Cancer of the Gullet

The gullet (oesophagus)

The oesophagus (pronounced e-sof-fa-gus), is also known as the gullet. It is a long, muscular tube that connects your throat to your stomach. It is at least 12 inches (30cm) long in adults. When you swallow food it is carried down the oesophagus to the stomach, and the walls of the oesophagus contract to move the food down.

At the upper part of the oesophagus it runs behind, but is separate from, the windpipe (trachea). The windpipe connects your mouth and nose with your lungs, enabling you to breathe.

Various lymph nodes (which filter fluid and can trap bacteria, viruses and cancer cells) are near the oesophagus; in your neck, in the middle of your chest and near the area where the oesophagus joins the stomach. A tumour can occur anywhere along the length of the oesophagus.

Causes of oesophageal cancer

Each year, nearly 7600 people in the UK are diagnosed with cancer of the oesophagus. It is becoming more common in Europe and North America. Men are affected more than women and it occurs generally in older people.

There are two types: squamous cell carcinoma and oesophageal cancer (which is known as adenocarcinoma). The causes are unknown, but cancer of the oesophagus would appear to be more common in people who have long-term acid reflux (backflow of stomach acid into the oesophagus). Damage to the oesophagus caused by acid reflux is known as Barrett's oesophagus.
Barrett’s oesophagus is a condition where abnormal cells develop in the lining of the lower end of the oesophagus. It is not a cancer, but over a long period of time a small number of people with this condition (around 1 in 100) may develop a cancer of the oesophagus.

Cancer of the oesophagus is more commonly seen in some populations in the Far East and Central Asia, which suggests that diet, or the environment, may affect its development.

Squamous cell carcinoma is more common among smokers and people who drink a lot of alcohol (especially spirits) or have a poor diet.

Other conditions affecting the oesophagus, such as achalasia, may also very occasionally lead to cancer. Achalasia is where the muscle that controls the opening between the oesophagus and the stomach does not relax properly. This makes food build up in the oesophagus and stops it emptying into the stomach.

In most people, cancer of the oesophagus is not caused by an inherited faulty gene, and so other members of your family are not likely to be at risk of developing it. However, a very small number of people who have a rare inherited skin condition known as tylosis may develop oesophageal cancer.