinks. An endoscopy with biopsy is the key test.
Warning signs
- Food sticking in the chest, first with solids such as roti or rice, later with liquids
- Weight loss without trying
- Pain behind the breastbone or on swallowing
- Bringing food back up, hoarse voice or a lasting cough
- Black stools or anaemia
Risk factors
- Tobacco in any form: smoking, chewing, gutka and betel quid
- Alcohol
- Drinking tea or other drinks very hot
- Long-standing reflux (acid damage can lead to Barrett's oesophagus)
- Achalasia and narrowing from swallowing chemicals in the past
Tests and treatment
An upper endoscopy with biopsy confirms the diagnosis. CT, PET-CT and EUS show how far it has spread. Treatment depends on the stage: very early cancers can sometimes be removed through an endoscope; others are treated with chemotherapy and radiotherapy, with or without surgery. A stent through the narrowing quickly helps swallowing when cure is not possible.
Lowering the risk
- Stop all forms of tobacco and alcohol
- Let hot drinks cool for a few minutes before sipping
- Get long-standing reflux checked
- See a doctor promptly for any swallowing difficulty that keeps coming back
Eating when swallowing is difficult
Eat more
- Soft, moist, energy-rich food: dal, khichdi, curd rice, soups, mashed vegetables, milk shakes
- Small bites, chewed well, with sips of fluid
- Nutrition drinks or tube feeding if weight is falling
Cut down
- Very hot tea and drinks; let them cool for a few minutes
- Tobacco in any form, and alcohol
- Dry, chunky foods such as dry roti, bread and large pieces of meat
Good to know
- After a stent, eat sitting upright, chew well, and take sips of water during meals.
- Keep weight steady; a dietitian helps a lot during treatment.
Common questions
Does hot tea cause cancer?
Drinking tea or water very hot, at scalding temperature, is a probable risk factor. Letting drinks cool for a few minutes removes this risk; tea itself is not the problem.
Can Barrett's oesophagus turn into cancer?
A small number do. Regular endoscopy checks find early changes, which can be treated through the endoscope.
Can food pipe cancer be cured?
Yes, when found early. Treatment combines chemotherapy, radiotherapy and surgery, depending on the stage. Swallowing difficulty should never be ignored.