Surgery for oesophageal cancer

Surgery for oesophageal cancer is done by specialist surgeons. It is not available in all hospitals, so you may need to travel to a hospital further away to have the operation.

Some very early stage oesophageal cancers are only in the inner layer of the oesophagus. Only a small number of people are diagnosed with very early stage oesophageal cancer.

Early stage oesophageal cancers can be treated using the following treatments:

• Endoscopic mucosal resection (EMR) – this removes small cancers on the inner layer of the oesophagus called the mucosa.
• Endoscopic submucosal dissection (ESD) – this can remove slightly larger cancers that may be growing into the layer of tissue below the mucosa, called the submucosa.

The doctor passes an endoscope through the mouth and into the oesophagus, so they can see the cancer. They then inject a small amount of fluid into the layer of cells below the cancer. The fluid lifts the cancer up from the muscle layer in the oesophagus. This makes it easier to remove the cancer. The doctor does this using suction and a small knife or wire loop called a snare.

The most common side effects are bleeding and narrowing of the oesophagus. There is a very small risk of a tear (perforation) in the wall of the oesophagus.

Your cancer doctor may recommend further treatment after an EMR or ESD. This is to reduce the risk of the cancer coming back. For example, they may suggest you have a treatment called radiofrequency ablation (RFA).

You do not usually have a general anaesthetic for EMR or ESD but you may be given medicine to numb the throat. Some people may be given medicine to make them drowsy (sedative). Your doctor or nurse will talk to you about the preparation and recovery for this type of surgery.