Esophageal cancer

For a lay person:

Oesophageal cancer is cancer of the food pipe that carries food from the throat to the stomach. Risk factors include smoking, heavy drinking, very hot drinks, obesity and long-standing acid reflux. Its main symptom is growing difficulty swallowing, often with weight loss.

For a trained medical person:

Squamous cell carcinoma (linked to tobacco, alcohol and thermal injury, common in parts of China) and adenocarcinoma (linked to reflux and Barrett's oesophagus). Diagnosis is by endoscopy with biopsy, with CT, PET and endoscopic ultrasound for staging. Treatment is endoscopic resection for very early disease, otherwise neoadjuvant chemoradiotherapy or chemotherapy with oesophagectomy, or definitive chemoradiotherapy, and palliative stenting for obstruction.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Liver Qi Stagnation; Spleen Deficiency and Phlegm-Damp; Internal Obstruction of Stasis and Toxins; Qi and Yin Deficiency; Diarrhea; Cough; Reflux Esophagitis. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: This needs specialist oncology care; Chinese medicine is adjunctive at most. See a doctor promptly for any new difficulty swallowing, and get urgent care for vomiting blood, black stools or being unable to swallow liquids; check herbs with your team during chemotherapy.