What is advanced oesophageal cancer?

Advanced oesophageal cancer means that a cancer that began in the food pipe (gullet or oesophagus) has spread to another part of the body.

Diagram showing oesophageal cancer that has spread to the liver

Unfortunately advanced cancer can’t usually be cured. But treatment might control it, help symptoms, and improve your quality of life for some time.

Sometimes cancer is advanced when it is first diagnosed. Or the cancer has come back and spread after treatment for the original cancer.

Cancers that have spread to another part of the body are called:

  • secondary cancer
  • metastases
  • metastatic cancer

Doctors also describe how advanced oesophageal cancer is by using the number staging system. Advanced cancer is stage 4 in the number staging system.

Locally advanced cancer

Locally advanced cancer means that the cancer has spread into the tissues around the oesophagus. It hasn’t spread to other organs in the body. This is different to an advanced cancer.  

Where oesophageal cancer spreads

Not all cancers will spread. But if the cancer does spread there are certain parts of the body that it is more likely to go to. The most common areas for oesophageal cancer to spread to include:

  • liver
  • lungs
  • lymph nodes
  • bone

Symptoms

The most common symptoms are:

  • feeling very tired
  • feeling generally unwell
  • problems swallowing
  • weight loss
  • increased acid reflux

Some people have pain but painkillers can usually control this well.

Other symptoms of advanced oesophageal cancer depend on what part of the body the cancer has spread to.

Tests

You might have tests to find out exactly where the cancer has spread to.

Treatment

Treatment aims to control the cancer for a time and reduce symptoms. Radiotherapy or drug treatments may shrink the cancer or stop it growing.

Some treatments can help you to swallow more easily if the cancer is partly blocking your oesophagus.  

How you might feel

Finding out that you can’t be cured is distressing and can be a shock. It’s common to feel uncertain and anxious. It's normal to not be able to think about anything else.

Lots of information and support is available to you, your family and friends. Some people find it helpful to find out more about their cancer and the treatments they might have. Many people find that knowing more about their situation can make it easier to cope.

    Talk to your doctor or specialist nurse to understand:

    • what your diagnosis means
    • what is likely to happen
    • what treatment is available
    • how treatment can help you

    You might feel that you don’t want to know much information straight away. Tell your doctor or nurse. You will always be able to ask for more information when you are ready.

    Everyone is different and there is no right way to feel.

    Survival

    Many people want to know what the outlook is and how their cancer will develop. This is different for each person. Your doctor is the best person to discuss this with you because they have all the information about your cancer.

    You can also talk to your specialist nurse. Or you can phone the Cancer Research UK nurses on 0808 800 4040, from Monday to Friday, 9am to 5pm.

    We have some general information about survival for oesophageal cancer if this is something you want to read about.

    • Oesophago-gastric cancer: assessment and management in adults 
      National Institute for Health and Care Excellence (NICE), January 2018

    • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
      R Obermannova and others
      Annals of Oncology, 2022. Volume 33. Pages 992-1004

    • A guide for patients with advanced cancer: Getting the most out of your oncologist
      ESMO, 2011

    • Principles and practice of oncology (11th edition)
      VT de Vita, TS Lawrence and SA Rosenberg
      Wolters Kluwer, 2019

    • Improving supportive and palliative care for adults with cancer 
      National Institute for Health and Care Excellence (NICE), March 2004

    • Patterns of distant organ metastases in esophageal cancer: a population based study
      D Ai and others
      Journal of Thoracic Disease, 2017. Volume 9. Pages 3023-3030

    Last reviewed: 
    27 Sep 2023
    Next review due: 
    28 Sep 2026

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