Browser does not support script.
Skip to main content
search here
Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
If the cancer is at an early stage|, surgery| may be used with the aim of curing the cancer. There are different types of operation to treat oesophageal cancer, depending on the size and position of the tumour, and whether or not it has spread.
Your doctor will discuss the most appropriate type of surgery with you. It’s important to discuss any operation fully with your doctor before it happens. You may find it helpful to make a list of any questions you have ahead of the discussion. Remember, no operation or procedure will be done without your consent. Some types of surgery may mean that you need to stay in hospital for a few weeks.
The most common type of operation is where the section of the oesophagus containing the tumour is removed. The remaining part of oesophagus is re-attached to the stomach. There are two main ways of doing this:
During these operations the top part of the stomach is often also removed. After the operation, your stomach will be higher than before, above (instead of below) the sheet of muscle which divides the chest from the abdomen. This may affect your eating|.
If it’s not possible to join your stomach to the remaining part of the oesophagus, it may be possible to remove a section of your large bowel (colon) to replace the part of the oesophagus that has been removed. Your doctors will explain this in more detail if they think this type of surgery may be used.
During your operation the surgeon will check the area around the oesophagus. They will also remove some of the nearby lymph nodes. This is called a lymphadenectomy and is done because the nodes may contain cancer cells. The lymph nodes will be examined under a microscope by the pathologist. Removing them helps to reduce the risk of the cancer coming back and also helps the doctors to find out the stage| of your cancer.
Occasionally, during the operation, the surgeon discovers that the tumour can’t be removed. This may be because the tumour has spread or gone through the wall of the oesophagus, or because many lymph nodes are affected. If this happens, the surgeon may insert a tube (stent) instead, to make eating and swallowing easier for you|.
Some people may be able to have either part, or all, of their operation by keyhole surgery (also called a minimally invasive oesophagectomy). Your surgeon can advise if it’s suitable for you. In this operation, only small cuts are used rather than single larger cuts. The surgeon uses a special instrument called a thoracoscope to see and work inside the chest and a laparoscope for inside the tummy (abdomen).
Sometimes during the procedure the surgeon decides that keyhole surgery is not suitable and will carry out standard surgery instead. Keyhole surgery should only be undertaken by experienced and specially trained surgical teams. Keyhole surgery isn’t widely available so you may have to travel to another hospital for the operation.
Having part of your oesophagus removed is a major operation. So, before you have this type of surgery, your doctors will need to make sure that you’re physically able to cope with it. You will usually see an anaesthetist before your operation. Tests are carried out to check your general health and fitness, and that your heart and lungs are working well.
If you’ve been having problems with eating and have lost weight you may be given extra help and support with your diet to help prepare you for the operation.
Usually, you will not have anything to eat or drink for six hours before your operation. Any chest hair will be shaved off. You may also be given special support stockings to wear. These are to help prevent blood clots developing in your legs during or after the operation.
Most people will be nursed in the intensive care or high-dependency unit for a few days after their operation. This is routine and doesn’t mean your operation has gone badly or that there are complications. A machine called a ventilator may be used to help you to breathe for a few hours – again, this is routine in some hospitals.
You are likely to have some pain and discomfort after the operation and your doctor or nurse will explain how this will be controlled. You may have your pain controlled using an epidural. This is a fine plastic tube that is inserted into the space around your spinal cord so that a drug can be given to numb the nerves.
Another way to control pain is through patient controlled analgesia (PCA). Painkilling medication is given by a pump that allows you to boost the amount if you need extra. Pain can usually be well controlled but it’s important to tell the staff caring for you if you are still in pain.
You may have several drips and drains in place for a few days after surgery including:
You’ll be encouraged to get out of bed and move around as soon as possible. This helps reduce the risk of complications after surgery such as blood clots and infections.
A physiotherapist will help you to clear your lungs of any fluid that may have built up as a result of your operation. You will be taught deep breathing exercises to help keep your lungs clear and regular leg movements to prevent blood clots forming in your legs. A physiotherapist and the ward nurses will help you with this. Your nurses will show you how to manage your drips and drains while walking.
At first you will only be allowed sips of liquid until your doctor is satisfied that the join in the oesophagus is healing. You will usually be able to drink after a few days.
You may feel afraid to swallow at first and may have a bad taste in your mouth. Mouthwashes can help relieve the bad taste. You may have a further barium swallow to make sure the join between the oesophagus and stomach has fully healed.
Some surgeons will put a small feeding tube directly into the small bowel during surgery so that you can be fed through this while you are not able to eat or drink. The tube is put into the middle part of the small bowel (the jejunum) through a small cut made in the wall of the abdomen (tummy). It is usually removed after you have begun to swallow again normally.
Gradually, you’ll be able to eat and drink fairly normally again. It is likely, however, that you will lose quite a lot of weight in the first few weeks after your operation. Try not to worry about it – the weight loss is normal and should slow down once you begin eating well| again. The weight loss doesn’t mean that your cancer has come back.
You may also have some diarrhoea| for a while, which can usually be controlled with medicine if it continues.
Normally the stomach stores food and releases it into the bowel in a controlled way. After an operation to remove part of your oesophagus, food can travel more quickly through the digestive system. This can cause symptoms that are known as dumping syndrome. There are two types: early dumping syndrome and late dumping syndrome. Late dumping syndrome is more common after an oesophagectomy.
Early dumping syndrome refers to symptoms that may happen within 30 minutes of eating a meal. You may feel dizzy, faint, and that your heart is beating faster. These symptoms may last for about 10-15 minutes. Some people also have tummy cramps and diarrhoea. The symptoms happen when food rapidly enters the bowel. This draws fluid into the bowel from the surrounding organs and tissues and causes a drop in blood pressure.If you have symptoms of early dumping syndrome you may be able to reduce the problem by:
Many people find that early dumping syndrome gets better on its own in time, and that symptoms get less severe and happen less often after a few months.
Late dumping syndrome usually happens a couple of hours after meals or when a meal has been missed. You may suddenly feel faint, sick and shaky. The problem is caused by low blood sugar levels. You can help to prevent or lessen the syndrome by following the advice for reducing the symptoms of early dumping syndrome. If you feel the symptoms coming on, taking glucose tablets may help you feel better.
If your symptoms continue or are severe your doctor may prescribe a medicine, such as octreotide or other similar drug, to help. In most people the symptoms of dumping syndrome become less severe and happen less often in time, but let your doctor or dietitian know if it continues to be a problem.
We have sections on nutritional support| and dietary problems after surgery|.
Before you leave hospital you’ll be given an appointment to attend an outpatient clinic for your post-operative check up. This is a good time to discuss any problems you have after your operation. But remember you can usually ring your hospital doctor, specialist nurse or ward nurse at any time if you have any problems.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.