My name is Karen Harrison-Phipps, I'm one of the consultant thoracic surgeons here at Guy's Hospital.

Guy's Hospital is part of the Guy's and St. Thomas' Foundation Trust, and one of the biggest teaching hospitals in London.

The gullet is a food tube that connects the mouth and the stomach, and it passes through the chest, between the lungs,

in what we call the 'mediastinum' which means 'the middle of the chest'.

The symptoms of gullet cancer are difficulty with eating

and that is known as dysphagia.

In addition, patients, because they find it difficult to eat, lose weight.

Those are the two most common symptoms, weight loss and a difficulty with eating.

Patients who do report weight loss with eating difficulty

would definitely be referred to a unit that specialises in diagnosing these problems,

and some of the tests would include just simple x-rays and perhaps more detailed x-rays in the form of CT scans.

But probably the most important test is an endoscopy test, which is a camera test where a small camera is passed down the gullet

this allows a very thorough inspection of the insides of the gullet but it also allows the operator to take a piece

or a biopsy away that is often very helpful in getting a diagnosis of gullet cancer.

The treatment options for gullet cancer are quite varied and there is a treatment option for every patient.

It just depends on their stage of cancer, and it depends on their fitness as a patient as well, so every patient is individual.

But broadly, the treatment options for gullet cancer would include surgery, chemotherapy and radiotherapy.

Where we can, we like to offer surgery, because often this gives the best chance of a cure,

and an operation to remove a gullet cancer is called an oesophagectomy.

It's quite a big operation, but now, with these operations being centred in large expert centres,

the results and the outlook can be quite promising.

When an operation is not possible for patients with gullet cancer there still are many treatment options.

These would include chemotherapy and radiotherapy,

but also a number of other treatments that may perhaps help the patient to swallow better.

Chemotherapy and radiotherapy in shrinking the tumour, can also gain good local control of the tumour,

and may prevent or reduce local spread of the tumour.

Sadly, gullet cancer, or oesophegeal cancer, is on the increase, especially in western societies.

This is down to the effects of increased alcohol consumption, a high incidence of smoking,

and perhaps increased alcohol leading to weight gain,

and the prescence of reflux, which means acid refluxing out of your stomach into the gullet.

All of these factors are thought to account for the increase in cancer of the gullet.

If, unfortunately, it is found that you do have cancer of the gullet, there are centres in the United Kingdom,

of excellence that provide top class treatment for cancer of the gullet,

including surgery, chemotherapy, and radiotherapy

and results are improving all the time.

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